Trial Review

The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers
Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/study/NCT01140347




Registration number
NCT01140347
Ethics application status
Date submitted
2/06/2010
Date registered
9/06/2010
Date last updated
28/12/2015

Titles & IDs
Public title
A Study of Ramucirumab (IMC-1121B) Drug Product (DP) and Best Supportive Care (BSC) Versus Placebo and BSC as 2nd-Line Treatment in Participants With Hepatocellular Carcinoma After 1st-Line Therapy With Sorafenib
Scientific title
A Multicenter, Randomized, Double-Blind, Phase 3 Study of Ramucirumab (IMC-1121B) Drug Product and Best Supportive Care (BSC) Versus Placebo and BSC as Second-Line Treatment in Patients With Hepatocellular Carcinoma Following First-Line Therapy With Sorafenib (REACH)
Secondary ID [1] 0 0
CP12-0919
Secondary ID [2] 0 0
13895
Universal Trial Number (UTN)
Trial acronym
REACH
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Hepatocellular Carcinoma 0 0
Condition category
Condition code
Cancer 0 0 0 0
Non melanoma skin cancer
Cancer 0 0 0 0
Kidney
Cancer 0 0 0 0
Liver

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Other - Placebo
Treatment: Other - Ramucirumab DP (IMC-1121B)
Other interventions - BSC

Experimental: Ramucirumab DP and BSC -

Placebo comparator: Placebo and BSC -


Treatment: Other: Placebo
8 mg/kg IV every 2 weeks

Treatment: Other: Ramucirumab DP (IMC-1121B)
8 milligrams/kilogram (mg/kg) intravenous (IV) every 2 weeks

Other interventions: BSC
Palliative and supportive care for disease-related symptoms and toxicity associated with treatment as deemed medically necessary and appropriate in the opinion of the investigator.
Intervention code [1] 0 0
Treatment: Other
Intervention code [2] 0 0
Other interventions
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Overall Survival (OS)
Timepoint [1] 0 0
Randomization to death from any cause (up to 37 months)
Secondary outcome [1] 0 0
Progression-Free Survival (PFS)
Timepoint [1] 0 0
Randomization to PD (up to 36 months)
Secondary outcome [2] 0 0
Percentage of Participants With Complete Response (CR) or Partial Response (PR) [Objective Response Rate (ORR)]
Timepoint [2] 0 0
Baseline to the date of first evidence of confirmed CR or PR (up to 37 months)
Secondary outcome [3] 0 0
Time to Radiographic Progression (TTP)
Timepoint [3] 0 0
Randomization to PD (up to 36 months)
Secondary outcome [4] 0 0
Change From Baseline in the Functional Assessment of Cancer Therapy (FACT) Hepatobiliary Symptom Index-8 (FHSI-8)
Timepoint [4] 0 0
Baseline, Prior to infusion on Day 1 of Cycle 4, Cycle 10, and Cycle 16 (14-day cycles), and end of treatment (up to 34 months)
Secondary outcome [5] 0 0
Change From Baseline in European Quality of Life Questionnaire-5 Dimensions (EQ-5D) Health State Score
Timepoint [5] 0 0
Baseline, Prior to infusion on Day 1 of Cycle 4, Cycle 10, and Cycle 16 (14-day cycles), end of treatment (up to 34 months)
Secondary outcome [6] 0 0
Number of Participants With Adverse Events (AEs) and the Number of Participants Who Died
Timepoint [6] 0 0
Baseline to study completion (up to 37 months)
Secondary outcome [7] 0 0
Maximum Concentration (Cmax) of Ramucirumab, Cycle 1
Timepoint [7] 0 0
1 hour following the completion of Cycle 1 (14-day cycle) infusion
Secondary outcome [8] 0 0
Cmax of Ramucirumab, Cycle 4
Timepoint [8] 0 0
1 hour following completion of Cycle 4 (14-day cycles) infusion
Secondary outcome [9] 0 0
Cmax of Ramucirumab, Cycle 7
Timepoint [9] 0 0
1 hour following completion of Cycle 7 (14-day cycles) infusion
Secondary outcome [10] 0 0
Number of Participants With Treatment Emergent Positive Anti-Ramucirumab Response [Serum Anti-Ramucirumab Antibody Assessment (Immunogenicity)]
Timepoint [10] 0 0
Prior to treatment and 1 hour post end of infusion for Cycles 1, 4 and 7 (14-day cycles)

Eligibility
Key inclusion criteria
Inclusion criteria:

* Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 or 1
* Child-Pugh score of <7 (Child-Pugh Class A only)
* Barcelona Clinic Liver Cancer (BCLC) Stage C or BCLC stage B not amenable to locoregional therapy or refractory to locoregional therapy
* Diagnosis of HCC (excluding fibrolamellar carcinoma) in the absence of histologic or cytologic confirmation
* There are either clinical, laboratory, or radiographic findings consistent with a diagnosis of liver cirrhosis
* Has a liver mass measuring at least 2 centimeters (cm) with characteristic vascularization seen on either triphasic computed tomography (CT) scan or magnetic resonance imaging (MRI) with gadolinium
* At least 1 measurable or evaluable lesion that is viable [that is (i.e.), is vascularized], and has not been previously treated with locoregional therapy. A lesion that has been previously treated will qualify as a measurable or evaluable lesion if there was demonstrable progression following locoregional therapy
* Previously treated with sorafenib and has discontinued sorafenib treatment at least 14 days prior to randomization. Participants may have experienced:

* Radiographically documented disease progression during sorafenib therapy or after discontinuation of sorafenib therapy, or
* Discontinuation of sorafenib due to an adverse drug reaction, despite dose reduction by 1 level and BSC
* The participant has received sorafenib as the only systemic therapeutic intervention. Any hepatic locoregional therapy that has been administered prior to sorafenib is allowed, but not following sorafenib. Radiation to metastatic sites [for example (e.g.), bone] following sorafenib therapy is permitted.
* Resolution of clinically significant toxicity of any anti-cancer therapy to Grade =1 by the National Cancer Institute Common Terminology Criteria for Adverse Events volume 4.0 (NCI-CTCAE v. 4.0).

Adequate Organ Function defined as:

* Total bilirubin <3.0 milligrams/deciliter (mg/dL) [51.3 micromole/liter (µmol/L)], aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =5 × upper limit of normal (ULN)
* Serum creatinine =1.2 × ULN or calculated creatinine clearance >50 milliliters/minute (mL/min)
* Absolute neutrophil count (ANC) =1.0 × 10^3/microliter (µL) (1.0 × 10^9/liter (L)]), hemoglobin =9 grams/deciliter (g/dL) [5.58 millimoles/liter (mmol/L)], and platelets =75 × 10^3/µL (75 × 10^9/L)
* International Normalized Ratio (INR) =1.5 and partial thromboplastin time (PTT) =5 seconds above ULN. Participants receiving prophylactic low-dose anticoagulant therapy are eligible provided that INR =1.5 and PTT =5 seconds above the ULN
* The participant's urinary protein is =1+ on dipstick or routine urinalysis. If urine dipstick or routine analysis indicates =2+ proteinuria, then a 24-hour urine must be collected and must demonstrate <1000 milligrams (mg) of protein in 24 hours to allow participation in the study
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Exclusion criteria:

* Major surgery within 28 days prior to randomization, or central venous access device placement within 7 days prior to randomization
* Hepatic locoregional therapy within 28 days prior to randomization
* Radiation to any nonhepatic (e.g., bone) site within 14 days prior to randomization
* Sorafenib within 14 days prior to randomization
* Received any investigational therapy or non-approved drug within 28 days prior to randomization
* Received any previous systemic therapy with vascular endothelial growth factor (VEGF) inhibitors or vascular endothelial growth factor receptor (VEGFR) inhibitors (including investigational agents) other than sorafenib for treatment of HCC
* Fibrolamellar carcinoma
* Received any transfusion, blood component preparation, erythropoietin, albumin preparation, or granulocyte colony-stimulating factors (G-CSF) within 14 days prior to randomization
* Therapeutic anticoagulation with warfarin, low-molecular-weight heparin, or similar agents. Participants receiving prophylactic, low-dose anticoagulation therapy are eligible provided that the coagulation parameters defined in the inclusion criteria (INR =1.5 and PTT =5 seconds above the ULN) are met
* Receiving ongoing therapy with nonsteroidal anti-inflammatory agents (NSAIDs, e.g., indomethacin, ibuprofen, naproxen, nimesulide, celecoxib, etoricoxib, or similar agents) or other antiplatelet agents (e.g., clopidogrel, ticlopidine, prasugrel, dipyridamole, picotamide, indobufen, anagrelide, triflusal). Aspirin (ASA) at doses up to 100 milligrams/day (mg/day) is permitted
* Symptomatic congestive heart failure, unstable angina pectoris, or symptomatic or poorly controlled cardiac arrhythmia
* Any arterial thrombotic event, including myocardial infarction, unstable angina, cerebrovascular accident, or transient ischemic attack, within 6 months prior to randomization
* Uncontrolled arterial hypertension systolic =150 / diastolic =90 millimeters of mercury (mm Hg) despite standard medical management
* Grade 3-4 gastrointestinal bleeding or any variceal bleeding episode in the 3 months prior to randomization requiring transfusion, endoscopic or operative intervention (participants with any bleeding episode considered life-threatening during the 3 months prior to randomization are excluded, regardless of transfusion or intervention status)
* Esophageal or gastric varices that require immediate intervention (e.g., banding, sclerotherapy) or represent a high bleeding risk. Participants with evidence of portal hypertension (including splenomegaly) or any prior history of variceal bleeding must have had endoscopic evaluation within the 3 months immediately prior to randomization. Participants with evidence of portal hypertension are eligible for study participation if endoscopic evaluation does not indicate esophageal or gastric varices that require immediate intervention or represent a high bleeding risk; however, these eligible participants must receive supportive therapy (e.g., beta blocker therapy) according to institutional standards and clinical guidelines during study participation
* Central nervous system (CNS) metastases or carcinomatous meningitis
* History of or current hepatic encephalopathy or current clinically meaningful ascites

