Clinical trial NCT00034333: Safety and Efficacy of Doxorubicin Adsorbed to Magnetic Beads Vs. IV Doxorubicin in Treating Liver Cancer
Official title: Study of Doxorubicin Hydrochloride Adsorbed to Magnetic Targeted Carriers (MTC-DOX) Administered by Intrahepatic Delivery Versus Intravenous Doxorubicin for Treatment of Patients With Unresectable Hepatocellular Carcinoma
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
PHASE3
Conditions: Carcinoma, Hepatocellular
Keywords: Hepatoma
Unresectable adult primary liver cancer
liver cancer
HCC
Hepatocellular Carcinoma
Lead sponsor: FeRx
Sponsor class: INDUSTRY
First posted: 2002-04-26
Enrollment: 240
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: MTC-DOX is Doxorubicin or DOX, a chemotherapy drug, that is adsorbed, or made to "stick", to magnetic beads (MTCs). MTCs are tiny, microscopic particles of iron and carbon. When DOX is added to MTCs, DOX attaches to the carbon part of the MTCs. MTC-DOX is directed to and deposited in the area of a tumor, where it is thought that it then "leaks" through the blood vessel walls. Once in the surrounding tissues, it is thought that Doxorubicin becomes "free from" the magnetic beads and will then be able to act against the tumor cells. The iron component of the particle has magnetic properties, making it possible to direct MTC-DOX to specific tumor sites in the liver by placing a magnet on the body surface. It is hoped that MTC-DOX used with the magnet may target the chemotherapy directly to liver tumors and provide a treatment to patients with liver cancer.

To be sure of the effect of MTC-DOX on liver cancer, it will be compared to the effect of Doxorubicin given through the vein.

The study treatments will be administered every three weeks, (which is considered a study treatment cycle), until you complete six treatment cycles, the tumor grows, disappears, or you experience a side effect, which may cause you to leave the study. Follow-up visits will occur on Days 3, 10, and 21 following treatment in the first cycle and Days 7 and 21 for the remaining cycles, and also 60 days after you receive your last treatment cycle.

Therefore, the purpose of this Phase 2/3 study is to evaluate safety, tolerance, and efficacy (survival time) of an MTC-DOX dosing strategy where the DOX dose is determined by tumor size


Eligibility criteria: Patients may be enrolled into this protocol only if all of the following inclusion criteria are met:

* Unresectable hepatocellular carcinoma diagnosed by CT scan and meets the criteria described in Section 23.
* Total combined cross-sectional area of all hepatic tumors as determined by CT scan is between 4 and 200 cm2.
* Center of the tumor(s) mass must be \</= 14 cm from the anterior lateral abdominal wall as determined by cross-sectional imaging at baseline. This is required for optimal placement of the magnet. If more than one tumor mass is present, all of the tumor masses must meet this criterion.
* Is ambulatory with a Karnofsky performance status score \> 60 and an estimated life expectancy of \> 3 months.
* Is judged by the investigator to have the initiative and means to be compliant with the protocol and be within geographical proximity to allow follow-up.
* Have the ability to give informed written consent prior to initiation of therapy.
* If female and of childbearing potential,must have a negative beta-HCG prior to receiving treatment.
* Must agree to use an effective method of contraception

Patients will be excluded from enrollment if any of the following apply:

* Has a history of cancer other than hepatocellular (excluding resected basal cell carcinoma; or curatively resected stage 1 or less cervical cancer if disease free for 5 years or more).
* Has had prior local radiation therapy within the last 4 weeks, mediastinal radiation therapy within the last 3 months, or chemotherapy within the last 4 weeks.
* Diffuse hepatocellular carcinoma or disease that precludes delivery of the drug to the tumor via a vessel that feeds the tumor.
* Has another active medical condition(s) or organ disease(s) that may either compromise patient safety or interfere with the safety and/or outcome (e.g., survival) evaluation of the study drugs. While this exclusion is not limited to the following abnormalities, if any of the following laboratory abnormalities are present, the patient should be excluded:

