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Nolatrexed Dihydrochloride Compared With Doxorubicin in Treating Patients With Recurrent or Unresectable Liver Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT00012324
Recruitment Status : Completed
First Posted : January 27, 2003
Last Update Posted : June 26, 2013
Information provided by:
National Cancer Institute (NCI)

Brief Summary:

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which chemotherapy regimen is more effective for liver cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of two different chemotherapy regimens in treating patients who have recurrent or unresectable liver cancer.

Condition or disease Intervention/treatment Phase
Liver Cancer Drug: doxorubicin hydrochloride Drug: nolatrexed dihydrochloride Phase 3

Detailed Description:


  • Compare the overall survival in patients with unresectable or recurrent hepatocellular carcinoma treated with nolatrexed dihydrochloride vs doxorubicin.
  • Compare time to progression, time to treatment failure, and response rates in patients treated with these regimens.
  • Compare the probability of survival at 3, 6, 9, and 12 months in patients treated with these regimens.
  • Compare the safety and clinical benefit of these regimens in these patients.
  • Compare the response rates and survival of patients who have received prior therapy or no prior therapy after treatment with these two regimens.
  • Compare the rates of conversion from unresectable to resectable lesions in patients treated with these regimens.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to CLIP score (0-1 vs 2-3) and Karnofsky performance status (60-70% vs 80-100%). Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive nolatrexed dihydrochloride IV continuously on days 1-5.
  • Arm II: Patients receive doxorubicin IV on day 1. Treatment continues in both arms every 3 weeks in the absence of unacceptable toxicity or disease progression.

Patients are followed every 2 months for survival.

PROJECTED ACCRUAL: Approximately 446 patients (223 per treatment arm) will be accrued for this study within 12 months.

Study Type : Interventional  (Clinical Trial)
Allocation: Randomized
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase III Randomized Controlled Study Comparing the Survival of Patients With Unresectable Hepatocellular Carcinoma (HCC) Treated With THYMITAQ to Patients Treated With Doxorubicin
Study Start Date : September 2000
Study Completion Date : November 2005

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Liver Cancer
U.S. FDA Resources

Primary Outcome Measures :
  1. Overall survival

Secondary Outcome Measures :
  1. Time to progression
  2. Time to treatment failure
  3. Response rate (complete response, partial response, stable disease)
  4. Survival probabilities at 3, 6, 9, and 12 months
  5. Safety
  6. Response to treatment in patients with and without prior therapy

Information from the National Library of Medicine

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


  • Histologically or cytologically proven or presumptive diagnosis of hepatocellular carcinoma

    • Presumptive diagnosis based on rising alpha-fetoprotein (AFP) levels over 2 assessments, CT scan or MRI of liver, spiral CT scan of portal/splenic vein, and biopsy evidence of cirrhosis
    • Unresectable or recurrent disease after prior surgical resection or embolization therapy
  • Fibrolamellar histology allowed if considered surgically unresectable based on tumor size, extrahepatic involvement, or multiple lobe involvement
  • CLIP (Cancer of the Liver Italian Program) score less than 4
  • Concurrent assignment to a transplantation list allowed



  • 18 and over

Performance status:

  • Karnofsky 60-100%

Life expectancy:

  • Not specified


  • Absolute neutrophil count at least 1,200/mm^3
  • Platelet count at least 80,000/mm^3


  • Bilirubin no greater than 3.0 mg/dL (except for known Gilbert's Syndrome)
  • AST no greater than 5 times upper limit of normal (ULN)
  • PT no greater than 1.5 times ULN


  • Creatinine no greater than 2.0 mg/dL


  • No uncontrolled hypertension within the past 3 months
  • No unstable angina, symptomatic congestive heart failure, or myocardial infarction within the past 3 months
  • No uncontrolled cardiac arrhythmia


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active bacterial infections
  • HIV negative
  • No AIDS
  • No other primary malignancy except carcinoma in situ of the cervix or urinary bladder or non-melanoma skin cancer
  • No mental incapacitation or psychiatric illness that would preclude study participation
  • No other severe disease that would preclude study participation
  • Candidate for placement of a central venous access device


Biologic therapy:

  • Prior biologic therapy allowed
  • No concurrent biologic therapy


  • No prior IV doxorubicin except intraarterial administration in locoregional therapy

Endocrine therapy:

  • Prior endocrine therapy allowed
  • No concurrent endocrine therapy


  • Prior radiotherapy allowed
  • No concurrent radiotherapy


  • See Disease Characteristics
  • Surgery allowed if previously unresectable lesions become resectable
  • Recovered from any prior surgery
  • No concurrent liver transplantation


  • No other concurrent investigational or marketed anticancer drugs
  • No other concurrent therapy for hepatocellular carcinoma
  • No concurrent terfenadine, astemizole, or cisapride that may not be interrupted during nolatrexed dihydrochloride administration

