Inclusion Criteria
Criteria:
- WBC >= 3,000/mm^3
- LVEF normal
- Histologically or cytologically confirmed hepatocellular carcinoma; Advanced disease,
unresectable disease, no Childs C criteria
- Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm by
conventional techniques or >= 10 mm by spiral CT scan
- Not a candidate for percutaneous ethanol injection or radiofrequency ablation (RFA)
- Prior transarterial chemoembolization, ethanol, and RFA allowed if new lesions are
present in the liver and there are no other sites of disease
- No pleural effusion or ascites requiring paracentesis within the past 4 weeks
- No known brain metastases
- ECOG performance status (PS) 0-1 OR Karnofsky PS 70-100%
- Life expectancy > 3 months
- Absolute neutrophil count >= 1,500/mm^3
- Platelet count >= 75,000/mm^3
- Bilirubin =< 2 times upper limit of normal (ULN)
- AST and ALT =<2.5 times ULN (5 times ULN if liver involvement by tumor)
- Creatinine =< 2 times ULN
- PT =< 1.5 times ULN (no anticoagulation)
- Albumin >= 2.5 mg/dL
- No history of allergic reactions attributed to compounds of similar chemical or
biological composition to dasatinib
- No evidence of encephalopathy
- No condition that would preclude ability to swallow and retain dasatinib tablets,
including any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral
medication;
- Requirement for IV alimentation;
- Prior surgical procedures affecting absorption:
- Active peptic ulcer disease
- No clinically significant ECG abnormalities
- No clinically significant cardiovascular disease, including any of the following:
- Myocardial infarction or ventricular tachyarrhythmia within the past 6 months;
- Prolonged QTc >= 480 msec (Fridericia correction);
- Major conduction abnormality (unless cardiac pacemaker is present)
- No other uncontrolled illness, including, but not limited to, any of the following:
- Ongoing or active infection;
- History of significant bleeding disorder, including congenital (von Willebrand's
disease) or acquired disorders (antifactor VIII antibodies);
- Psychiatric illness or social situation that would preclude study compliance
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Recovered from all prior therapy
- One prior systemic chemotherapy regimen allowed
- Prior cryosurgery allowed
- More than 4 weeks since prior transarterial chemoembolization
- More than 4 weeks since prior radiotherapy
- Prior or concurrent localized palliative radiotherapy (i.e., bony metastasis) allowed
provided it was administered for =< 3 days
- At least 7 days since prior and no concurrent antithrombotic and/or antiplatelet
agents (e.g., warfarin, heparin, low molecular weight heparin, acetylsalicylic acid,
and/or ibuprofen)
- At least 7 days since prior and no concurrent agents with proarrhythmic potential
- At least 7 days since prior and no concurrent medications or substances that are
potent inhibitors or inducers of CYP3A4
- No concurrent combination antiretroviral therapy for HIV-positive patients
- No concurrent embolization or chemoembolization
- No concurrent systemic antacids (H2 receptor antagonists or proton pump inhibitors)
- Locally active antacids allowed provided they are held for 2 hours before and 2 hours
after dasatinib dose
- No other concurrent investigational agents
- No other concurrent anticancer agents or therapies