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s


The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
1/10/2010
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
1/03/2015
Sample size
Target
Accrual to date
Final
565
Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
Recruitment hospital [1] 0 0
ImClone Investigational Site - Bankstown
Recruitment hospital [2] 0 0
ImClone Investigational Site - Kogarah
Recruitment hospital [3] 0 0
ImClone Investigational Site - Liverpool Bc
Recruitment hospital [4] 0 0
ImClone Investigational Site - Kurralta Park
Recruitment hospital [5] 0 0
ImClone Investigational Site - Prahran
Recruitment postcode(s) [1] 0 0
2200 - Bankstown
Recruitment postcode(s) [2] 0 0
2217 - Kogarah
Recruitment postcode(s) [3] 0 0
1871 - Liverpool Bc
Recruitment postcode(s) [4] 0 0
5037 - Kurralta Park
Recruitment postcode(s) [5] 0 0
3181 - Prahran
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
California
Country [2] 0 0
United States of America
State/province [2] 0 0
Connecticut
Country [3] 0 0
United States of America
State/province [3] 0 0
Florida
Country [4] 0 0
United States of America
State/province [4] 0 0
Louisiana
Country [5] 0 0
United States of America
State/province [5] 0 0
Massachusetts
Country [6] 0 0
United States of America
State/province [6] 0 0
Michigan
Country [7] 0 0
United States of America
State/province [7] 0 0
Missouri
Country [8] 0 0
United States of America
State/province [8] 0 0
New Jersey
Country [9] 0 0
United States of America
State/province [9] 0 0
New York
Country [10] 0 0
United States of America
State/province [10] 0 0
North Carolina
Country [11] 0 0
United States of America
State/province [11] 0 0
Ohio
Country [12] 0 0
United States of America
State/province [12] 0 0
Pennsylvania
Country [13] 0 0
United States of America
State/province [13] 0 0
South Carolina
Country [14] 0 0
United States of America
State/province [14] 0 0
Texas
Country [15] 0 0
United States of America
State/province [15] 0 0
Washington
Country [16] 0 0
United States of America
State/province [16] 0 0
Wisconsin
Country [17] 0 0
Austria
State/province [17] 0 0
Linz
Country [18] 0 0
Austria
State/province [18] 0 0
Salzburg
Country [19] 0 0
Austria
State/province [19] 0 0
Steyr
Country [20] 0 0
Austria
State/province [20] 0 0
Vienna
Country [21] 0 0
Belgium
State/province [21] 0 0
Bonheiden
Country [22] 0 0
Belgium
State/province [22] 0 0
Brussels
Country [23] 0 0
Belgium
State/province [23] 0 0
Charleroi
Country [24] 0 0
Belgium
State/province [24] 0 0
Edegem
Country [25] 0 0
Belgium
State/province [25] 0 0
Leuven
Country [26] 0 0
Belgium
State/province [26] 0 0
Liège
Country [27] 0 0
Belgium
State/province [27] 0 0
Ottignies
Country [28] 0 0
Brazil
State/province [28] 0 0
Belo Horizonte
Country [29] 0 0
Brazil
State/province [29] 0 0
Botucatu
Country [30] 0 0
Brazil
State/province [30] 0 0
Brasilia
Country [31] 0 0
Brazil
State/province [31] 0 0
Campinas
Country [32] 0 0
Brazil
State/province [32] 0 0
Ijui
Country [33] 0 0
Brazil
State/province [33] 0 0
Ribeirao Preto
Country [34] 0 0
Brazil
State/province [34] 0 0
Rio De Janeiro
Country [35] 0 0
Brazil
State/province [35] 0 0
Salvador
Country [36] 0 0
Brazil