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00012324

  Hide Study Locations
United States, Arizona
Arizona Clinical Research Center, Incorporated
Tucson, Arizona, United States, 85715
United States, Arkansas
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States, 72205
United States, California
Tower Cancer Research Foundation
Beverly Hills, California, United States, 90211
Scripps Cancer Center at Scripps Clinic
La Jolla, California, United States, 92037
David and Donna Long Center for Cancer Treatment at Sharp Grossmont Hospital
La Mesa, California, United States, 91942
Veterans Affairs Medical Center - Long Beach
Long Beach, California, United States, 90822
California Pacific Medical Center - Pacific Campus
San Francisco, California, United States, 94115
Olive View - UCLA Medical Center Foundation
Sylmar, California, United States, 91342
California Hematology/Oncology Medical Group
Torrance, California, United States, 90505
United States, Delaware
Helen F. Graham Cancer Center
Newark, Delaware, United States, 19713
United States, District of Columbia
Lombardi Cancer Center at Georgetown University Medical Center
Washington, District of Columbia, United States, 20007
United States, Florida
Florida Cancer Institute - Bayonet Point
Hudson, Florida, United States, 34667
University of Miami Sylvester Comprehensive Cancer Center
Miami, Florida, United States, 33136
Oncology-Hematology Group of South Florida, P.A.
Miami, Florida, United States, 33176
Ocala Research Institute, Incorporated
Ocala, Florida, United States, 34480
United States, Hawaii
Cancer Research Center of Hawaii
Honolulu, Hawaii, United States, 96813
United States, Illinois
Robert H. Lurie Comprehensive Cancer Center at Northwestern University
Chicago, Illinois, United States, 60611
University of Illinois at Chicago Cancer Center
Chicago, Illinois, United States, 60612
United States, Iowa
Holden Comprehensive Cancer Center at University of Iowa
Iowa City, Iowa, United States, 52242-1009
United States, Louisiana
Louisiana Oncology Associates - Lafayette
Lafayette, Louisiana, United States, 70506
Stanley S. Scott Cancer Center at Louisiana State University Medical Center - New Orleans
New Orleans, Louisiana, United States, 70112
United States, Maryland
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
Baltimore, Maryland, United States, 21215
United States, Minnesota
University of Minnesota Cancer Center
Minneapolis, Minnesota, United States, 55455
United States, Missouri
Saint Louis University Cancer Center
Saint Louis, Missouri, United States, 63110
Siteman Cancer Center at Barnes-Jewish Hospital
Saint Louis, Missouri, United States, 63110
United States, Nebraska
UNMC Eppley Cancer Center at the University of Nebraska Medical Center
Omaha, Nebraska, United States, 68198-7680
United States, New Jersey
Hackensack University Medical Center
Hackensack, New Jersey, United States, 07601
United States, New Mexico
Veterans Affairs Medical Center - Albuquerque
Albuquerque, New Mexico, United States, 87108
United States, New York
Albert Einstein Cancer Center at Albert Einstein College of Medicine
Bronx, New York, United States, 10467
New York Weill Cornell Cancer Center at Cornell University
New York, New York, United States, 10021
Herbert Irving Comprehensive Cancer Center at Columbia University
New York, New York, United States, 10032
SUNY Upstate Medical University Hospital
Syracuse, New York, United States, 13210
New York Medical College
Valhalla, New York, United States, 10595
United States, Ohio
Cleveland Clinic Taussig Cancer Center
Cleveland, Ohio, United States, 44111
United States, Pennsylvania
Albert Einstein Cancer Center
Philadelphia, Pennsylvania, United States, 19141
United States, South Carolina
Cancer Centers of the Carolinas - Eastside
Greenville, South Carolina, United States, 29615
United States, Texas
Medical City Dallas Hospital
Dallas, Texas, United States, 75230
Joe Arrington Cancer Research and Treatment Center
Lubbock, Texas, United States, 79410-1894
Canada, Manitoba
St. Boniface General Hospital
Winnipeg, Manitoba, Canada, R2H 2A6
Canada, Ontario
Ottawa Hospital Regional Cancer Centre - General Campus
Ottawa, Ontario, Canada, K1H 8L6
Princess Margaret Hospital
Toronto, Ontario, Canada, M5G 2M9
Puerto Rico
Fundacion de Investagacion De Diego
Santurce, Puerto Rico, 00909
Sponsors and Collaborators
Eximias Pharmaceutical
Study Chair: Gregory R. Suplick Eximias Pharmaceutical

ClinicalTrials.gov Identifier: NCT00012324     History of Changes
Other Study ID Numbers: ZARIX-ZX101-301
CDR0000068506 ( Registry Identifier: PDQ (Physician Data Query) )
First Posted: January 27, 2003    Key Record Dates
Last Update Posted: June 26, 2013
Last Verified: October 2005

Keywords provided by National Cancer Institute (NCI):
localized unresectable adult primary liver cancer
advanced adult primary liver cancer
recurrent adult primary liver cancer
adult primary hepatocellular carcinoma

Additional relevant MeSH terms:
Carcinoma, Hepatocellular
Liver Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases
Liposomal doxorubicin
Antibiotics, Antineoplastic
Antineoplastic Agents
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antimetabolites, Antineoplastic
Folic Acid Antagonists