研究疾病:
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肝癌
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研究疾病代码:
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Target disease:
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Liver cancer
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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单臂
Single arm
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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观察和评价健脾消积方颗粒剂治疗晚期原发性肝癌的有效性和安全性;探讨中药健脾消积方通过调节肠道菌群发挥抗癌作用和机制及中药对肝癌患者代谢组学的影响。
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Objectives of Study:
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To observe and evaluate the efficacy and safety of Jianpi Xiaoji Recipe in the treatment of advanced primary liver cancer; to explore the anti-cancer effect and mechanism of Chinese medicine Jianpi Xiaoji Recipe by regulating intestinal flora and Chinese medicine for metabolomics of liver cancer patients impact.
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药物成份或治疗方案详述:
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Description for medicine or protocol of treatment in detail:
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纳入标准:
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(1)年龄为18~75岁;ECOG全身状态( performance status,PS)0~2分;预计生存期不少于12周;
(2)病理学确诊或符合临床诊断的的晚期原发性肝癌(HCC),巴塞罗那原发性肝癌临床分期(BCLC) C 期,且不适合手术或局部治疗,或经过手术和/或局部治疗后进展;
(3)Child-Pugh肝功能评级:A级与较好的B级(≤7分且肝性脑病评分为1);
(4)既往经过分子靶向治疗(索拉非尼及其类似物等)或/和系统化疗(单药或联合用药)治疗失败(疾病进展或毒性不能耐受);索拉非尼类似药物包括:仑伐替尼、索拉非尼氘代物;
(5)主要器官功能正常,即符合下列标准:
1)血常规检查标准需符合:
a)ANC≥1.5×10^9/L;
b) Hb≥90g/L;
c) PLT≥90×10^9/L;
(14天内未输血及血制品,未使用G-CSF及其他造血刺激因子)
2)生化检査需符合以下标准:
a) TBIL<3×ULN;
b)ALT和AST<5×ULN;
c)BUN和Cr≤1×ULN或内生肌酐清除率≥5Oml/min( Cockcroft-Gault公式);
(6)育龄妇女必须已经采取可靠的避孕措施或在入组前7天内进行妊娠试验(血清或尿液),且结果为阴性,并且愿意在试验期间和末次给予试验药物后8周采用适当的方法避孕。对于男性,须同意在试验期间和末次给予试验药物后8周采用适当的方法避孕或已手术绝育;
(7)受试者自愿加入本研究,并签署知情同意书,依从性好,配合随访。
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Inclusion criteria
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(1) The age is 18 to 75 years old; the ECOG system status (PS) is 0 to 2 points; the expected survival period is not less than 12 weeks;
(2) Pathologically confirmed or clinically diagnosed advanced primary liver cancer (HCC), Barcelona primary liver cancer clinical stage (BCLC) C, and not suitable for surgery or local treatment, or after surgery and / or local treatment;
(3) Child-Pugh liver function rating: grade A and better grade B (<= 7 points and hepatic encephalopathy score of 1);
(4) Previous treatment with molecular targeted therapy (sorafenib and its analogs, etc.) or/and systemic chemotherapy (single or combined) failed (disease progression or toxicity intolerance); sorafenib-like drugs include: Vatinib, sorafenib, surrogate;
(5) The main organs function normally, that is, they meet the following criteria:
1) Blood routine examination standards must meet:
a) ANC >= 1.5 x 10^9 / L;
b) Hb >= 90g/L;
c) PLT >= 90 x 10^9 / L;
(No blood transfusion and blood products within 14 days, no G-CSF and other hematopoietic stimulating factors).
2) Biochemical examinations must meet the following criteria:
a) TBIL<3 x ULN;
b) ALT and AST < 5 x ULN;
c) BUN and Cr <= 1 x ULN or endogenous creatinine clearance >= 5Oml / min (Cockcroft-Gault formula);
(6) Women of childbearing age must have taken reliable contraceptive measures or performed a pregnancy test (serum or urine) within 7 days prior to enrollment and the results were negative, and were willing to use appropriate methods of contraception during the trial and 8 weeks after the last administration of the test drug. For men, consent must be given to the appropriate method of contraception or surgical sterilization during the trial and 8 weeks after the last administration of the test drug;
(7) Subjects voluntarily joined the study and signed informed consent, with good adherence and follow-up.
