Overview

This trial is active, not recruiting.

Condition carcinoma, hepatocellular
Treatments mapatumumab, placebo, sorafenib
Phase phase 2
Targets RAF, FLT-3, KIT, PDGF, VEGF
Sponsor Human Genome Sciences Inc., a GSK Company
Collaborator GlaxoSmithKline
Start date February 2011
End date May 2013
Trial size 101 participants
Trial identifier NCT01258608, 200149, HGS1012-C1103

Summary

Mapatumumab is a fully human, agonist monoclonal antibody that activates the cell death pathway in tumor cells by specifically binding to TRAIL-R1 with high affinity. Sorafenib, a multikinase inhibitor, is the standard of care for treatment of patients with advanced hepatocellular carcinoma (HCC). The mechanisms of sorafenib and mapatumumab action suggest that these agents could interact synergistically. This is a Phase 2, multi-center, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of mapatumumab in combination with sorafenib in subjects with advanced hepatocellular carcinoma.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking double blind (subject, investigator)
Primary purpose treatment
Arm
(Experimental)
Mapatumumab 30 milligrams (mg)/kilogram (kg) intravenously on Day 1 of each cycle (i.e. every 21 days) plus sorafenib 400 mg orally twice daily continuously in each cycle until radiologic disease progression or unacceptable toxicity
mapatumumab
Mapatumumab will be supplied as a lyophilized formulation in 10 mL vials containing 100 mg mapatumumab for intravenous infusion at the dose of 30 mg/kg.
sorafenib
Sorafenib will be supplied as tablets, each containing 274 mg sorafenib tosylate, equivalent to 200 mg of sorafenib, to be administered 400 mg (2 x 200 mg tablets) orally twice daily.
(Placebo Comparator)
Placebo intravenously on Day 1 of each cycle (i.e. every 21 days) plus sorafenib 400 mg orally twice daily continuously in each cycle until radiologic disease progression or unacceptable toxicity
placebo
Normal saline solution for intravenous infusion will be administered as placebo for mapatumumab
sorafenib
Sorafenib will be supplied as tablets, each containing 274 mg sorafenib tosylate, equivalent to 200 mg of sorafenib, to be administered 400 mg (2 x 200 mg tablets) orally twice daily.

Primary Outcomes

Measure
Time to progression (TTP)
time frame: From randomization until radiologic progressive disease (PD) is documented

Secondary Outcomes

Measure
Overall survival (OS)
time frame: From the date of randomization until death from any cause
Progression-free survival (PFS)
time frame: From randomization until radiologic PD or death is documented.
Overall response
time frame: From randomization until radiologic PD is documented
Disease control
time frame: From randomization until radiologic PD is documented
Time to response
time frame: From randomization until radiologic PD is documented
Duration of response
time frame: From randomization until radiologic PD is documented
Frequency and severity of adverse events (AEs)
time frame: First dose of study drug until 30 days following cessation of study drug
Clinical laboratory tests
time frame: For the duration on treatment and 30 days after the last dose
Vital signs
time frame: For the duration on treatment and 30 days after the last dose
Anti-mapatumumab antibody response
time frame: Day 1 of Cycles 1, 2, 4, 6, every 2 cycles thereafter; and at least 30 days after the last dose.
Serum mapatumumab concentration
time frame: Cycle 1 (Day 1 and Day 8), Day 1 of Cycles 2, 4 and 6 and thereafter each even cycle and at least 30 days after the last dose.

