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To prove that the efficacy and safety of 'Green Cross CELL* Immuncell-LC group' is superior to 'non-treatment group(Control group)' in patient undergone curative resection(PEIT, RFA or operation) for hepatocellular carcinoma in Korea
Multicenter, randomized, open-labeled phase 3 clinical trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immunotherapy Group | Experimental | Adjuvant adoptive immune therapy using a CIK cell agent(Immuncell-LC) 16 times(4 treatments at a frequency of once per week, followed by 4 treatments every 2 weeks, then 4 treatments every 4 weeks, and finally 4 treatments every 8 weeks. |
|
| Control Group | No Intervention | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with no adjuvant treatment |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Immuncell-LC | Biological | Activated T lymphocyte |
|
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence Free Survival(RFS) | RFS was measured from the date of randomization to the first recurrence or to death from any cause. | Every 3months from the baseline for 24 months and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Recurrence Free Survival(RFS) Rate | RFS rate was measured from the date of randomization to the first recurrence or to death from any cause. | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival(OS) | Overall survival was measured from the date of randomization until death from any cause. | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Cancer-specific Survivals |
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Inclusion Criteria:
Prior to the test, patient is fully explained about the purpose/ contents and characteristics of the testing medication, and the patient him(her)self, the guardian or the legal representative signed on written consent.
The patient is more than 20 and less than 80 years old
The patient is diagnosed as hepatocellular carcinoma by pathological/ radiological test and he (she) is in the stage of I or II. (refer to the attached file 10). Hepatocellular carcinoma should be shown by radiological test; on dynamic CT, dynamic MRI or on angiography.
Child-Pugh Score should be less than 6 (refer to the attached file 7)
No matter how the patient has been treated before, his (her) tumor should be totally removed by curative resection (PEIT, RFA or operation) in 12 weeks. (based on the agreement date for written consent) The tumor's removal should be perfectly confirmed by pathological or radiological test with the mentioned method in 3) at least 4 weeks later.
ECOG Performance status (ECOG-PS) is less than 1 or equal to (refer to the exhibit 8)
Patient's remaining life-time should be expected at least more than 3 months.
Patient should meet below conditions by blood test, kidney and liver function test
: Re-evaluation is possible during screening
Leukocyte count is bigger than (3 multiply 109/L)
Absolute Neutrophil Count (ANC) is bigger than or equal to 1,000/µL
Hemoglobin is bigger than or equal to 8.5 g/dL
Thrombocyte count is bigger than (5 multiply 1010/L)
BUN and serum Creatinine is less than or equal to 1.5 multiply normal upper-limit
No more disease abdominal extrahepatic transfer is confirmed by abdominal CT/ MRI
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jung Hwan Yoon, MD | Seoul National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Korea University Ansan Hospital | Ansan-si | Gojan1-dong/Danwon-gu | 425-707 | South Korea | ||
| Korea University Guro Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11022927 | Background | Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J, Shimada K, Sakamoto M, Hirohashi S, Ohashi Y, Kakizoe T. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial. Lancet. 2000 Sep 2;356(9232):802-7. doi: 10.1016/S0140-6736(00)02654-4. | |
| 25747273 | Derived |
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This phase 3 clinical study was a multicenter, randomized, open-labeled trial. The study was conducted at 5 university affiliated hospitals in Korea. All eligible participants were assigned randomly, in a 1:1 ratio, to receive adjuvant adoptive immune therapy using a CIK cell agent or no adjuvant treatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | Immunotherapy Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with adjuvant adoptive immune therapy using a CIK cell agent |
| FG001 | Control Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with no adjuvant treatment |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
A total of 230 eligible participants were assigned randomly to either the immunotherapy group(n=115) or the control group(n=115). Among these randomized patients, 226(114 in the immunotherapy group and 112 in the control group) were included in the efficacy analysis. 4 patients were excluded due to violation of the inclusion and exclusion criteria.
