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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01915589
Registration number
NCT01915589
Ethics application status
Date submitted
24/07/2013
Date registered
5/08/2013
Date last updated
8/04/2021
Titles & IDs
Public title
Refametinib(BAY86-9766) in RAS Mutant Hepatocellular Carcinoma (HCC)
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Scientific title
A Prospective, Single-arm, Multicenter, Uncontrolled, Open-label Phase II Trial of Refametinib (BAY86-9766) in Patients With RAS Mutant Hepatocellular Carcinoma (HCC)
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Secondary ID [1]
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2013-000311-25
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Secondary ID [2]
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16553
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Carcinoma, Hepatocellular
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Condition category
Condition code
Cancer
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Non melanoma skin cancer
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Cancer
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Kidney
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Cancer
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Liver
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Refametinib (BAY86-9766)
Experimental: Refametinib (BAY86-9766) - For purposes of data recording, the treatment period will be divided into 3-week cycles. Patients will continue on treatment until at least one of the following occurs (main criteria): Death Unacceptable toxicity Subject withdraws consent Substantial non-compliance with the protocol Treating physician determines discontinuation of treatment is in the subject's best interest. Radiological progression as determined by RECIST (Version 1.1) or mRECIST criteria or clinical progression (e.g. Eastern Cooperative Oncology group performance status - ECOG PS =3) patients may continue to receive study treatment if identified as having continued clinical benefit as judged by the treating physician.
Treatment: Drugs: Refametinib (BAY86-9766)
All patients who meet the entry criteria will receive refametinib 50 mg (2x20 mg + 1x10 mg capsules or 50 mg tablet) bid.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Objective tumor response according to Modified Response Evaluation Criteria in Solid Tumors (mRECIST) assessed by central radiological review
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Assessment method [1]
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Timepoint [1]
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Approximately 36 months
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Secondary outcome [1]
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Objective tumor response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 assessed by central radiological review
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Assessment method [1]
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Timepoint [1]
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Approximately 36 months
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Secondary outcome [2]
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Objective tumor response according to RECIST 1.1 and mRECIST assessed by investigators
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Assessment method [2]
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Timepoint [2]
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Approximately 36 months
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Secondary outcome [3]
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Disease control (central and investigator's assessment)
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Assessment method [3]
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Timepoint [3]
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Approximately 36 months
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Secondary outcome [4]
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Overall survival
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Assessment method [4]
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Timepoint [4]
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Approximately 36 months
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Secondary outcome [5]
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Time to radiographic tumor progression (central and investigator's assessment)
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Assessment method [5]
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Timepoint [5]
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Approximately 36 months
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Secondary outcome [6]
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Duration of response (central and investigator's assessment)
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Assessment method [6]
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Timepoint [6]
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Approximately 36 months
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Secondary outcome [7]
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Time to objective response (central and investigator's assessment)
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Assessment method [7]
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Timepoint [7]
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Approximately 36 months
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Secondary outcome [8]
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Change in tumor size (central and investigator's assessment)
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Assessment method [8]
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Timepoint [8]
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Approximately 36 months
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Secondary outcome [9]
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Best overall response (central and investigator's assessment)
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Assessment method [9]
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Timepoint [9]
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Approximately 36 months
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Secondary outcome [10]
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Progression-free survival (central and investigator's assessment)
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Assessment method [10]
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Timepoint [10]
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Approximately 36 months
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Secondary outcome [11]
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Number of participants with adverse events as a measure of safety and tolerability
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Assessment method [11]
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Timepoint [11]
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Approximately 36 months
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Eligibility
Key inclusion criteria
Eligibility criteria for RAS mutation testing
* Unresectable or metastatic HCC, confirmed either by histology or clinically according to the American Association for the Study of Liver Disease (AASLD) criteria for cirrhotic patients. For non-cirrhotic patients, histological confirmation is mandatory.
* Male or female =18 years of age.
* Eastern Cooperative Oncology Group (ECOG) performance state 0 or 1.
* Life expectancy of at least 12 weeks.
* No prior use of targeted agents, experimental therapy or systemic anti-cancer treatment for HCC (except sorafenib)
* No previous treatment with refametinib(BAY86-9766). Criteria for study treatment eligibility
* Patient must harbor GTPase Kirsten rat sarcoma viral oncogene homolog (KRAS) or Neuroblastoma RAS viral oncogene homolog (NRAS) mutation based on Beads, emulsions, amplification, and magnetic technology, sensitive mutation detection (BEAMing) plasma test.
