ClinicalTrials.gg
CompletedNCT00712790Updated Jan 6, 2016

Study of SIR-Spheres Plus Sorafenib as 1st Line Treatment for Non-resectable Primary Hepatocellular Carcinoma (HCC)

A Phase 1/2 interventional study of Sorafenib and SIR-Spheres in Hepatocellular Carcinoma, sponsored by Singapore Clinical Research Institute. Completed at 5 sites in 4 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2016-01-06.

Sponsored by Singapore Clinical Research Institute · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
35
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This Phase I/II trial will evaluate the safety and activity of chemo-radiotherapy comprising a regimen of Sorafenib chemotherapy plus SIR-Spheres yttrium-90 microspheres (chemo-radiotherapy, also known as "chemo-SIRT"), for first-line treatment of patients with primary hepatocellular carcinoma (HCC) in whom surgical resection is not feasible.

This study is designed as a prelude to a planned future randomised comparative study that will compare the efficacy of Sorafenib plus SIR-Spheres versus Sorafenib alone, in this patient population.

02

Conditions studied

  • Hepatocellular Carcinoma

Keywords

  • First line treatment for Hepatocellular Carcinoma
03

In context

Carcinoma, Hepatocellular

3,648 studies on the registry are indexed under Carcinoma, Hepatocellular; 1,061 are open to participants now.

This study's enrollment of 35 is below the median of 54 across 2,618 interventional studies indexed under Carcinoma, Hepatocellular.

Browse Carcinoma, Hepatocellular studies →

Lead sponsor

Singapore Clinical Research Institute is the lead sponsor of 3 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Unresectable HCC with or without systemic .
  • Willing, able and mentally competent to provide written prior to any testing under this study protocol, including screening tests and evaluations that are not considered to be part of the subject's routine care.
  • Aged 18 years or older of either gender and any race, religion or socioeconomic group.
  • Unequivocal diagnosis of primary HCC (as defined above)
  • HCC that is not amenable to surgical resection or immediate liver transplantation, or that is not optimally treatable with local ablative techniques such as radio-frequency ablation, consistent with the practice of the clinical trial centre.
  • , defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥10 mm with spiral CT scan.
  • performance status 0 - 1.
  • Adequate haematological, renal and hepatic function as follows:
  • Leukocytes ≥ 2,500/μL
  • ≥ 1,500/μL
  • ≥ 50,000/μL
  • > 9.5 g/dL
  • Total ≤ 2.0 mg/dL (SIR-Spheres should not be administered as a whole liver treatment if the total bilirubin is > 2X the institutional ).
  • ≤ 2.0
  • ALP ≤ 5 x institutional upper limit of normal
  • / ALT ≤ 5 x institutional upper limit of normal
  • Albumin ≥ 2.5 g/dL
  • Creatinine ≤ 2.0 mg/dL
  • The blood results must be less than 29 days old at the time of confirming patient eligibility to receive protocol treatment.
  • of at least 3 months without any active treatment. This is defined as a patient who has OKUDA I or II inoperable HCC.
  • Suitable for protocol treatment as determined by clinical assessment undertaken by the Investigator.
  • Female patients must be either or, if premenopausal, must have a negative pregnancy test and agree to use two forms of if sexually active during their study participation.
  • Male patients must be surgically sterile, or if sexually active and having a pre-menopausal female partner then must be using an acceptable form of contraception.
  • Hepatic arterial anatomy suitable for implantation of SIR-Spheres, as assessed by hepatic angiogram.
  • Lung shunt fraction less than or equal to 20% as assessed by a Tc-99m macroaggregated albumin liver to lung breakthrough scan.

Exclusion criteria

Exclusion Criteria:

  • Had previous external beam radiation therapy to the liver.
  • Any ascites or other clinical signs of liver failure, on physical examination.
  • Abnormal synthetic and excretory liver function tests (LFTs) as determined by serum albumin (must be \< 2.5 g/dL) and total (must be > 2.0 mg/dL), respectively.
  • Tumours amenable to surgical resection for cure at presentation.
  • Greater than 20% lung shunting of the hepatic artery blood flow determined by Tc-99 MAA scan.
  • Pre-assessment angiogram and Tc-99 MAA scan that demonstrates significant and uncorrectable activity in the stomach, pancreas or bowel.
  • Been treated with Capecitabine within the previous 8 weeks, or who will be treated with Capecitabine within 8 weeks of treatment with SIR-Spheres, due to the possible risk of potentiating or causing liver dysfunction.
  • Complete main portal vein thrombosis.
  • Subjects who have had hepatic artery directed therapy.
  • Subjects who have had prior chemotherapy or other medical agents used to treat hepatocellular carcinoma.
  • Prior external hepatic radiation therapy for HCC, or any other concomitant therapy for HCC or any agent planned while on this protocol.
  • Subjects with inferior vena cava (IVC) tumour thrombus or invasion
  • Currently receiving any other investigational agents for the treatment of their cancer.
  • Any other concurrent , except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for at least five years.
  • Presence of clinical signs of due to their poor prognosis and because progressive neurologic dysfunction would confound the evaluation of neurologic and other adverse events.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (except viral hepatitis), symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Any of the following to angiography and selective visceral catheterization:

