Trial Identifiers
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Scientific Title
Paediatric Hepatic International Tumour Trial
Other Non-Commercial Sponsor
University of Birmingham
Summary
This trial has several arms (groups), and participants will be allocated based on their diagnosis. Group A will consist of participants with Very Low Risk Hepatoblastoma (HB), and they will receive 2 cycles of Cisplatin (2x100mg/m2). Group B will consist of participants with Low Risk HB. Participants who are have their tumours removed with surgery after 2 cycles of Cisplatin will be randomised to receive 4 or 6 cycles of Cisplatin overall (80mg/m2). Participants who do not undergo surgery will continue to receive up to 6 cycles of Cisplatin (80mg/m2) until surgery. Group C will consist of participants with Intermediate Risk HB. Participants will be randomised to receive Cisplatin (80mg/m2), Carboplatin (500mg/m2) and Doxorubicin (60mg/m2) as SIOPEL-3HR (5 cycles), Cisplatin (100mg/m2), Doxorubicin (60mg/m2) 5-Fluorouracil (600mg/m2) and Vincristine (4.5mg/m2) as C5VD (6 cycles), or 6 cycles of high dose Cisplatin (100mg/m2). Group D will consist of participants with High Risk HB. Participants will receive SIOPEL-4 regimen (Cisplatin 70mg/m2, Doxorubicin 30mg/m2) then have surgery. Post surgery, patients with remaining metastases will be randomised to receive 6 cycles of either Carboplatin (500mg/m2) and Doxorubicin (40mg/m2) alternating with Carboplatin (800mg/m2) and Etoposide (400mg/m2), or Carboplatin (500mg/m2) and Doxorubicin (40mg/m2) alternating with Vincristine (3mg/m2) and Irinotecan (250mg/m2). Patients with no metastases will receive the standard treatment of 3 cycles of Carboplatin (500mg/m2) and Doxorubicin (40mg/m2). Group E will consist of those with Hepatocellular Carcinoma (HCC) that has been removed in surgery. Patients with an underlying predisposition to HCC through genetic, viral or metabolic conditions will be followed up (no intervention). De novo or fibrolamellar HCC patients will receive 4 cycles of PLADO regimen (Cisplatin (80mg/m2) and Doxorubicin (60mg/m2)) over 4 cycles. Group F will consist of those with HCC that has not been removed in surgery. Participants will be randomised to receive up to 6 cycles of PLADO (Cisplatin 80mg/m2, Doxorubicin 60mg/m2) with Sorafenib (300mg/m2) or up to 8 cycles of PLADO with Sorafenib and GEMOX (Gemcitabine 1000mg/m2, Oxaliplatin 100mg/m2) with Sorafenib (300mg/m2)