Table 1.
Interventions and Assessments | Sorafenib group: initiate treatment weeks 1-4; continue therapy weeks ≥5 | TAREa+sorafenib group | Follow-up every 8 weeks ±14 daysc (for both groups) | ||||
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First workup and TARE treatment: Weeks 1-4 | Second workup and TARE treatment for patients with bilobar disease: Weeks 5-8 | Sorafenib treatment: initiate and continue sorafenib treatment >2 to <6 weeks after TARE | Workup and retreatmentb for patients with hepatic progression | ||
Interventions | |||||||
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Administer sorafenibd | ✓ |
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✓ | ✓c |
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Calculate liver volume and mass |
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✓ |
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✓ |
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Hepatic angiogram, 99mTc-MAA scanf, calculate TARE dose, administer TAREg |
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✓ | ✓ |
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✓ |
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Assessments | |||||||
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ECOGh Performance Status |
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✓ | ✓ |
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✓ | ✓i |
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Hematologyj, coagulationk, chemistry panel, liver function tests | ✓l | ✓l |
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✓ | ✓m |
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Tumor markers for hepatocellular carcinoma (alpha-fetoprotein) | ✓ | ✓ |
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✓m |
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Triple-phase MRIn/spiral CTo abdomen, Child-Pugh score, spiral CT chest and pelvis, quality-of-life questionnaire |
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|
|
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✓m |
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Assess and report adverse events, review and record concurrent medication | ✓ | ✓ | ✓ |
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✓ | ✓m |
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Final end point, efficacy and safety documentation, and exit patient |
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✓i |
aTARE: transarterial radioembolization.
bAdditional TARE workup and administration in lesions amenable to further TARE.
cThe follow-up visits should be scheduled from the day of randomization. A window of ±14 days is permissible from the scheduled date.
dAccording to package insert at weeks 1-4 for sorafenib group patients and after all initial TARE administrations for TARE+sorafenib group patients only.
eSorafenib to be stopped 7 days before subsequent TARE administration in disease progression and restarted 2 weeks after TARE is administered.
f99mTc-MAA scan: technetium-99m macroaggregated albumin.
gAdditional TARE may be administered only after progression if lesions are amenable to treatment.
hECOG: Eastern Cooperative Oncology Group.
iBoth before and after progression of disease resulting in termination of further treatment.
jHematology tests: white blood cells, hemoglobin, hematocrit, and platelets.
kCoagulation tests: prothrombin time, partial thromboplastin time, and international normalized ratio for prothrombin time.
lIf treatment commences within 14 days of randomization, the clinical laboratory assessments are not required to be repeated.
mPrior to progression of disease resulting in termination of further treatment.
nMRI: magnetic resonance imaging.
oCT: computed tomography.