STOPPER CHINA:With Tandem Microspheres in the Treatment of Localized Hepatocellular Carcinoma

Study Overview
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Brief Summary
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A Single-arm Trial of Transcatheter Arterial Chemoembolization with Tandem Microspheres in the Treatment of Localized Hepatocellular Carcinoma

Detailed Description
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It is a prospective, single-arm, multicenter study. The primary effectiveness endpoint for this clinical trial is 6-month overall objective tumor response (ORR).

Official Title
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A Single-arm Trial of Transcatheter Arterial Chemoembolization With Tandem Microspheres in the Treatment of Localized Hepatocellular Carcinoma

Conditions
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Localized Hepatocellular Carcinoma

Intervention / Treatment
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* Device: Tandem Microsphere loaded with Epirubicin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject is able to provide informed consent and must sign the Institutional Review Board/Ethics Committee (IRB/EC) approved Informed Consent Form. Male or female of age ≥18 and ≤75 years. Confirmed diagnosis of HCC according to the diagnostic criteria included in the management guideline issued by China's Ministry of Health in 2017. HCC is diagnosed for the first time or recurrence of tumor after surgical or ablation treatment. Single tumor less than 7cm in diameter or multiple tumors with maximum 3 lesions with >1cm in diameter, individual diameter <7cm and less than 10cm in total diameter. no previous chemotherapy, radiotherapy or transarterial embolization (with or without chemotherapy) for HCC Preserved liver function (Child-Pugh A or B7). ECOG Performance Status 0 or 1. Exclusion Criteria: Presence of vascular invasion or extra-hepatic spread of disease, or diffuse HCC, defined as >50% liver involvement , or arteriovenuous fistula Macrovascular invasion of main or primary branches of portal vein at entry into the study Any contraindication for TACE treatment Any contraindication for Epirubicin administration Advanced liver disease (bilirubin levels >2 mg/dl, AST or ALT >5 times upper limit of normal) Renal failure or insufficient renal function (Creatinine levels >2 mg/dl) Subject unable to receive MRI examination Pregnant or breast feeding woman, or plan to become pregnant during treatment or within 12 months of treatment couldn't commit reliable birth control measures during treatment or within 12 months of treatment Subject is participating other investigational drug or device clinical trial within 30 days of signing the informed consent Subject is not suitable to participate in the study as judged by investigator

