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The purpose of this study is to test the safety of Bumetanide , at different doses to find out what effects, if any, it has on people who undergo tumor TAE as part of their regular care. Bumetanide is a commonly used medication to reduce the amount of water in the body.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bumetanide | Experimental | Three escalating doses of bumetanide will be used: 0.01 mg/kg (level 1), 0.02 mg/kg (level 2) and 0.04 mg/kg (level 3) in a standard 3+3 design. Starting with level 1, three patients will first be enrolled at each level. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hepatic artery embolization (HAE) | Procedure | The intervention being studied is HAE for the treatment of HCC in combination with Bumetanide. HAE is a standard of care procedure. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum tolerated dose (MTD) (phase I) | Three escalating doses of bumetanide will be used: 0.01 mg/kg (level 1), 0.02 mg/kg (level 2) and 0.04 mg/kg (level 3) in a standard 3+3 design. Starting with level 1, three patients will first be enrolled at each level. | 1 year |
| estimate the local tumor progression (LTP) rates (phase II) | After the last first stage patient has three months followup, 6-month LTP will be estimated using Kaplan-Meier methods. If the one-sided 90% lower confidence bound is less than 40% the study will stop. Otherwise 12 more patients will be enrolled for a total of 30. At the end of the study 12-month LTP will be estimated using competing risk (cumulative incidence) methods. | 1 year |
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Inclusion Criteria:
Patients with diagnoses of HCC according to European Association for the Study of Liver disease (EASL) criteria for diagnosis (See Appendix 1). Regional lymphadenopathy will be allowed.
Patients within unresectable HCC
At least 18 years old
ECOG performance status 0 or 1
Radiographically measurable disease per mRECIST 1.1
Meets standard of care to undergo embolization
Exclusion Criteria:
Women who are pregnant or lactating
Documented hypersensitivity to bumetanide or sulfonamides
Patients with resectable HCC
High risk for post-embolization hepatic failure:
°Child's C cirrhosis
°> 80% liver involvement by tumor
Contraindication to angiography/embolization including:
ECOG score 2
Main portal vein tumor thrombus
BCLC D = patients with distant metastasis
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| Name | Affiliation | Role |
|---|---|---|
| Hooman Yarmohammadi, MD | Memorial Sloan Kettering Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Memorial Sloan Kettering Basking Ridge (Consent and follow-up only) | Basking Ridge | New Jersey | 07920 | United States | ||
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| Label | URL |
|---|---|
| Memorial Sloan Kettering Cancer Center | View source |
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| Bumetanide | Drug | Intra-arterial (IA) injection of 0.01mg/kg of Bumetanide in the first cohort, 0.02 mg/kg in the second cohort and 0.04 mg/kg of IA Bumetanide in the final cohort patients during standard HAE until stasis is evident. |
|
| Memorial Sloan Kettering Monmouth (Consent and follow-up only) |
| Middletown |
| New Jersey |
| 07748 |
| United States |
| Memorial Sloan Kettering Bergen (Consent and follow-up only) | Montvale | New Jersey | 07645 | United States |
| Memorial Sloan Kettering Westchester (Consent and follow-up only) | Harrison | New York | 10604 | United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10065 | United States |
| ID | Term |
|---|---|
| D002034 | Bumetanide |
| ID | Term |
|---|---|
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D062368 | meta-Aminobenzoates |
| D062365 | Aminobenzoates |
| D001565 | Benzoates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D013457 | Sulfur Compounds |
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