Temsirolimus in Treating Patients With Advanced Liver Cancer and Cirrhosis

Study Overview
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Brief Summary
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RATIONALE: Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying how well temsirolimus works in treating patients with advanced liver cancer and cirrhosis.

Detailed Description
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OBJECTIVES: Primary To determine the 3-month disease-control rate according to RECIST criteria in patients with advanced hepatocellular carcinoma and Child-Pugh class B cirrhosis. Secondary To determine the 3-month objective response rate according to RECIST criteria in these patients. To determine the 1-month metabolic response rate on PET/CT scan in these patients. To determine the 1-month perfusion response rate on hepatic perfusion CT scan in these patients. To determine the time to progression in patients treated with this drug. To determine the progression-free survival of patients treated with this drug. To determine the overall survival of patients treated with this drug. To assess quality of life according to QLQ-C30 and QLQ-HCC18 questionnaires. To determine the clinical and biological tolerance of this drug in these patients. To determine the rate of m-TOR pathway activation and VEGF level. To evaluate the pharmacokinetics of this drug in select patients. OUTLINE: This is a multicenter study. Patients receive temsirolimus IV over 30-60 minutes on day 1. Treatment repeats once a week in the absence of disease progression or unacceptable toxicity. Patients also undergo fludeoxyglucose F 18 (FDG) positron emission tomography/computed tomography (PET/CT) scan and perfusion CT scan of the liver at baseline and periodically during study treatment. Patients complete quality of life questionnaires (QLC-C30 and QLQ-HCC18) periodically. Some patients undergo blood and tissue sample collection periodically for pharmacological and laboratory studies. After completion of study therapy, patients are followed for up to 24 months.

Official Title
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Advanced Hepatocellular Carcinoma on Child B Cirrhosis: Tolerance and Efficacy of Torisel® (Temsirolimus)

Conditions
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Liver Cancer

Intervention / Treatment
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* Drug: temsirolimus


Participation Criteria
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Eligibility Criteria
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DISEASE CHARACTERISTICS: Diagnosis of hepatocellular carcinoma (HCC) according to the European Association for the Study of the Liver (EASL) criteria Advanced disease Must be morphologically evaluable HCC not accessible to other treatment (e.g., surgery, radiofrequency, or chemoembolization) and can not benefit from antiangiogenic therapy CLIP score ≤ 3 (except for patients with tumors invading more than 50% of tumor volume) Child-Pugh cirrhosis score between B7 and B9, meeting the following criteria: Diagnosed clinically, biologically (e.g., prothrombin time, platelets, or albumin), endoscopically (signs of portal hypertension) and morphologically (dysmorphic liver on ultrasound or CT scan), or by liver biopsy Not a candidate for transplantation and has not received a liver transplant PATIENT CHARACTERISTICS: ECOG performance status 0-2 Life expectancy ≥ 3 months Platelet count ≥ 50,000/mm^3 Neutrophil count ≥ 1,500/mm^3 Creatinine clearance ≥ 60 mL/min GFR ≥ 30 mL/min Serum cholesterol ≤ 350 mg/dL Triglycerides ≤ 300 mg/dL Not pregnant or nursing Fertile patients must use effective contraception during and for more than 2 months after completion of study therapy No history of other cancer on treatment No cardiopulmonary disease impairment, including a history of stable or unstable angina or myocardial infarction No active infection except for viral hepatitis No HIV positivity PRIOR CONCURRENT THERAPY: See Disease Characteristics At least 2 weeks since prior inhibitors or inducers of P-glycoprotein, CYP3A4, or CYP3A5 At least 4 weeks since prior surgery, radiotherapy (except radiotherapy to the bone), transarterial chemoembolization, immunotherapy, or other investigational drug for HCC At least 6 months since prior chemotherapy

Ages Eligible for Study
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Minimum Age: 18 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
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Temsirolimus<br>Temsirolimus | Drug: temsirolimus<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 3-month disease-control rate according to RECIST criteria |  | 2010 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 3-month objective response rate according to RECIST criteria |  | 2010 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adult primary hepatocellular carcinoma, advanced adult primary liver cancer, localized unresectable adult primary liver cancer, recurrent adult primary liver cancer