State/province [36] 0 0
Sao Jose Rio Preto
Country [37] 0 0
Brazil
State/province [37] 0 0
São Paulo
Country [38] 0 0
Bulgaria
State/province [38] 0 0
Plovdiv
Country [39] 0 0
Bulgaria
State/province [39] 0 0
Sofia
Country [40] 0 0
Bulgaria
State/province [40] 0 0
Varna
Country [41] 0 0
Canada
State/province [41] 0 0
Ontario
Country [42] 0 0
Czech Republic
State/province [42] 0 0
Brib
Country [43] 0 0
Czech Republic
State/province [43] 0 0
Hradec Kralove
Country [44] 0 0
Czech Republic
State/province [44] 0 0
Olomouc
Country [45] 0 0
Czech Republic
State/province [45] 0 0
Prague
Country [46] 0 0
Finland
State/province [46] 0 0
Helsinki
Country [47] 0 0
France
State/province [47] 0 0
Amiens
Country [48] 0 0
France
State/province [48] 0 0
Angers
Country [49] 0 0
France
State/province [49] 0 0
Avignon
Country [50] 0 0
France
State/province [50] 0 0
Besancon
Country [51] 0 0
France
State/province [51] 0 0
Bordeaux
Country [52] 0 0
France
State/province [52] 0 0
Clermont-Ferrand
Country [53] 0 0
France
State/province [53] 0 0
La Roche Sur Yon
Country [54] 0 0
France
State/province [54] 0 0
Limoges
Country [55] 0 0
France
State/province [55] 0 0
Marseille
Country [56] 0 0
France
State/province [56] 0 0
Nice
Country [57] 0 0
France
State/province [57] 0 0
Paris
Country [58] 0 0
France
State/province [58] 0 0
Poitiers
Country [59] 0 0
France
State/province [59] 0 0
Reims
Country [60] 0 0
France
State/province [60] 0 0
Saint-Etienne
Country [61] 0 0
Germany
State/province [61] 0 0
Berlin
Country [62] 0 0
Germany
State/province [62] 0 0
Bielefeld
Country [63] 0 0
Germany
State/province [63] 0 0
Bonn
Country [64] 0 0
Germany
State/province [64] 0 0
Düsseldorf
Country [65] 0 0
Germany
State/province [65] 0 0
Essen
Country [66] 0 0
Germany
State/province [66] 0 0
Frankfurt
Country [67] 0 0
Germany
State/province [67] 0 0
Freiburg
Country [68] 0 0
Germany
State/province [68] 0 0
Hamburg
Country [69] 0 0
Germany
State/province [69] 0 0
Hannover
Country [70] 0 0
Germany
State/province [70] 0 0
Homburg
Country [71] 0 0
Germany
State/province [71] 0 0
Leipzig
Country [72] 0 0
Germany
State/province [72] 0 0
Magdeburg
Country [73] 0 0
Germany
State/province [73] 0 0
Munich
Country [74] 0 0
Germany
State/province [74] 0 0
Münster
Country [75] 0 0
Germany
State/province [75] 0 0
Tübingen
Country [76] 0 0
Germany
State/province [76] 0 0
Ulm
Country [77] 0 0
Germany
State/province [77] 0 0
Weiden
Country [78] 0 0
Hong Kong
State/province [78] 0 0
Kowloon
Country [79] 0 0
Hong Kong
State/province [79] 0 0
Pokfulam
Country [80] 0 0
Hong Kong
State/province [80] 0 0
Shatin
Country [81] 0 0
Hungary
State/province [81] 0 0
Budapest
Country [82] 0 0
Israel
State/province [82] 0 0
Beer Sheva
Country [83] 0 0
Israel
State/province [83] 0 0
Petah Tiqva
Country [84] 0 0
Israel
State/province [84] 0 0
Tel Aviv
Country [85] 0 0
Italy
State/province [85] 0 0
Bari
Country [86] 0 0
Italy
State/province [86] 0 0
Benevento
Country [87] 0 0
Italy
State/province [87] 0 0
Bologna
Country [88] 0 0
Italy
State/province [88] 0 0
Genova
Country [89] 0 0
Italy
State/province [89] 0 0
Lecce
Country [90] 0 0
Italy
State/province [90] 0 0
Milano
Country [91] 0 0
Italy
State/province [91] 0 0
Modena