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: single -arm<br>A Single-arm Trial of Transcatheter Arterial Chemoembolization with Tandem Microspheres in the Treatment of Localized Hepatocellular Carcinoma | Device: Tandem Microsphere loaded with Epirubicin<br>* The primary objective of this study is to evaluate the safety and efficacy of transcatheter arterial chemoembolization with Tandem Microspheres loaded with Epirubicin in the treatment of patients with localized hepatocellular carcinoma (HCC)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Objective Tumor Response at 6 Months by MRI (Magnetic Resonance Imaging) | The objective response rate measured by MRI used EASL (European Society for the Study of the Liver) and mRECIST (Improved criteria for evaluating the efficacy of solid tumors) , Overall Response (OR) = CR + PR. Per Response Evaluation Criteria In Solid Tumors Criteria (mRECIST ) for target lesions : Complete Response (CR), Disappearance of any intratumoral arterial enhancement in all target lesions; Partial Response (PR), At least a 30% decrease in the sum of the diameters of viable (enhancement in the arterial phase) target lesions, taking as reference the baseline sum of the diameters of target lesions. Per Response Evaluation Criteria In Solid Tumors Criteria (EASL) for target lesions: Complete Response (CR), Disappearance of all known disease and no new lesions determined by two observations not less than 4 weeks apart; Partial Response (PR), At least 50% reduction in total tumor load of all measurable lesions determined by two observations not less than 4 weeks apart. | At 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Kaplan-Meier Analyses the Percent of Participants for Time to Progression (TTP) at 12 Months | Kaplan-Meier analyses the percent of participants for TTP which is defined as the length of time from the treatment initiation to either the date of the first disease progression occurred, as assessed by the investigators, or the date of the subject died due to any cause, whichever comes earlier. EASL and mRECIST response assessment of target lesion for HCC. TTP (also referred as time to treatment failure) will be measured by a few data items list below: The date of the disease progression in the Overall Response form The date of lost-to-follow due to: Adverse events Progressive disease/insufficient therapeutic response Death Failure to return Refusing treatment/being unwilling to cooperate/withdrawing consent The very last date by scanning all available dates in the database The desired cut-off days | At 12 months | 
| Number of Participants With Objective Tumor Response at 30-day | The objective response rate measured by MRI used EASL (European Society for the Study of the Liver) and mRECIST (Improved criteria for evaluating the efficacy of solid tumors) , Overall Response (OR) = CR + PR. Per Response Evaluation Criteria In Solid Tumors Criteria (mRECIST ) for target lesions : Complete Response (CR), Disappearance of any intratumoral arterial enhancement in all target lesions; Partial Response (PR), At least a 30% decrease in the sum of the diameters of viable (enhancement in the arterial phase) target lesions, taking as reference the baseline sum of the diameters of target lesions. Per Response Evaluation Criteria In Solid Tumors Criteria (EASL) for target lesions: Complete Response (CR), Disappearance of all known disease and no new lesions determined by two observations not less than 4 weeks apart; Partial Response (PR), At least 50% reduction in total tumor load of all measurable lesions determined by two observations not less than 4 weeks apart. | At 1month | 
| Kaplan-Meier Analyses the Percent of Participants for PPF(Proportion Progression-Free) at 12 Months | Kaplan-Meier analyses the percent of participants for PPF which is defined as the length of time from the treatment initiation, that treated subjects are still progression-free. EASL and mRECIST response assessment of target lesion for HCC. The data items to be captured will include: The date of the disease progression in the Overall Response form The very last date by scanning all available dates in the database The desired cut-off days The proportion of any time point will be determined by the Kaplan-Meier estimates. | from first TACE to 12 months | 
| Kaplan-Meier Analyses the Percent of Participants for Overall Survival | Kaplan-Meier analyses the percent of participants for Overall survival which is defined as the length of time from the treatment initiation, that treated subjects are still alive. The Kaplan-Meier analysis is aimed to capture the all-cause death for each subject. Subjects who are lost-to-follow will be considered being censored. There are three critical data items to be captured: Death date The very last date in the database (e.g. follow-up visit date and/or site reported AE date) The desired cut-off days (e.g. 6-month OS at 182 days, 12-month OS at 365 days) In addition to the Kaplan-Meier survival curve, the median survival time (mOS) will also be used to represent the study cohort. | from first TACE to 12 months | 
| Number of Adverse Events Relate to Study Device in 12 Months Post Procedure | Number and documents of adverse events relate to study device in 12 months post procedure | in 12 months | 
| Number of Participants With Objective Tumor Response at 3 Months | The objective response rate measured by MRI used EASL (European Society for the Study of the Liver) and mRECIST (Improved criteria for evaluating the efficacy of solid tumors) , Overall Response (OR) = CR + PR. Per Response Evaluation Criteria In Solid Tumors Criteria (mRECIST ) for target lesions : Complete Response (CR), Disappearance of any intratumoral arterial enhancement in all target lesions; Partial Response (PR), At least a 30% decrease in the sum of the diameters of viable (enhancement in the arterial phase) target lesions, taking as reference the baseline sum of the diameters of target lesions. Per Response Evaluation Criteria In Solid Tumors Criteria (EASL) for target lesions: Complete Response (CR), Disappearance of all known disease and no new lesions determined by two observations not less than 4 weeks apart; Partial Response (PR), At least 50% reduction in total tumor load of all measurable lesions determined by two observations not less than 4 weeks apart. | At 3 months | 
| Kaplan-Meier Analyses the Percent of Participants for Time to Extrahepatic Spread | Kaplan-Meier analyses the percent of participants for Time to Extrahepatic Spread which the length of time from the treatment initiation to the development of extrahepatic spread of the disease via imaging assessment. The data items to be considered will include: The date of the extrahepatic spread in the Overall Response form The very last date by scanning all available dates in the database The desired cut-off days | At 12 month |