Arsenic Trioxide TACE and Intravenous Administration Compared With Arsenic Trioxide TACE Alone in Unresectable Hepatocellular Carcinoma: a Randomized, Parallel, Controlled, Multi-center Clinical Study
Inclusion Criteria:
- Having signed informed consent;
- Histological or clinical diagnosis of hepatocellular carcinoma(HCC);
- The target lesion should had at least one diameter line available for measurement,
with the maximum diameter ≥5cm and ≤10cm;
- Barcelona Clinic Liver Cancer staging B or C;
- Child-Pugh liver function class: score≤7;
- Eastern Cooperative Oncology Group performance 0 or 1;
- At least 12 weeks life expectancy;
- Never received systemic treatment, such as oral molecularly targeted drugs and
systemic chemotherapy;
- Be able to abide by the treatment and follow-up plan;
- Adequate results for laboratory tests, including:
1. Neutrophil count≥1.5×109/L, platelet count≥60×109 /L; hemoglobin≥85g/L;
2. Total bilirubin≤51.3 μmol/L, albumin≥28 g/L,and alanine aminotransferase and
aspartate aminotransferase≤5 times the upper limit of the normal range;
3. Amylase and lipase≤1.5 times the upper limit of the normal range
4. Serum creatinine≤20 g/L
5. Prothrombin time international normalized ratio ≤1.7; or prothrombin
time≤4seconds above control;
6. Left ventricular ejection fraction≥50% according to two-dimensional
echocardiography;
- Contraception: during the trail and 12 weeks after the withdrawal, female of
childbearing age (WOCBP), WOCBP whose male partners receive study drug or male must
use appropriate contraceptive to avoid pregnancy;
Exclusion Criteria:
- Disease should be excluded:
1. CT / MRI showed diffuse lesions;
2. Extrahepatic metastasis (metastasis in lungs not included);
3. Invasion in the main portal vein / vena cava or other major vascular;
4. Previous shunt surgery;
5. PreviousTACE or transarterial embolization for HCC, unless there is a untreated
lesion;
6. Hepatic encephalopathy in the past or present;
7. Current ascites requiring treatment;
- Medical history and concomitant diseases:
1. Previous or current cancer other than HCC, unless it is cervical carcinoma in
situ, treated basal cell carcinoma, superficial bladder tumors (Ta, Tis and T1).
Cancer having received curative treatment 5 years ago will not be excluded;
2. Disease history in the cardiovascular system as the following:
(a)Uncontrolled hypertension;(b)Congestive heart failure in New York Heart
Association grade 3 or 4; (c)Active coronary artery disease within 12 months,
unstable angina or newly diagnosed angina/myocardial infarction;(d)Arrhythmia
requiring drugs other than β-blockers and digoxin;(e)Valvular heart disease ≥ CTCAE
grade 2; c) Corrected QT interval (Fridericia)> 450 ms confirmed by 2 ECGs in a row
d) Thrombotic or embolic events within 6 months, e) Gastrointestinal bleeding within
6 months; f) Unstable and / or active stomach ulcer within 6 months, unless
gastroscopy showed it to be fully recovered; g) Variceal bleeding within 6 months; h)
Unhealed wound or ulcer, fracture within 3 months; i) Major surgery, open biopsy, or
severe trauma within 3 weeks; j) History of organ transplant or subjects in the
transplant waiting list; k) Uncontrolled abnormal thyroid function; l) HIV infection;
m) Active or untreated hepatitis B;
- laboratory tests unsuitable for the enrollment:
1. Hyponatremia, serum sodium <130 mmol / L;
2. Hypokalemia, serum potassium <3.5 mmol / L;
- Allergic reactions to arsenic trioxide and any other drugs used in this trail;
- Forbidden therapies and/or drugs:
1. Condensation treatment (e.g., warfarin or heparin);
2. Chronic antiplatelet therapy (Aspirin ≥ 300 mg / day; clopidogrel ≥ 75 mg /
day);
3. Radiotherapy within 4 weeks;