Sorafenib With or Without Gemcitabine and Oxaliplatin in Treating Patients With Locally Advanced, Unresectable, or Metastatic Liver Cancer
Condition: Liver Cancer
MeSH terms: Liver Neoplasms
Study type: Interventional
Phase: Phase 2

Summary: 
      RATIONALE: Sorafenib tosylate may stop the growth of tumor cells by blocking some of the
      enzymes needed for cell growth and by blocking blood flow to the tumor. Drugs used in
      chemotherapy, such as gemcitabine hydrochloride and oxaliplatin, work in different ways to
      stop the growth of tumor cells, either by killing the cells or by stopping them from
      dividing. It is not yet known whether sorafenib tosylate is more effective when given with or
      without gemcitabine hydrochloride and oxaliplatin in treating patients with liver cancer.

      PURPOSE: This randomized phase II trial is studying sorafenib tosylate to see how well it
      works when given with or without gemcitabine hydrochloride and oxaliplatin in treating
      patients with locally advanced, unresectable, or metastatic liver cancer.
    

Detailed description: 
      OBJECTIVES:

      Primary

        -  Assess progression-free survival (RECIST) in patients with locally advanced,
           unresectable or metastatic hepatocellular carcinoma treated with sorafenib tosylate with
           vs without gemcitabine hydrochloride and oxaliplatin.

      Secondary

        -  Evaluate the tolerability of these regimens in these patients.

        -  Determine the objective response rate (RECIST) in patients treated with these regimens.

        -  Assess the overall survival of patients treated with these regimens.

        -  Evaluate the pharmacokinetics of sorafenib tosylate.

        -  Assess biomarkers (e.g., pERK levels) associated with treatment response.

        -  Assess angiogenic response by functional imaging.

      OUTLINE: This is a multicenter study. Patients are stratified according to performance status
      and CLIP score. Patients are randomized to 1 of 2 treatment arms.

        -  Arm I: Patients receive oral sorafenib tosylate as in arm I. Patients also receive
           gemcitabine hydrochloride IV over 100 minutes on day 1 and oxaliplatin IV over 2 hours
           on day 2. Treatment with gemcitabine hydrochloride and oxaliplatin repeats every 14 days
           for 12 courses in the absence of disease progression or unacceptable toxicity.

        -  Arm II: Patients receive oral sorafenib tosylate twice daily on days 1-14. In both arms,
           courses with sorafenib tosylate repeat every 14 days in the absence of disease
           progression or unacceptable toxicity.

      Blood samples and/ or tumor tissue samples may be collected for further analysis.

      After completion of study therapy, patients are followed every 2 months until disease
      progression and then every 6 months thereafter.
    

Intervention name(s): gemcitabine hydrochloride; oxaliplatin; sorafenib tosylate
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Given IV; Given IV; Given orally.
Intervention MeSH terms: Gemcitabine; Oxaliplatin; Sorafenib
Allocation: Randomized
Intervention model: Parallel Assignment
Primary purpose: Treatment
Keywords: adult primary hepatocellular carcinoma; localized unresectable adult primary liver cancer; recurrent adult primary liver cancer; advanced adult primary liver cancer