Sorafenib Dose Ramp-Up in Hepatocellular Carcinoma (HCC)

Completed · Phase 4

Conditions studied: Hepatocellular Carcinoma

In brief

Open-label study to evaluate the safety and tolerability of Sorafenib dose ramp-up (starting at a lower dose and then gradually increasing the dose) versus standard Sorafenib dosing in subjects with unresectable and/or metastatic hepatocellular carcinoma.

Key facts

Study ID

NCT01203787

Run by

University of Florida

People needed

120

Starts

2010-12-01

Expected to finish

2014-03-01

Last updated by the study team

2015-03-05

Who can join

Age: 20 and older, up to 75. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• HCC must be unresectable and/or metastatic
• CPT score <9 at the time of screening (that is all Child A and Child B with a score of 7 or 8)
• Age 20-75 years
• Signed informed consent
• EGD for variceal screening performed as per standard of care prophylaxis with non-selective beta-blockers or ligation
• ECOG Performance Status ≤ 2.
• Adequate bone marrow, liver and renal function as assessed by the following:
• Hemoglobin > 8.5 g/dl
• Absolute neutrophil count (ANC) > 1,500/mm3
• Platelet count > 50,000/mm3
• Total bilirubin < 3 mg/dl
• ALT and AST ( < 5 x ULN)
• Creatinine < 1.5 times ULN
• Women of childbearing potential must have a negative serum pregnancy test performed within 7 days prior to the start of treatment
• Women of childbearing potential and non-surgically sterile men must agree to use adequate contraception (barrier method of birth control) prior to study entry and for the duration of study participation. Men should use adequate birth control for at least three months after the last administration of sorafenib.
• Ability to understand and the willingness to sign a written informed consent. A signed informed consent must be obtained prior to any study specific procedures.
• INR< 2.3. Patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly, or as defined by the local standard of care, until INR is stable.
• Life expectancy of at least 24 weeks

You may not qualify if…

• Absence of informed consent
• Child-Pugh score >9
• ECOG PS >2
• Active alcohol dependence per PI discretion
• History of organ or bone marrow transplant
• Plans to relocate from the study center within the period of the trial
• Pregnancy or breastfeeding
• Contraindications to sorafenib
• Cardiac disease: Congestive heart failure > class II NYHA. Patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months.
• Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy.
• Known brain metastasis. Patients with neurological symptoms must undergo a CT scan/MRI of the brain to exclude brain metastasis.
• Uncontrolled hypertension defined as systolic blood pressure > 150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management.
• Known human immunodeficiency virus (HIV) infection
• Active clinically serious infection > CTCAE Grade 2.
• Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months.
• Bleeding
• Pulmonary hemorrhage/bleeding event > CTCAE Grade 2 within 4 weeks of first dose of study drug.
• Any other hemorrhage/bleeding event > CTCAE Grade 3 within 4 weeks of first dose of study drug.
• Evidence or history of bleeding diathesis or coagulopathy
• Serious non-healing wound, ulcer, or bone fracture.
• Major surgery, open biopsy or significant traumatic injury within 4 weeks prior to first study drug.
• Use of St. John's Wort or rifampin (rifampicin).
• Known or suspected allergy to sorafenib or any agent given in the course of this trial.
• Any condition that impairs patient's ability to swallow whole pills.
• Any malabsorption problem.

Where it is running

• Brooke Army Medical Center — San Antonio, Texas, United States
• University of Florida Hepatology — Gainesville, Florida, United States
• Mayo Clinic — Jacksonville, Florida, United States
• Florida Hospital Transplant Center — Orlando, Florida, United States
• Tampa General Hospital — Tampa, Florida, United States
• Loyola University Medical Center — Maywood, Illinois, United States
• Henry Ford Health System — Detroit, Michigan, United States
• Drexel University College of Medicine — Philadelphia, Pennsylvania, United States
• University of Texas Health Science Center Houston — Houston, Texas, United States

Full record on ClinicalTrials.gov

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