Study Of Sunitinib Malate Versus Sorafenib In Patients With Inoperable Liver Cancer

• Progression-Free Survival (PFS) [ Time Frame: Baseline, every 4 weeks during treatment, every 8 weeks posttreatment up to Week 150 ] [ Designated as safety issue: No ]
  The period from randomization until disease progression or death.
• Time to Tumor Progression (TTP) [ Time Frame: Baseline, every 4 weeks during treatment, every 8 weeks posttreatment up to Week 150 ] [ Designated as safety issue: No ]
  Time in weeks from randomization to first documentation of objective tumor progression or death due to cancer, whichever comes first. Tumor progression was determined from oncologic assessment data (where data meet the criteria for progressive disease [PD])
• European Quality of Life (EQ-5D)- Health State Profile Utility Score [ Time Frame: Day 1 of each cycle ] [ Designated as safety issue: No ]
  EQ-5D: participant rated questionnaire to assess health-related quality of life in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state (eg, "confined to bed"). Scoring formula assigns a utility value for each domain in the profile. Score is transformed and results in a score range -0.594 to 1.000; higher score indicates better health state.

• Progression Free Survival [ Time Frame: From Screening/baseline until patient progression or death ] [ Designated as safety issue: No ]
• Time to Tumor Progression [ Time Frame: From screening/baseline until patient progression ] [ Designated as safety issue: No ]
• Safety (adverse events and laboratory abnormalities) [ Time Frame: From screening/baseline to end of study treatment ] [ Designated as safety issue: No ]
• Health Status [ Time Frame: From baseline to end of study treatment ] [ Designated as safety issue: No ]

The study will evaluate the efficacy and safety of sunitinib (Arm A), given at 37.5 mg orally once daily, compared to sorafenib (Arm B), given orally at 400 mg twice daily, in patients with inoperable liver cancer. A total number of 1200 patients will be enrolled, 600 on Arm A and 600 on Arm B. Study treatment may be adjusted based on patient tolerance. and will be given until disease progression, occurrence of unacceptable toxicity, or other withdrawal criteria are met. After discontinuation of study treatment, patients will be followed up in order to collect information on further antineoplastic therapy and survival.

This study was terminated on April 22th, 2010, based on a higher incidence of serious adverse events in the sunitinib arm compared to the sorafenib arm, and the fact that sunitinib did not meet the criteria to demonstrate that it was either superior or non-inferior to sorafenib in the survival of patients with advanced hepatocellular cancer. Patients on sunitinib who are judged by the investigator as receiving clinical benefit may chose to remain on study and continue treatment with sunitinib until clinical benefit as per the investigator's judgment.

• Drug: sunitinib malate
  sunitinib capsules at starting dose of 37.5 mg PO daily, until disease progression, occurrence of unacceptable toxicity, or other withdrawal criteria are met. Sunitinib dosing interruptions and/or reductions are allowed based on patient tolerability.
  Other Name: Sutent®
• Drug: sorafenib
  sorafenib tablets at starting dose of 400 mg PO twice daily, until disease progression, occurrence of unacceptable toxicity, or other withdrawal criteria are met. Sorafenib dosing interruptions and/or reductions are allowed based on patient tolerability.
  Other Name: Nexavar®

• Experimental: Arm A
  sunitinib arm
  Intervention: Drug: sunitinib malate
• Active Comparator: Arm B
  sorafenib arm
  Intervention: Drug: sorafenib

Inclusion Criteria:

• Histologically-confirmed diagnosis of hepatocellular carcinoma
• presence of measurable disease by radiographic imaging
• Child-Pugh class A
• ECOG PS 0 or 1
• adequate organ function.

Exclusion Criteria:

• Prior treatment with any systemic treatment for hepatocellular carcinoma
• prior local treatment within 4 weeks from entry
• presence of clinically relevant ascites
• severe hemorrhage <4 weeks of starting study treatment
• known HIV or serious acute or chronic illness
• current treatment on another clinical trial
• pregnancy or breastfeeding