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| ID | Title | Description |
|---|---|---|
| BG000 | Immunotherapy Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with adjuvant adoptive immune therapy using a CIK cell agent |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Recurrence Free Survival(RFS) | RFS was measured from the date of randomization to the first recurrence or to death from any cause. | Posted | Median | 95% Confidence Interval | months | Every 3months from the baseline for 24 months and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
Adverse events were assessed from the time the patient provided written informed consent until the end of the study or drop-out, and until at least 30 days after the last dose of immunotherapy.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Immunotherapy Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with adjuvant adoptive immune therapy using a CIK cell agent |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Sudden hearing loss | Ear and labyrinth disorders | CTCAE (3.0) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Upper respiratory tract infection | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Jung-Hwan Yoon, MD, PhD | Seoul National University College of Medicine | +82-2-2072-2228 | yoonjh@snu.ac.kr |
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| ID | Term |
|---|---|
| D006528 | Carcinoma, Hepatocellular |
| ID | Term |
|---|---|
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
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Cancer-specific survival was measured from the date of randomization until death resulting from HCC. |
| Every 3 months from baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Overall Survival(OS) Rate | Overall survival rate was measured from the date of randomization until death from any cause. | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Cancer-specific Survival Rate | Cancer-specific survival rate was measured from the date of randomization until death resulting from HCC. | Every 3 months from baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
| Seoul |
| Guro 2-Dong, Guro-Gu |
| 152-703 |
| South Korea |
| Samsung Medical Center | Seoul | Ilwon-dong/Gangnam-gu | 135-710 | South Korea |
| Seoul Asan Medical center | Seoul | Pungnab2-dong/Songpa-gu | 138-736 | South Korea |
| Seoul National University Hospital | Seoul | Yeongun-dong/Jongro-gu | 110-744 | South Korea |
| Lee JH, Lee JH, Lim YS, Yeon JE, Song TJ, Yu SJ, Gwak GY, Kim KM, Kim YJ, Lee JW, Yoon JH. Adjuvant immunotherapy with autologous cytokine-induced killer cells for hepatocellular carcinoma. Gastroenterology. 2015 Jun;148(7):1383-91.e6. doi: 10.1053/j.gastro.2015.02.055. Epub 2015 Mar 4. |
| BG001 | Control Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with no adjuvant treatment |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Treatment modality | Number | participants |
|
| HCC stage | HCC staging criteria is AJCC staging system(6th edition) developed by the American Joint Committee on Cancer for describing the extent of disease progression in cancer patients. It utilizes in part the TNM scoring system: Tumor size, Lymph Nodes affected, Metastases. The TNM Staging System is based on the extent of the tumor (T), the extent of spread to the lymph nodes (N), and the presence of metastasis (M). Once the T, N, and M are determined, they are combined, and an overall "Stage" of I, II, III, IV is assigned. Higher stage cancers are more advanced. | Number | participants |
|
| Number of HCC | Tumor assessments were performed using dynamic computed tomography or magnetic resonance imaging. All scans were reviewed by 2 independent radiologists at each site(hospital) with more than 5 years' experience, who were unaware of the group assignment. In cases of discordance, an additional third independent experienced radiologist reviewed images and consensus was achieved among the 3 radiologists. | Number | participants |
|
| Size of HCC | Tumor assessments were performed using dynamic computed tomography or magnetic resonance imaging. All scans were reviewed by 2 independent radiologists at each site(hospital) with more than 5 years' experience, who were unaware of the group assignment. In cases of discordance, an additional third independent experienced radiologist reviewed images and consensus was achieved among the 3 radiologists. | Median | Inter-Quartile Range | centimeter |
|
| ECOG performance status | ECOG (Eastern Cooperative Oncology Group) performance status assesses the daily living abilities of the patient, on a scale ranging from 0(fully active) to 5(dead). | Number | participants |
|
| Cause of liver disease | Number | participants |
|
| Alpha fetoprotein level | Median | Inter-Quartile Range | ng/mL |
|
| PIVKA-II | Median | Inter-Quartile Range | mAU/mL |
|
| Aspartate aminotransferase level | Median | Inter-Quartile Range | IU/L |
|
| Alanine aminotransferase level | Median | Inter-Quartile Range | IU/L |
|
| Alkaline phosphatase level | Median | Inter-Quartile Range | IU/L |
|
| Albumin level | Median | Inter-Quartile Range | g/dL |
|
| Total bilirubin level | Median | Inter-Quartile Range | mg/dL |
|
| Prothrombin time | Median | Inter-Quartile Range | seconds |
|
| Creatinine level | Median | Inter-Quartile Range | mg/dL |
|
| Platelet | Median | Inter-Quartile Range | x 10^3/mm^3 |
|
Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with no adjuvant treatment |
|
|
|