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排除标准:
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(1)已知为肝胆管细胞癌或混合细胞癌或纤维板层细胞癌;目前或既往患有其他恶性肿瘤(经充分治疗的皮肤基底细胞癌或鳞状细胞癌、宫颈原位癌除外),经根治性治疗且有近?5?年内无复发转移的证据的除外;
(2)有症状的中枢神经系统或软脑膜转移(入组前21天已完成治疗且症状稳定的脑转移患者可以入组,但需经颅脑MRI、CT或静脉造影评价确认为无脑出血症状);
(3)归因于任何先前治疗的毒性尚未恢复,仍有1级以上(CTCAE 5.0分级)的毒性反应(任何级别的脱发除外);
(4)既往肝移植史或准备进行肝移植的患者;
(5)入组 前4 周内接受过重大外科手术或出现重度创伤性损伤、骨折或溃疡;
(6)具有明显影响口服药物吸收的因素,如无法吞咽、慢性腹泻和肠梗阻等;
(7)有临床症状、需要对症处理的浆膜腔积液(包括胸水、腹水、心包积液);
注:无症状的浆膜腔积液者可以入组,有症状的浆膜腔积液者经过积极对症处理(不能使用抗癌药物进行浆膜积液的处理),经研究者判断适合入组的患者,允许入组;
(8)活动性感染需要抗微生物治疗的(例如需采用抗菌药物、抗病毒药物,不包括慢性乙肝抗乙肝治疗药物治疗的);
(9)具有精神类药物滥用史且无法戒除者或有精神障碍的;
(10)入组前 4 周内参加过其他抗肿瘤药物临床试验的;
(11)既往或同时患有其它未治愈的恶性肿瘤,已治愈的皮肤基底细胞癌、宫颈原位癌和浅表性膀胱癌除外;
(12)怀孕或哺乳期妇女:有生育能力的患者不愿或无法采取有效的避孕措施者;
(13)研究者判断其他可能影响临床研究进行、资料和样品的收集及研究结果判定的情况。
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Exclusion criteria:
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(1) Known as hepatobiliary cell carcinoma or mixed cell carcinoma or fibrostratic cell carcinoma; currently or previously suffering from other malignant tumors (except for well-treated skin basal cell carcinoma or squamous cell carcinoma, cervical carcinoma in situ), radically Except for treatment and evidence of no recurrence of metastasis within the last 5 years;
(2) Symptomatic central nervous system or pia mater metastasis (patients with brain metastasis who have completed treatment and stable symptoms 21 days before enrollment can be enrolled, but need to be confirmed by brain MRI, CT or venography. Bleeding symptoms);
(3) Toxic effects of grade 1 or higher (CTCAE 5.0 grade) are still attributable to any previous treatment toxicity (except for any level of hair loss);
(4) Patients with a history of previous liver transplantation or who are ready for liver transplantation;
(5) Major surgery or severe traumatic injury, fracture or ulcer in the first 4 weeks of enrollment;
(6) Factors that have a significant impact on oral drug absorption, such as inability to swallow, chronic diarrhea, and intestinal obstruction;
(7) Serous effusion (including pleural effusion, ascites, pericardial effusion) with clinical symptoms and need for symptomatic treatment;
Note: Asymptomatic serous effusion can be enrolled, symptomatic serous effusion after active symptomatic treatment (can not use anticancer drugs for the treatment of serosal effusion), the researchers judged suitable for enrollment Patient, allowed to join;
(8) Active infections require anti-microbial treatment (eg antibiotics, antiviral drugs, and chronic hepatitis B anti-hepatitis B treatments);
(9) A person with a history of psychotropic substance abuse who is unable to quit or has a mental disorder;
(10) Participated in other clinical trials of anti-tumor drugs within 4 weeks before enrollment;
(11) Previous or concurrently with other unhealed malignant tumors, except for cured skin basal cell carcinoma, cervical carcinoma in situ, and superficial bladder cancer;
(12) Pregnant or lactating women: those who have fertility are unwilling or unable to take effective contraceptive measures;
(13) The investigator judges other conditions that may affect clinical research, data and sample collection, and research findings.
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研究实施时间:
Study execute time:
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从From
2020-01-01
至To
2023-01-01
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征募观察对象时间:
Recruiting time:
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从From
2020-01-01
至To
2021-01-01
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