Study of Cabozantinib in Combination With Atezolizumab Versus Sorafenib in Subjects With Advanced HCC Who Have Not Received Previous Systemic Anticancer Therapy (COSMIC-312)

  • STATUS
    Recruiting
  • End date
    Dec 1, 2023
  • participants needed
    740
  • sponsor
    Exelixis
Updated on 29 May 2022
liver cancer
cancer
measurable disease
cabozantinib
TACE
sorafenib
ablation therapy
atezolizumab

Summary

This Phase 3 study evaluates the safety and efficacy of cabozantinib in combination with atezolizumab versus the standard of care sorafenib in adults with advanced hepatocellular carcinoma (HCC) who have not received previous systemic anticancer therapy. A single-agent cabozantinib arm will be enrolled in which subjects receive single agent cabozantinib in order to determine its contribution to the overall safety and efficacy of the combination with atezolizumab.

Description

This is a multicenter, randomized, open-label, controlled Phase 3 trial of cabozantinib in combination with atezolizumab versus sorafenib in adults with advanced HCC who have not received previous systemic anticancer therapy in the advanced HCC setting. The primary objective of this study is to evaluate the effect of cabozantinib in combination with atezolizumab on the duration of progression-free survival (PFS) and duration of overall survival (OS) versus sorafenib. The secondary objective is to evaluate the activity of single-agent cabozantinib compared with sorafenib in this patient population.

Details
Condition Hepatocellular Carcinoma
Treatment Sorafenib, Cabozantinib, Atezolizumab
Clinical Study IdentifierNCT03755791
SponsorExelixis
Last Modified on29 May 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Histological or cytological diagnosis of HCC or clinical diagnosis of HCC in cirrhotic patients by CT or MRI per the AASLD 2018 or EASL 2018 guidelines
The subject has disease that is not amenable to a curative treatment approach (eg, transplant, surgery, ablation therapy) or locoregional therapy (eg, TACE)
Measurable disease per RECIST 1.1 as determined by the Investigator
Barcelona Clinic Liver Cancer (BCLC) stage Category B or C
Child-Pugh Score of A
Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

Exclusion Criteria

Known fibrolamellar carcinoma, sarcomatoid HCC or mixed hepatocellular cholangiocarcinoma
Prior systemic anticancer therapy for advanced HCC including but not limited to chemotherapy, small molecule kinase inhibitors, and immune checkpoint inhibitors (ICIs). Subjects who have received local intratumoral or arterial chemotherapy are eligible; local anticancer therapy must be completed ≥ 28 days before randomization
Radiation therapy for bone metastasis within 2 weeks, any other radiation therapy within 8 weeks prior to randomization
Known brain metastases or cranial epidural disease unless adequately treated with radiotherapy and/or surgery (including radiosurgery) and stable for at least 8 weeks prior to randomization
Concomitant anticoagulation with oral anticoagulants
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