The primary purpose of the study is to evaluate the pharmacokinetic profile, safety, and efficacy of LifePearl™ microspheres loaded with Doxorubicin in the treatment of unresectable HCC.
This is a multicentre, prospective dose escalation/PK study, designed to assess the clinical performance of LifePearl™ beads loaded with Doxorubicin in the primary treatment of unresectable HCC by chemoembolization. Data from this study will be used as supportive data post CE-mark approval. The main objective of the study is to evaluate the safety and pharmacokinetic profile of LifePearl™ beads loaded with Doxorubicin in the treatment of patients with unresectable liver cancer (HCC) by chemoembolization. This will be measured as treatment-related complications and plasma levels of Doxorubicin in peripheral blood. In addition, objective tumour response will be assessed by computed tomography or MRI. Two cohorts of patients will be evaluated: Cohort I to assess safety (dose escalation) and pharmacokinetic profile; Cohort II will assess pharmacokinetic profile, safety and efficacy with the doxorubicin dose determined with Cohort I.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
First, an angiography of the celiac trunk, superior mesenteric artery and hepatic artery will be obtained by using a peripheral arterial approach. Arterial embolization will be performed through catheterization of intrahepatic arteries, as selectively as possible (tumor feeders, subsegmental, segmental). The size of the microcatheter must be consistent with the size of LifePearl beads used. Microspheres of 200 µm will be be used. They will be loaded with the appropriate dose of doxorubicin injectable solution, mixed with the contrast media and distributed according to the location of the HCC lesions. The endpoint of the procedure will be achieved end when stasis of the feeders is achieved and confirmed with angiography of the whole liver.
Pharmacokinetic analysis will be performed in cohort I and II after the first treatment only. In addition to blood samples taken for biochemistry and haematology analysis, blood will be taken for pharmacokinetic assessment: Whole venous blood samples (6 ml in 2 tubes) will be taken from peripheral blood into ethylenediaminetetraacetic acid (EDTA) tubes prior to and at 5mins, 20mins, 40mins, 1h, 2h, 6h, 24h, 48h and 7 days after the procedure, and if needed (i.e. value at d7 is detectable) at 1 month (for safety assessment visit) either during hospital stay or in the outpatient clinic.
Evgenidio Therapeftirio "Agia Trias"
Athens, Greece
Hospital Clínic i provincial de Barcelona
Barcelona, Spain
Centre Hospitalier Universitaire Vaudois
Lausanne, Switzerland
Maximum Tolerated Dose (MTD) of Doxorubicine
Adverse Events (CTCAE v4.03 toxicity criteria) occurring within 28 days of the treatment. Grade ≥4 or Grade 3 in two patients at any one dose will mean the MTD has been achieved.
Time frame: 1 month
Peak Plasma Concentration (Cmax)
Maximum Plasma Concentration Doxorubicine
Time frame: 1 month
Adverse Events
Occurence of grade 3-4-5 treatment-related adverse events as Assessed by CTCAE v4.0.
Time frame: 1 month
Area under the Curve (AUC)
Time frame: 1 month
Angiographic Stasis
Ability to achieve stasis of bloodflow in the embolised arteries by angiographic assessment.
Time frame: 1 day
Total dose delivered
Sum of all doses Doxorubicine administered (maximum two chemoembolizations)
Time frame: 2 months
Response rate
Response rate assessed by Response Evaluation Criteria in Solid Tumors(RECIST) 1.1, EASL (European Association for the Study of the Liver) and mRECIST (modified RECIST) criteria 3 months after the first treatment
Time frame: 3 months
Time to Progression
Progression will be defined by the Barcelona Clinic Liver Cancer (BCLC)-refined RECIST
Time frame: 24 months
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Overall Survival
The length of time from either the date of diagnosis or the start of treatment that patients diagnosed with the disease are still alive.
Time frame: 24 months
Progression Free Survival
The length of time during and after the treatment that a patient lives with the disease but it does not get worse.
Time frame: 24 months