Country [92] 0 0
Italy
State/province [92] 0 0
Padova
Country [93] 0 0
Italy
State/province [93] 0 0
Palermo
Country [94] 0 0
Italy
State/province [94] 0 0
Pavia
Country [95] 0 0
Italy
State/province [95] 0 0
Rome
Country [96] 0 0
Italy
State/province [96] 0 0
Udine
Country [97] 0 0
Japan
State/province [97] 0 0
Chiba
Country [98] 0 0
Japan
State/province [98] 0 0
Fukuoka
Country [99] 0 0
Japan
State/province [99] 0 0
Hyogo
Country [100] 0 0
Japan
State/province [100] 0 0
Ishikawa
Country [101] 0 0
Japan
State/province [101] 0 0
Kanagawa
Country [102] 0 0
Japan
State/province [102] 0 0
Kochi
Country [103] 0 0
Japan
State/province [103] 0 0
Kyoto
Country [104] 0 0
Japan
State/province [104] 0 0
Miyagi
Country [105] 0 0
Japan
State/province [105] 0 0
Osaka-Pref
Country [106] 0 0
Japan
State/province [106] 0 0
Osaka
Country [107] 0 0
Japan
State/province [107] 0 0
Saga
Country [108] 0 0
Japan
State/province [108] 0 0
Tochigi
Country [109] 0 0
Japan
State/province [109] 0 0
Tokushima
Country [110] 0 0
Japan
State/province [110] 0 0
Tokyo
Country [111] 0 0
Korea, Republic of
State/province [111] 0 0
Anyang
Country [112] 0 0
Korea, Republic of
State/province [112] 0 0
Incheon
Country [113] 0 0
Korea, Republic of
State/province [113] 0 0
Seodaemun-Gu
Country [114] 0 0
Korea, Republic of
State/province [114] 0 0
Seoul
Country [115] 0 0
Netherlands
State/province [115] 0 0
Amsterdam
Country [116] 0 0
Netherlands
State/province [116] 0 0
Rotterdam
Country [117] 0 0
Norway
State/province [117] 0 0
Oslo
Country [118] 0 0
Philippines
State/province [118] 0 0
Quezon City
Country [119] 0 0
Portugal
State/province [119] 0 0
Lisbon
Country [120] 0 0
Portugal
State/province [120] 0 0
Santa Maria Da Feira
Country [121] 0 0
Romania
State/province [121] 0 0
Bucharest
Country [122] 0 0
Romania
State/province [122] 0 0
Cluj-Napoca
Country [123] 0 0
Romania
State/province [123] 0 0
Craiova
Country [124] 0 0
Spain
State/province [124] 0 0
Avila
Country [125] 0 0
Spain
State/province [125] 0 0
Girona
Country [126] 0 0
Spain
State/province [126] 0 0
Madrid
Country [127] 0 0
Spain
State/province [127] 0 0
Ourense
Country [128] 0 0
Spain
State/province [128] 0 0
Valencia
Country [129] 0 0
Sweden
State/province [129] 0 0
Stockholm
Country [130] 0 0
Switzerland
State/province [130] 0 0
Bern
Country [131] 0 0
Taiwan
State/province [131] 0 0
Changhua
Country [132] 0 0
Taiwan
State/province [132] 0 0
Kuei Shan Hsiang
Country [133] 0 0
Taiwan
State/province [133] 0 0
Liouying/Tainan
Country [134] 0 0
Taiwan
State/province [134] 0 0
Niaosung
Country [135] 0 0
Taiwan
State/province [135] 0 0
Taichung
Country [136] 0 0
Taiwan
State/province [136] 0 0
Tainan
Country [137] 0 0
Taiwan
State/province [137] 0 0
Taipei
Country [138] 0 0
Thailand
State/province [138] 0 0
Bangkok
Country [139] 0 0
Thailand
State/province [139] 0 0
Hat Yai

Funding & Sponsors
Primary sponsor type
Commercial sector/industry
Name
Eli Lilly and Company
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/GMT - 5 hours, EST)
Address 0 0
Eli Lilly and Company
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
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 are available at https://clinicaltrials.gov/study/NCT01140347