* Patients must have at least one uni-dimensional measurable lesion by Computed tomography (CT) or Magnetic resonance (MR) according to RECIST 1.1 and mRECIST which is either naïve (not previously treated by local therapy such as surgery, radiation therapy, hepatic arterial therapy, chemoembolization, radiofrequency ablation, percutaneous ethanol injection or cryoablation) or previously treated and has progressed until baseline (both measureable lesion and/or progressed lesion have to be confirmed by central image review of baseline and progression scan).
* ECOG performance status of 0 or 1.
* Liver function status of Child-Pugh Class A.
* Adequate bone morrow, liver, and renal function
* Patient has within normal range cardiac function confirmed by the enrolling clinical institute as measured by echocardiogram or multiple gated acquisition (MUGA) scan.
* Patients who are therapeutically anti-coagulated with an agent such as warfarin or heparin are allowed to participate provided that no prior evidence of underlying abnormality in these parameters exists. Close monitoring of at least weekly evaluations will be performed until International normalized ratio (INR) is stable (within Child Pugh class A threshold) based on a measurement at pre-dose, as defined by the local standard of care.
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Minimum age
18
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Any Cancer curatively treated < 3 years prior to study entry, except cervical carcinoma in situ (CIS), treated basal cell carcinoma, and superficial bladder tumors [Staging: noninvasive papillary tumor (Ta), CIS carcinoma (Tis) and tumor invades lamina propria (T1)]
* Subjects who are eligible for surgery, liver transplantation, ablation or transarterial chemoembolization for HCC.
* History of cardiac disease
* Uncontrolled hypertension (systolic blood pressure [BP] >150 mmHg or diastolic blood pressure > 90 mmHg despite optimal medical management).
* Ongoing infection > Grade 2 according to National Cancer Institute - Common Toxicity Criteria for Adverse Events version 4.03 (NCI-CTCAE version 4.03) Hepatitis B is allowed if no active replication (defined as abnormal Alanine aminotransferase [ALT] >2x Upper limit normal [ULN] associated with Hepatitis B virus [HBV] DNA >20,000 IU/mL) is present. Hepatitis C is allowed if no antiviral treatment is required.
* Known history of, or symptomatic metastatic brain or meningeal tumors (head CT or MR at Screening to confirm the absence of central nervous system [CNS] disease if patient had symptoms suggestive or consistent with CNS disease).
* History of interstitial lung disease (ILD).
* History of hepatic encephalopathy.
* History of organ allograft, cornea transplantation will be allowed.
* History or current evidence of retinal vein occlusion (RVO) or central serous retinopathy (CSR).
* Visible retinal pathology as assessed by ophthalmologic exam that was considered a risk factor for RVO or CSR.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/09/2013
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
8/10/2014
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Sample size
Target
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Accrual to date
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Final
16
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
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United States of America
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District of Columbia
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United States of America
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Florida
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United States of America
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New York
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Austria
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Graz
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Belgium
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Bruxelles - Brussel
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Belgium
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Charleroi
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Belgium
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Gent
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Belgium
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Leuven
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Czechia
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Praha 2
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France
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CLERMONT-FERRAND Cedex 1
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France
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Creteil
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France
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Lille
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France
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Marseille
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France
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France
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Vandoeuvre-les-nancy
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Germany
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Baden-Württemberg
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Germany
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Bayern
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Germany
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Niedersachsen
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Germany
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Germany
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Rheinland-Pfalz
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Germany
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Berlin
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Shatin
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Hungary
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Budapest
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Hungary
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Debrecen
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Italy
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Chiba
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Osaka
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Japan
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Tokyo
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Busan
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A Coruña
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Catalunya
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Alicante
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Valencia
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Genève
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Tainan
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Bangkok
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United Kingdom
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West Midlands
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Bayer
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Ethics approval
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Summary
Brief summary
This is a study to investigate the potential clinical benefit of refametinib in patients with unresectable or metastatic HCC carrying a RAS mutation. The study will be conducted in 2 stages. Approximately 95 patients (15 at Stage 1/ 80 at Stage 2) will be accrued to this study to receive treatment. Stage 2 of the trial will only be conducted if at least 5 out of 15 patients at Stage 1 show at least confirmed partial response (PR) according to modified response evaluation criteria in solid tumors (mRECIST) assessed by central image review. Refametinib is an oral (i.e. taken by mouth) protein kinase inhibitor. A kinase inhibitor targets certain key proteins that are essential for the survival of the cancer cell. By specifically targeting these proteins, refametinib may stop cancer growth. The growth of the tumor may be decreased by preventing these specific proteins from functioning. The primary endpoint (the most meaningful result to be tracked) of this study is based on the rate of response, i.e. the disease getting smaller. The aim is to show that the therapy with refametinib improves the response rate in this RAS mutation patient population.
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Trial website
https://clinicaltrials.gov/study/NCT01915589
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Bayer Study Director
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Bayer
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01915589
Download to PDF