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Child-Pugh Class A. - Barcelona Clinic Liver Cancer (BCLC) advanced stage (C) hepatocellular carcinoma, or BCLC intermediate stage (B) hepatocellular carcinoma if treatment with transarterial chemoembolization is not considered appropriate - Measurable disease demonstrating intratumoral arterial enhancement by contrast enhanced computerized tomography (CT), with use of multislice scanners, or contrast enhanced dynamic magnetic resonance imaging (MRI), with at least 1 tumor lesion that meets the following criteria: located in the liver; can be accurately measured in at least 1 dimension; well delineated area of viable, hypervascular (contrast enhancement in the arterial phase) tumor that is >2 centimeter (cm) in the axial plane; suitable for repeat measurement; OR not previously treated with locoregional or systemic treatment unless the lesion shows a well-delineated area of viable (contrast enhancement in the arterial phase) tumor that is >2 cm in the axial plane. (If the lesion is poorly demarcated or exhibits atypical enhancement as a result of the previous intervention, then it cannot be selected as a target lesion) - Radiologic eligibility (measurable disease) must be must be confirmed by the BICR prior to randomization. - Adequate bone marrow, renal and liver function as defined in the protocol. - Performance status of 0, 1 or 2 on the Eastern Cooperative Oncology Group (ECOG) Scale - Age 18 years or older - Have the ability to understand the requirements of the study, provide written informed consent (including consent for the use and disclosure of research-related health information), and comply with the study and follow-up procedures. Exclusion Criteria: - Any co-morbid condition that in the judgment of the investigator renders the subject at high risk of treatment complications or reduces the possibility of assessing clinical effect. - Received prior investigational or non-investigational cytotoxic chemotherapy, hormonal therapy, biological therapy (including but not limited to monoclonal antibodies, small molecules or other immunotherapy) to treat hepatocellular carcinoma. - History of organ allograft. - Previously received mapatumumab or sorafenib. - Underwent resection, radiofrequency ablation, radiation or chemoembolization within 4 weeks before enrollment or not recovered from such treatments. - Need for concomitant anticancer therapy (surgery, radiation therapy, chemotherapy, immunotherapy, radiofrequency ablation) or other investigational agents during the study treatment period. - Major surgery (i.e., the opening of a major body cavity, requiring the use of general anesthesia) within 4 weeks before enrollment; minor surgery (except for insertion of vascular access device) within 2 weeks before enrollment; or not yet recovered from the effects of the surgery. - Systemic steroids within 1 week before enrollment except steroids used as part of an antiemetic regimen or maintenance-dose steroids for non-cancerous disease. - Hepatic encephalopathy, per the investigator's evaluation. - History of clinically significant gastrointestinal bleeding requiring procedural intervention (e.g., variceal banding, transjugular intrahepatic portosystemic shunt procedure, arterial embolization, topical coagulation therapy) within 4 weeks before enrollment. - Gastrointestinal disease resulting in an inability to take oral medication or a requirement for intravenous hyperalimentation. - History of any infection requiring hospitalization or intravenous antibiotics within 2 weeks before enrollment. - Known brain or spinal cord metastases unless adequately treated (surgery or radiotherapy) with no evidence of progression and neurologically stable off anticonvulsants and steroids. - Known human immunodeficiency virus infection. - Unstable angina, myocardial infarction, cerebrovascular accident, >= Class II congestive heart failure according to the New York Heart Association Classification for Congestive Heart Failure within 6 months before enrollment. - Cardiac arrhythmias requiring anti-arrhythmic therapy other than beta blockers or digoxin. - Uncontrolled hypertension (systolic blood pressure >150 millimeters of mercury [mmHg] or diastolic pressure >90 mmHg despite optimal medical management). - Using and unable to discontinue use of concomitant strong CYP3A4 inducers (e.g., including but not limited to St. John's Wort, dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, phenobarbital) - Pregnant female or nursing mother. All females with an intact uterus (unless amenorrheic for the 24 months before enrollment) must have a negative serum pregnancy test at screening. All non-sterile or non-postmenopausal females must practice a medically accepted method of contraception over the course of the study and for 60 days after the last dose of study agent. - Males who do not agree to use effective contraception during the study and for a period of 60 days following the final dose of study agent. - Subject is currently enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(s) or subject is receiving other investigational agents. - Acute or chronic severe renal insufficiency (glomoerular filtration rate <30 milliliters [mL]/minute/1.73 square meters) or acute renal insufficiency of any severity due to the hepato-renal syndrome. - Hepatitis B virus deoxyribonucleic acid (DNA) levels >2,000 international units/mL.

Additional Information

Official title A Randomized, Multi-Center, Blinded, Placebo-Controlled Study Of Mapatumumab ([HGS1012], A Fully Monoclonal Antibody To TRAIL-R1) In Combination With Sorafenib As A First-Line Therapy In Subjects With Advanced Hepatocellular Carcinoma
Trial information was received from ClinicalTrials.gov and was last updated in August 2016.
Information provided to ClinicalTrials.gov by GlaxoSmithKline.
Location data was received from the National Cancer Institute and was last updated in August 2016.