The purpose of this study is to evaluate the safety and efficacy of the combination therapy with Transcatheter Arterial Chemoembolization (TACE) and sorafenib compared to TACE alone in patients with unresectable hepatocellular carcinoma (HCC) who are not candidates for surgical resection or percutaneous ablation therapy.
TACE with sorafenib Group Sorafenib will be administrated at a dose of 400mg o.d. before the first TACE. After 2days drug rest, TACE will be conducted. Sorafenib will be resumed at a dose of 400mg o.d. from 3 days after TACE(the resumption day can be postponed until 21 days after TACE). When tolerability is confirmed at 1 week after resumption, the dose of sorafenib will be increased to 400mg b.i.d. When tumor increases, TACE will be repeated. Control group TACE will be conducted at scheduled day. When tumor increases, TACE will be repeated. The treatment regimen will be continued until untreatable progression which is defined as follows: * Child-Pugh grade C * Tumor growth (125 percent from baseline status) * Vascular invasion(Vp3,Vp4) * Extra hepatic spread which size is more than 10mm
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
228
Sorafenib will be administrated at a dose of 400mg o.d. before the first TACE. After 2days drug rest, TACE will be conducted. Sorafenib will be resumed at a dose of 400mg o.d. from 3 days after TACE(the resumption day can be postponed until 21 days after TACE). When tolerability is confirmed at 1 week after resumption, the dose of sorafenib will be increased to 400mg b.i.d. When tumor increases, TACE will be repeated.
TACE will be conducted at scheduled day. When tumor increases, TACE will be repeated.
Kinki University Hospital
Ōsaka-sayama, Osaka, Japan
Progression Free Survival
Patients will be evaluated for these endpoints every 8 weeks
Time frame: every 8 week
Overall Survival
The overall survival is defined as time from randomization to death due to any cause, and will be evaluated every 8 weeks in the protocol treatment, and every one year in the follow-up period,respectively.
Time frame: every 8 week
Time To Progression
Time to progression is defined as time from randomization to radiological progression and will be evaluated every 8 week.
Time frame: every 8 weeks
Objective Response Rate
Objective Response Rate is defined as best response
Time frame: 4week after TACE
Tumor markers
Change of tumor markers
Time frame: every 4 weeks
Safety
Number of participants with adverse events as a measure of safety and tolerability(According to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0)
Time frame: every 4 weeks
Time To Untreatable Progression(TTUP)
Time to untreatable progression is defined as time from randomization to untreatable progression and will be evaluated every 8 week.
Time frame: every 8 week till untreatable progression, assessed up to 100 months
Time to Child-Pugh C
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Time to Child-Pugh C is defined as time from randomization to Child-Pugh C and will be evaluated every 8 week.
Time frame: every 8 week till liver deterioration to Child-Pugh C, assessed up to 100 months
Time to intrahepatic tumor progression
Time to intrahepatic tumor progression is defined as time from randomization to intrahepatic tumor progression and will be evaluated every 8 week.
Time frame: every 8 week till intrahepatic tumor progression, assessed up to 100 months
Time to vascular invasion
Time to vascular invasion is defined as time from randomization to vascular invasion and will be evaluated every 8 week.
Time frame: every 8 week till vascular invasion, assessed up to 100 months
Time to Extrahepatic spread
Time to extrahepatic spread is defined as time from randomization to extrahepatic spread and will be evaluated every 8 week.
Time frame: every 8 week till extrahepatic spread, assessed up to 100 months