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NCT Number: NCT02753881

Pharmacokinetics of Doxorubicin in cTACE of Liver Cancer

Patients with primary and secondary liver cancer may participate in this study. The purpose is to perform an analysis of the effects of doxorubicin and its metabolite doxorubicinol on the body (doxorubicin pharmacokinetics ) after conventional transarterial chemoembolization (cTACE). cTACE is a procedure in which chemotherapy drugs are injected, followed by an injection of small beads to block the tumor-feeding arteries. Doxorubicin is a chemotherapeutic agent used in the cTACE procedure. This study will examine doxorubicin pharmacokinetics in patients who: 1) receive whole liver cTACE; and 2) receive super-selective CTACE (i.e., delivered in close proximity to the tumor).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Yale University, Department of Diagnostic Radiology

New Haven, Connecticut, 06520, United States

About this study

Patients with primary and secondary liver cancer may participate in this study. The purpose is to perform an analysis of the effects of doxorubicin and its metabolite doxorubicinol on the body (doxorubicin pharmacokinetics ) after conventional transarterial chemoembolization (cTACE). A pharmacokinetics profile (PK profile) will be constructed and will include peak of plasma concentration (Cmax), time of maximum concentration (TMax), and area under the concentration curve (AUC). This composite measure will be used to compare patients in cTACE lobar administration and cTACE superselective administration. In addition, the PK profile will be correlated with toxicity, tumor burden, body surface area, and gender. Feasibility and safety will also be assessed.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age ≥ 18 years.
  • Histologically, cytologically, or radiologically confirmed liver dominant or liver only malignancy.
  • Preserved liver function (Child-Pugh A-B class) without significant liver decompensation.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 at study entry.
  • Measurable or evaluable disease that will be directly treated with intrahepatic therapy (as defined by Response Evaluation Criteria in Solid Tumors [RECIST] 1.1).
  • Suitable for TACE based on blood parameters such as platelet count, bilirubin, and international normalized ratio.
  • May be enrolled with a history of prior liver directed intra-arterial therapy if intra-arterial therapy to the target lesion occured > 1 year prior to enrollment date. Intra-arterial therapy to different targets within 1 year prior to enrollment date will not exclude subjects.

Exclusion criteria

  • Serum total bilirubin > 3.0 mg/dL
  • Creatinine > 2.0 mg/dL
  • Platelets < 50000/µL
  • Complete portal vein thrombosis with reversal of flow
  • Ascites (trace ascites on imaging is acceptable)

Treatment and study plan

whole liver lobe cTACE doxorubicin

Drug

Doxorubicin CTACE administered in a whole liver lobe manner.

superselective cTACE doxorubicin

Drug

Doxorubicin CTACE administered in a super-selective (close to the tumor) manner.

Primary outcomes

  1. Pharmacokinetics Profile-- Peak of Plasma Concentration (Dose-normalized)

    Time frame: 0, 5, 10, 20, 40 minutes, 1, 2, 4, 24 hours, and 3-4 weeks post dose

    Peak of plasma concentration (Cmax) of both doxorubicin and doxorubicinol reported for 10 lobar subjects, 10 superselective subjects with Lipiodol distribution to 1 segment, and 10 superselective subjects with Lipiodol distribution to multiple segments after dose normalization.

  2. Pharmacokinetics Profile-- Peak of Plasma Concentration

    Time frame: 0, 5, 10, 20, 40 minutes, 1, 2, 4, 24 hours, and 3-4 weeks post dose

    Peak of plasma concentration (Cmax) of doxorubicin and doxorubicinol reported for 10 lobar subjects, 10 superselective subjects with Lipiodol distribution to 1 segment, and 10 superselective subjects with Lipiodol distribution to multiple segments.

  3. Pharmacokinetics Profile-- Area Under the Concentration Time Curve (Dose Normalized)

    Time frame: 0, 5, 10, 20, 40 minutes, 1, 2, 4, 24 hours, and 3-4 weeks post dose

    Area under the concentration time curve (AUC) reported for doxorubicin and doxorubicinol reported for 10 lobar subjects, 10 superselective subjects with Lipiodol distribution to 1 segment, and 10 superselective subjects with Lipiodol distribution to multiple segments after dose normalization.

  4. Pharmacokinetics Profile-- Area Under the Concentration Time Curve

    Time frame: 0, 5, 10, 20, 40 minutes, 1, 2, 4, 24 hours, and 3-4 weeks post dose

    Area under the concentration time curve (AUC) reported for doxorubicin and doxorubicinol reported for 10 lobar subjects, 10 superselective subjects with Lipiodol distribution to 1 segment, and 10 superselective subjects with Lipiodol distribution to multiple segments.

  5. Pharmacokinetics Profile-- Time of Maximum Concentration

    Time frame: 0, 5, 10, 20, 40 minutes, 1, 2, 4, 24 hours, and 3-4 weeks post dose

    Median time of maximum concentration (Tmax) reported for doxorubicin and doxorubicinol reported for 10 lobar subjects, 10 superselective subjects with Lipiodol distribution to 1 segment, and 10 superselective subjects with Lipiodol distribution to multiple segments.

Secondary outcomes

  1. Number of Participants With Technical Success of cTACE Procedure.

    Time frame: assessed at baseline (at the time of the cTACE procedure)

    Feasibility/technical success (yes/no) is measured by ability to administer a therapeutic dose, which is determined clinically.

  2. Assessment and Frequency of Toxicities (Laboratory and Clinical Adverse Events) According to NCI Common Toxicity Criteria for AE (CTCAE) 5.0.

    Time frame: up to 4 weeks post cTACE

    Adverse events assessed by CTCAE 5.0 and stratified by Lipiodol distribution. 30 patients were reviewed for toxicities.

Sponsors and collaborators

Lead sponsor

Yale University

Other

Registry information

Official study title

Pharmacokinetics of Doxorubicin in Conventional Transarterial Chemoembolization (cTACE) of Primary and Secondary Liver Cancer

Important dates

Study start
2015
Primary completion
2019
Study completion
2019
First posted
Apr 28, 2016
Registry last updated
Aug 3, 2020

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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