    • Bleeding diathesis, not correctable by the standard forms of therapy.
    • Severe peripheral vascular disease that would preclude arterial catheterization.
    • Portal hypertension with hepatofugal flow as documented on baseline spiral CT scan.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to SIR-Spheres.
  • Inability or unwillingness to understand or sign a written document (non English-speaking patients may use an interpreter).
  • Female subjects who are pregnant or currently breastfeeding.
  • For female subjects, unless or surgically sterile, unwillingness to practice effective , as defined by the Investigator, during the study. The rhythm method is not to be used as the sole method of contraception.
  • For male subjects, unwillingness to practice effective contraception (as defined by the Investigator) while taking part in this study, because the effect of the SIR-Spheres treatment on sperm or upon the development of an unborn child are unknown.
  • Current enrolment in any other investigational drug or device study.
Terms in these criteria, in plain language(18)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
35 participants (actual)

Study arms

  • Experimental
    Sequential Radioembolization-Sorafenib

    Sorafenib (400 mg twice-daily) was initiated 14 days post-radioembolization with yttrium-90 (Y) resin microspheres given as a single procedure.

    Drug: Sorafenib · Radiation: SIR-Spheres

Interventions

  • Tablet, 400mg orally, twice daily

    Also known as: BAY 43-9006

  • RadiationSIR-Spheres

    one time treatment and capped at 3.0 Gbq

    Also known as: Yttrium-90 Microspheres

06

What researchers measure

Primary outcomes

  1. Toxicity and safety

    Time frame: 2 years

  2. Tumour response rate (liver ± any site).

    Time frame: 2 years

Secondary outcomes

  1. Progression free survival at any site.

    Time frame: 2 years

  2. Progression free survival in the liver.

    Time frame: 2 years

  3. Survival

    Time frame: 2 years

  4. Hepatic and extra-hepatic recurrence rate.

    Time frame: 2 years

  5. Quality of life.

    Time frame: 2 years

  6. Rate of downstaging to surgical resection or ablative therapy.

    Time frame: 2 years

07

Study locations

5 sites
  • Seoul National University Bundang Hospital
    Seoul, Korea, Republic of
  • Selayang Hospital
    Selangor, Malaysia
  • Yangon GI & Liver Centre
    Yangon, Myanmar
  • Singapore General Hospital
    Singapore, 169608, Singapore
  • National Cancer Centre
    Singapore, 169610, Singapore
08

References and documents

Publications

  • Chow PK, Poon DY, Khin MW, Singh H, Han HS, Goh AS, Choo SP, Lai HK, Lo RH, Tay KH, Lim TG, Gandhi M, Tan SB, Soo KC; Asia-Pacific Hepatocellular Carcinoma Trials Group. Multicenter phase II study of sequential radioembolization-sorafenib therapy for inoperable hepatocellular carcinoma. PLoS One. 2014 Mar 10;9(3):e90909. doi: 10.1371/journal.pone.0090909. eCollection 2014. PubMed 24614178 ↗
09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Jun 2008, a primary completion of Jun 2009 and a completion of Apr 2014. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 7, 2008
First posted
Jul 10, 2008
Start
Jun 2008
Primary completionActual
Jun 2009
CompletionActual
Apr 2014
Last update
Jan 6, 2016
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 6, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00712790
Lead sponsor
Singapore Clinical Research Institute
Collaborators
National Medical Research Council (NMRC), Singapore, Bayer Healthcare Pharmaceuticals, Inc./Bayer Schering Pharma, Sirtex Medical
Responsible party
Pierce K.H.Chow (MBBS MMed, FAMS, FRCSE, PhD | Senior Consultant Surgeon, Singapore General Hospital) — Principal investigator
First posted
Jul 10, 2008
Start date
Jun 2008
Primary completion
Jun 2009
Completion
Apr 2014
Last update
Jan 6, 2016

Study contacts

Pierce Chow, Phd
study chair · SGH

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jan 2016. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Sorafenib

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