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Efficacy and Safety Doxorubicin Transdrug Study in Patients Suffering From Advanced Hepatocellular Carcinoma (ReLive)

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Onxeo Identifier:
First received: July 26, 2012
Last updated: February 27, 2017
Last verified: February 2017

The purpose of this phase III study is to determine whether Doxorubicin Transdrug (DT) is effective in the treatment of patients suffering from advanced Hepatocellular Carcinoma (HCC) after failure or intolerance to Sorafenib. Patients with HCC with or without cirrhosis and with good liver functions are eligible. Only those who can not benefit from treatment for which efficacy is demonstrated are eligible.

These patients are usually proposed either best standard of care (BSC) or participation to clinical trials. Patients eligible for the RELIVE study will receive either DT at 20 mg/m2 or DT at 30 mg/m2 or the BSC.

Condition Intervention Phase
Carcinoma, Hepatocellular
Drug: Doxorubicin
Drug: Best Standard of Care
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: No masking
Primary Purpose: Treatment
Official Title: Multicentre, Randomised, Controlled, Open-label Study Comparing the Efficacy and Safety of Slow Repeated IV Infusions of 2 Doses of Doxorubicin Transdrug™ (DT) (20mg/m2 and 30mg/m2) to Those of Best Standard of Care (BSC) in Patients With Advanced Hepatocellular Carcinoma (HCC) After Failure or Intolerance to Sorafenib. ReLive Study.

Resource links provided by NLM:

Further study details as provided by Onxeo:

Primary Outcome Measures:
  • Overall survival(OS) in each group [ Time Frame: At 1 year (expected average) ]
    Survival status will be collected at each visit (at least every 2 weeks) during the study treatment period and then every 3 months until death for an expected average of 1 year.

Secondary Outcome Measures:
  • Incidence and severity of all Treatment Emergent Adverse Events according to NCI-CTC v4.0 scale in each group [ Time Frame: Until 1 month after last treatment intake ]
    Adverse events will be collected at each visit (at least every 2 weeks) during the study treatment period, and then 1 month after the last treatment intake for an expected average of 6 months.

Estimated Enrollment: 390
Study Start Date: June 2012
Estimated Study Completion Date: January 2019
Estimated Primary Completion Date: July 2017 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Doxorubicin Transdrug (DT) at 20mg/m2
DT will be infused over 6 hours through the intravenous (IV) route at dose of 20 mg/m2 on Day 1 and will be repeated every 4 weeks until disease progression or unacceptable toxicity
Drug: Doxorubicin
Other Name: Doxorubicin Transdrug (DT) at 20mg/m2
Experimental: Doxorubicin Transdrug (DT) at 30 mg/m2
DT will be infused over 6 hours through the IV route at dose of 30 mg/m2 on Day 1 and will be repeated every 4 weeks until disease progression or unacceptable toxicity
Drug: Doxorubicin
Other Name: Doxorubicin Transdrug (DT) at 30mg/m2
Active Comparator: Best Standard of Care
Patients randomized in the control group will receive treatment according to the investigator's choice, until disease progression or unacceptable toxicity
Drug: Best Standard of Care

Detailed Description:
Doxorubicin-Transdrug™ (DT) is a nanoparticle formulation of doxorubicin.In in vitro and in vivo models, DT was shown to overcome the multidrug resistance (MDR) and to be more effective than doxorubicin on both sensitive and resistant tumour models and in particular in the X/myc bi-transgenic MDR murine model of HCC.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male or non-pregnant, non-breast feeding female;
  • Aged ≥ 18 years;
  • Patient with:

    • advanced HCC (BCLC-C according to BCLC staging classification) having progressed under Sorafenib therapy or intolerant to Sorafenib, or;
    • intermediate HCC (BCLC-B) non eligible or non responders to transarterial chemoembolization (TACE), and having progressed under or intolerant to Sorafenib therapy
  • Patients with porta hepatis lymph nodes, extrahepatic metastases, or portal/suprahepatic vein thrombosis without extension in inferior/superior vena cava, are eligible;
  • HCC diagnosed according to the AASLD and/or EASL criteria:

    • Radiological Criteria applicable in cirrhotic liver:
  • Nodule ≥ 10 mm: one imaging technique among MRI and CT-scan showing typical appearances for HCC defined as arterial enhancement and rapid washout in portal venous or delayed phase;
  • If appearance not typical for HCC on initial imaging: second contrast enhanced study (CT or MRI) showing typical appearances for HCC defined as arterial enhancement and rapid wash-out in portal venous or delayed phase;

    • And/Or cyto-histology criteria (e.g. in case of atypical lesions for HCC at imaging, absence of cirrhosis);
  • Without cirrhosis or with a non decompensated cirrhosis (Child-Pugh score from A5 to B7 included);
  • ECOG Performance Status 0 or 1;
  • Laboratory tests as follows:

    • Platelets ≥ 50,000 /mm3
    • Neutrophil count ≥ 1000/mm3
    • Hemoglobin ≥ 10g/dL
    • Serum transaminases < 5 ULN (NCI/CTC grades 0, 1, or 2)
    • Alkaline phosphatases < 5 ULN (NCI/CTC grades 0, 1, or 2)
    • Serum bilirubin < 35 µM/L (or 2.0 mg/dL);
  • Signed and dated written informed consent form.

Exclusion Criteria:

  • Cirrhosis with a Child-Pugh score B8-C15;
  • Untreated chronic hepatitis B;
  • Patients eligible for curative treatments (transplantation, surgical resection, percutaneous treatment);
  • Patients eligible for palliative treatments with demonstrated efficacy: TACE, Sorafenib; Patients who failed to Sorafenib treatment or intolerant to sorafenib are eligible and can be included if Sorafenib has been stopped at least 2 weeks before randomization;
  • Prior history of malignancy with the exception of adequately treated basal cell carcinoma or in situ cervical cancer in complete remission since five years at least;
  • HCC developed on transplanted liver;
  • HIV infection;
  • Risk of variceal bleeding;
  • SaO2 < 95%;
  • Presence of a significant acute or chronic respiratory disease defined as NCI/CTCAE > grade 2;
  • Presence of recent (< 6 months) or current cardiac failure (class III or IV NYHA classification), recent (< 6 months) acute coronary syndrome, clinically significant ECG abnormalities or recent (less than 6 months) acute vascular diseases (stroke, MI…);
  • Prior cumulative dose of 300 mg/m² of doxorubicin or equivalent;
  • Patients currently treated with immunosuppressive agents that cannot be stopped;
  • Patients whose medical or surgical conditions are unstable and may not allow the study completion or compliance, and specially patients with uncontrolled diabetes;
  • Uncontrolled systemic infection;
  • Patients with a life expectancy of less than 2 months;
  • Patients who have received an experimental drug in another clinical trial in the last 30 days prior to randomization in the present clinical trial;
  • Women of child-bearing age who are unwilling or unable to use an effective contraception method during the study treatment period and for 6 months after the last administration of study drug, and their male partner(s) refusing to use a condom (if applicable);
  • Men who are unwilling or unable to use a condom during the study treatment period and for 6 months after the last administration of study drug, and their female partner(s) refusing to use one of the appropriate effective contraception methods (if applicable);
  • Patients unwilling or unable to comply with protocol requirements and scheduled visits.
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Please refer to this study by its identifier: NCT01655693

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Sponsors and Collaborators
Principal Investigator: Philippe Merle, MD Croix-Rousse Hospital - Lyon-France
  More Information

Responsible Party: Onxeo Identifier: NCT01655693     History of Changes
Other Study ID Numbers: BA2011/03/04
2011-002843-92 ( EudraCT Number )
Study First Received: July 26, 2012
Last Updated: February 27, 2017

Keywords provided by Onxeo:
Intermediate/advanced hepatocellular carcinoma
After failure or intolerance to Sorafenib.

Additional relevant MeSH terms:
Carcinoma, Hepatocellular
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Liver Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Liposomal doxorubicin
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antibiotics, Antineoplastic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors processed this record on May 24, 2017