| Secondary | Overall Survival(OS) | Overall survival was measured from the date of randomization until death from any cause. | Posted | Median | 95% Confidence Interval | months | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
|
|
|
| Secondary | Cancer-specific Survivals | Cancer-specific survival was measured from the date of randomization until death resulting from HCC. | Posted | Median | 95% Confidence Interval | months | Every 3 months from baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
|
|
|
| Primary | Recurrence Free Survival(RFS) Rate | RFS rate was measured from the date of randomization to the first recurrence or to death from any cause. | Posted | Number | percentage of participants | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
|
|
| Secondary | Overall Survival(OS) Rate | Overall survival rate was measured from the date of randomization until death from any cause. | Posted | Number | percentage of participants | Every 3months from the baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
|
|
| Secondary | Cancer-specific Survival Rate | Cancer-specific survival rate was measured from the date of randomization until death resulting from HCC. | Posted | Number | percentage of participants | Every 3 months from baseline for 24 months, and then every 3-6 months until the data cut-off date, up to LSLV(Last Subject Last Visit) |
|
|
|
| 9 |
| 115 |
| 71 |
| 115 |
| EG001 | Control Group | Patients who had undergone curative treatment(surgical resection, radiofrequency ablation[RFA], or percutaneous ethanol injection[PEI]) for HCC of pretreatment clinical stage I or II according to the American Joint Committee on Cancer staging system(6th edition) based on radiologic imaging studies were eligible for this study with no adjuvant treatment | 4 | 115 | 47 | 115 |
| Laceration | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| Herpes zoster | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment |
|
| Meniscus lesion | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| Bladder neoplasm | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastric ulcer | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastric adenoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | CTCAE (3.0) | Non-systematic Assessment |
|
| Humerus fracture | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| Foot fracture | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| High frequency ablation | Surgical and medical procedures | CTCAE (3.0) | Non-systematic Assessment |
|
| Hepatic vein stenosis | Hepatobiliary disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Oesophageal varices haemorrhage | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Haemorrhoids | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Dermatitis acneiform | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Body tinea | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Abdominal pain upper | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Sudden hearing loss | Ear and labyrinth disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Hyperuricaemia | Metabolism and nutrition disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Chills | General disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Pyrexia | General disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Nausea | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Herpes zoster | Infections and infestations | CTCAE (3.0) | Non-systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Fatigue | General disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Laceration | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| Asthenia | General disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Dermatitis | Skin and subcutaneous tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Epigastric discomfort | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | CTCAE (3.0) | Non-systematic Assessment |
|
| Chest discomfort | General disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Hypertension | Vascular disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastritis erosive | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Insomnia | Psychiatric disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastritis | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastric polyps | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Gastric ulcer | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Constipation | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Haemorrhoids | Gastrointestinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Headache | Nervous system disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Weight decreased | Investigations | CTCAE (3.0) | Non-systematic Assessment |
|
| Weight increased | Investigations | CTCAE (3.0) | Non-systematic Assessment |
|
| Flank pain | Musculoskeletal and connective tissue disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Foot fracture | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
| Productive cough | Respiratory, thoracic and mediastinal disorders | CTCAE (3.0) | Non-systematic Assessment |
|
| Humerus fracture | Injury, poisoning and procedural complications | CTCAE (3.0) | Non-systematic Assessment |
|
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| D009369 | Neoplasms |
| D008113 | Liver Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
| RFS rate 36 months |
|
| RFS rate 48 months |
|
| OS rate 36 months |
|
| OS rate 48 months |
|
| Cancer-specific survival rate 36 months |
|
| Cancer-specific survival rate 48 months |
|