WBC \< 2,000 /uL Platelets \< 50,000/uL Hemoglobin \< 8.0 gm/dL Total bilirubin \> 3.0 mg/dL ALT or AST \>/= 5 x upper limit of normal Serum Creatinine \>2.0 mg/dL INR \>/= 1.5

* Has cardiac dysfunction with a left ventricular ejection fraction \< 40%.
* Has clinically significant pulmonary impairment
* Plans concomitant chemotherapy, radiation therapy, hormonal and/or biological treatment for cancer including immunotherapy while on study.
* Has an indwelling cardiac pacemaker, cerebral aneurysm clips, or any other indwelling device or appliance that could be adversely affected by the use of the external magnet.
* Has documented evidence of hemachromatosis or hemosiderosis.
* Has CT or ultrasound evidence of portal vein invasion or thrombosis.
* Prior orthotopic hepatic transplant.
* Has received previous treatment with doxorubicin, idarubicin, and/or other anthracyclines or anthracenes.
* Has a known allergy to doxorubicin, MTC-DOX or any of their components.
* Has been treated with any investigational drug, investigational biologic, or investigational therapeutic device within 30 days of initiating study treatment.

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Long Beach
country: United States
facility: Long Beach VA Medical Center
state: California
city: San Francisco
country: United States
facility: VAMC San Francisco and Comprehensive Cancer Ctr.
state: California
city: Chicago
country: United States
facility: Northwestern Univ. Med. School
state: Illinois
city: New York
country: United States
facility: Weill Medical College of Cornell University
state: New York
city: Chapel Hill
country: United States
facility: Univ. of North Carolina at Chapel Hill
state: North Carolina
city: Cleveland
country: United States
facility: Cleveland Clinic Foundation
state: Ohio
city: Philadelphia
country: United States
facility: Hospital of the University of Pennsylvania
state: Pennsylvania
city: Pittsburgh
country: United States
facility: Allegheny-Singer Research Institute
state: Pennsylvania
city: Galveston
country: United States
facility: University of Texas Medical Branch
state: Texas
city: Temple
country: United States
facility: Scott & White Mem. Hosp. & Clinic
state: Texas
city: Richmond
country: United States
facility: McGuire DVAMC
state: Virginia
city: Graz
country: Austria
facility: Landeskrankenhaus Graz University Hospital
city: Vienna
country: Austria
facility: University Hospital Vienna
city: Cologne
country: Germany
facility: University Hospital Cologne
city: Frankfurt
country: Germany
facility: University Hospital Am Main
city: Pokfulam
country: Hong Kong
facility: Queen Mary Hospital, University of Hong Kong
city: Shatin, N.T.
country: Hong Kong
facility: Chinese Universtiy of Hong Kong
city: Pesochny
country: Russian Federation
facility: Central Research Institute of Roentgenology and Radiology
state: St. Petersburg
city: Moscow
country: Russian Federation
facility: N.N. Blokhin Cancer Research Center RAMS
city: Bangkok
country: Thailand
facility: Chulalongkorn University Hospital
city: Bangkok
country: Thailand
facility: Siriraj Hospital, Mahidol University
city: Bangkok
country: Thailand
facility: National Cancer Institute
city: Chiang Mai
country: Thailand
facility: Chiang Mai University
city: Khon Kaen
country: Thailand
facility: Khon Kaen Universtiy
city: Kiev
country: Ukraine
facility: Institute of Oncology AMS of Ukraine
city: Edgbaston
country: United Kingdom
facility: Queen Elizabeth Hospital
state: Birmingham
city: Leicester
country: United Kingdom
facility: Leicester Royal Infirmary
state: England
city: London
country: United Kingdom
facility: St. George's Hospital
state: England
city: Edinburgh
country: United Kingdom
facility: Edinburgh Royal Infirmary
state: Scotland
Study officials:
affiliation: FeRx
name: Joy Koda, Ph.D.
role: STUDY_CHAIR
References: