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Combination Chemotherapy in Treating Patients With Stage III or Stage IV Ovarian Epithelial Cancer or Primary Peritoneal Cancer

Primary Purpose

Primary Peritoneal Carcinoma, Stage III Ovarian Cancer, Stage IV Ovarian Cancer

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Paclitaxel
Carboplatin
Gemcitabine Hydrochloride
Pegylated Liposomal Doxorubicin Hydrochloride
Topotecan Hydrochloride
Therapeutic Conventional Surgery
Sponsored by
Gynecologic Oncology Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Peritoneal Carcinoma

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Histologically confirmed stage III or IV ovarian epithelial or serous primaryperitoneal carcinoma The following are ineligible: Germ cell tumors Sex cord-stromal tumors Carcinosarcomas Mixed Mullerian tumors or carcinosarcomas Metastatic carcinomas from other sites to theovary Low malignant potential tumors, including micropapillary serouscarcinomas Mucinous primary peritoneal carcinoma Prior ovarian low malignant potential tumor (borderline carcinoma) that was surgically resected with subsequent development of invasive adenocarcinoma allowed if no prior chemotherapy Optimal (no greater than 1 cm) or suboptimal residual disease after initial surgery Prior breast cancer allowed provided the following are true: Disease-free for more than 5 years No prior cytotoxic chemotherapy for breast cancer Prior or concurrent primary endometrial cancer allowed if the following conditions are met: Stage no greater than IB Less than 3 mm invasion without vascular or lymphatic invasion No poorly differentiated subtypes, including papillary serous, clear cell, or other FIGO grade 3 lesions Performance status - GOG 0-2 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST no greater than 2.5 times ULN Alkaline phosphatase no greater than 2.5 times ULN No acute hepatitis Creatinine no greater than 1.5 times ULN No unstable angina No myocardial infarction within the past 6 months No evidence of abnormal cardiac conduction (e.g., bundle branch block, heart block) unless stable for the past 6 months Not pregnant or nursing Fertile patients must use effective contraception No greater than grade 1 sensory or motor neuropathy No active infection that requires antibiotics No other invasive malignancy within the past 5 years except nonmelanoma skin cancer No severe or ongoing gastrointestinal bleeding that requires blood product support See Disease Characteristics Prior chemotherapy for cancer involving the abdominal cavity or pelvis allowed provided the following are true: More than 3 years since prior therapy No evidence of recurrent disease No prior radiotherapy to any portion of the abdominal cavity or pelvis Prior radiotherapy for localized breast, head and neck, or skin cancer allowed provided the following are true: More than 3 years since prior therapy No evidence of recurrent disease See Disease Characteristics No more than 12 weeks since prior surgical resection

Sites / Locations

  • Gynecologic Oncology Group

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Experimental

Experimental

Experimental

Experimental

Arm Label

Arm I

Arm II

Arm III

Arm IV

Arm V

Arm Description

Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment continues every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.

Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1 and gemcitabine IV over 30 minutes on days 1 and 8.

Patients receive chemotherapy as in arm I during courses 1-8 and doxorubicin HCl liposome IV over 1 hour on day 1 during courses 1, 3, 5, and 7. Treatment continues as in arm I.

Patients receive topotecan IV over 30 minutes on days 1-3 and carboplatin IV over 30 minutes on day 3. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy.

Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 8. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy. Patients with initial unresectable or suboptimal residual disease (more than 1 cm) may undergo interval cytoreductive surgery between courses 4 and 5 of chemotherapy.

Outcomes

Primary Outcome Measures

Overall Survival
Proportion of participants whose overall survival exceeded 5 years.
Progression-free Survival
Median duration in months of progression free survival.

Secondary Outcome Measures

Number of Participants With Observed Adverse Effects (Grade 3 and Above) Assessed by Common Toxicity Criteria Version 2.0

Full Information

First Posted
March 3, 2001
Last Updated
April 3, 2019
Sponsor
Gynecologic Oncology Group
Collaborators
SWOG Cancer Research Network, Medical Research Council, National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00011986
Brief Title
Combination Chemotherapy in Treating Patients With Stage III or Stage IV Ovarian Epithelial Cancer or Primary Peritoneal Cancer
Official Title
A Phase III Randomized Trial Of Paclitaxel And Carboplatin Versus Triplet Or Sequential Doublet Combinations In Patients With Epithelial Ovarian Or Primary Peritoneal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
January 2001 (undefined)
Primary Completion Date
March 2010 (Actual)
Study Completion Date
January 28, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Gynecologic Oncology Group
Collaborators
SWOG Cancer Research Network, Medical Research Council, National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which combination chemotherapy regimen is most effective in treating ovarian epithelial cancer and peritoneal cancer. Randomized phase III trial to compare the effectiveness of various combination chemotherapy regimens in treating patients who have stage III or stage IV ovarian cancer or primary peritoneal cancer.
Detailed Description
OBJECTIVES: Compare the efficacy of paclitaxel and carboplatin with or without gemcitabine, doxorubicin HCl liposome, or topotecan, in terms of overall and progression-free survival, in patients with stage III or IV ovarian epithelial or serous primary peritoneal carcinoma. Determine the response rate in patients with measurable disease treated with these regimens. Compare the toxic effects of these regimens in these patients. Compare the complications in patients treated with these regimens. Determine the dose-intensity and cumulative dose delivery for these regimens in these patients. OUTLINE: This is a randomized, multicenter study. Patients are stratified into 1 of 3 strata according to extent of residual disease and plans for interval cytoreductive surgery: Stratum A: Optimal (microscopic or macroscopic) residual disease without plans for surgery Stratum B: Suboptimal residual disease without plans for surgery Stratum C: Suboptimal residual disease with plans for surgeryPatients are randomized to 1 of 5 treatment arms. Arm I: Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment continues every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity. Arm II: Patients receive chemotherapy as in arm I and gemcitabine IV over 30 minutes on days 1 and 8. Treatment continues as in arm I. Arm III: Patients receive chemotherapy as in arm I during courses 1-8 and doxorubicin HCl liposome IV over 1 hour on day 1 during courses 1, 3, 5, and 7. Treatment continues as in arm I. Arm IV: Patients receive topotecan IV over 30 minutes on days 1-3 and carboplatin IV over 30 minutes on day 3. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy. Arm V: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 8. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy. Patients with initial unresectable or suboptimal residual disease (more than 1 cm) may undergo interval cytoreductive surgery between courses 4 and 5 of chemotherapy. Patients are followed every 3 months for 2 years and then every 6 months. PROJECTED ACCRUAL: Approximately 4,000-5,000 patients (800-1,000 per treatment arm) will be accrued for this study within 3.5-5 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Peritoneal Carcinoma, Stage III Ovarian Cancer, Stage IV Ovarian Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
4312 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Active Comparator
Arm Description
Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment continues every 3 weeks for 8 courses in the absence of disease progression or unacceptable toxicity.
Arm Title
Arm II
Arm Type
Experimental
Arm Description
Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1 and gemcitabine IV over 30 minutes on days 1 and 8.
Arm Title
Arm III
Arm Type
Experimental
Arm Description
Patients receive chemotherapy as in arm I during courses 1-8 and doxorubicin HCl liposome IV over 1 hour on day 1 during courses 1, 3, 5, and 7. Treatment continues as in arm I.
Arm Title
Arm IV
Arm Type
Experimental
Arm Description
Patients receive topotecan IV over 30 minutes on days 1-3 and carboplatin IV over 30 minutes on day 3. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy.
Arm Title
Arm V
Arm Type
Experimental
Arm Description
Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 8. Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I chemotherapy. Patients with initial unresectable or suboptimal residual disease (more than 1 cm) may undergo interval cytoreductive surgery between courses 4 and 5 of chemotherapy.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Anzatax, TAX
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Gemcitabine Hydrochloride
Other Intervention Name(s)
dFdC, dFdCyd
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
Pegylated Liposomal Doxorubicin Hydrochloride
Other Intervention Name(s)
doxorubicin HCl liposome, TLC D-99
Intervention Type
Drug
Intervention Name(s)
Topotecan Hydrochloride
Other Intervention Name(s)
Hycamtin, SKF S-104864-A, TOPO
Intervention Description
Given IV
Intervention Type
Procedure
Intervention Name(s)
Therapeutic Conventional Surgery
Intervention Description
Undergo surgery
Primary Outcome Measure Information:
Title
Overall Survival
Description
Proportion of participants whose overall survival exceeded 5 years.
Time Frame
Up to 9 years
Title
Progression-free Survival
Description
Median duration in months of progression free survival.
Time Frame
From the date of enrollment to first progression or death or last contact, if alive and progression free.
Secondary Outcome Measure Information:
Title
Number of Participants With Observed Adverse Effects (Grade 3 and Above) Assessed by Common Toxicity Criteria Version 2.0
Time Frame
Up to 9 years

10. Eligibility

Sex
Female
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed stage III or IV ovarian epithelial or serous primaryperitoneal carcinoma The following are ineligible: Germ cell tumors Sex cord-stromal tumors Carcinosarcomas Mixed Mullerian tumors or carcinosarcomas Metastatic carcinomas from other sites to theovary Low malignant potential tumors, including micropapillary serouscarcinomas Mucinous primary peritoneal carcinoma Prior ovarian low malignant potential tumor (borderline carcinoma) that was surgically resected with subsequent development of invasive adenocarcinoma allowed if no prior chemotherapy Optimal (no greater than 1 cm) or suboptimal residual disease after initial surgery Prior breast cancer allowed provided the following are true: Disease-free for more than 5 years No prior cytotoxic chemotherapy for breast cancer Prior or concurrent primary endometrial cancer allowed if the following conditions are met: Stage no greater than IB Less than 3 mm invasion without vascular or lymphatic invasion No poorly differentiated subtypes, including papillary serous, clear cell, or other FIGO grade 3 lesions Performance status - GOG 0-2 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Bilirubin no greater than 1.5 times upper limit of normal (ULN) AST no greater than 2.5 times ULN Alkaline phosphatase no greater than 2.5 times ULN No acute hepatitis Creatinine no greater than 1.5 times ULN No unstable angina No myocardial infarction within the past 6 months No evidence of abnormal cardiac conduction (e.g., bundle branch block, heart block) unless stable for the past 6 months Not pregnant or nursing Fertile patients must use effective contraception No greater than grade 1 sensory or motor neuropathy No active infection that requires antibiotics No other invasive malignancy within the past 5 years except nonmelanoma skin cancer No severe or ongoing gastrointestinal bleeding that requires blood product support See Disease Characteristics Prior chemotherapy for cancer involving the abdominal cavity or pelvis allowed provided the following are true: More than 3 years since prior therapy No evidence of recurrent disease No prior radiotherapy to any portion of the abdominal cavity or pelvis Prior radiotherapy for localized breast, head and neck, or skin cancer allowed provided the following are true: More than 3 years since prior therapy No evidence of recurrent disease See Disease Characteristics No more than 12 weeks since prior surgical resection
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Bookman
Organizational Affiliation
Gynecologic Oncology Group
Official's Role
Principal Investigator
Facility Information:
Facility Name
Gynecologic Oncology Group
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19103
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
30633128
Citation
Rose PG, Java JJ, Salani R, Geller MA, Secord AA, Tewari KS, Bender DP, Mutch DG, Friedlander ML, Van Le L, Method MW, Hamilton CA, Lee RB, Wenham RM, Guntupalli SR, Markman M, Muggia FM, Armstrong DK, Bookman MA, Burger RA, Copeland LJ. Nomogram for Predicting Individual Survival After Recurrence of Advanced-Stage, High-Grade Ovarian Carcinoma. Obstet Gynecol. 2019 Feb;133(2):245-254. doi: 10.1097/AOG.0000000000003086. Erratum In: Obstet Gynecol. 2019 Apr;133(4):830.
Results Reference
derived
PubMed Identifier
24779680
Citation
Han MK, Tayob N, Murray S, Dransfield MT, Washko G, Scanlon PD, Criner GJ, Casaburi R, Connett J, Lazarus SC, Albert R, Woodruff P, Martinez FJ. Predictors of chronic obstructive pulmonary disease exacerbation reduction in response to daily azithromycin therapy. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1503-8. doi: 10.1164/rccm.201402-0207OC.
Results Reference
derived
PubMed Identifier
23969788
Citation
Nickles Fader A, Java J, Ueda S, Bristow RE, Armstrong DK, Bookman MA, Gershenson DM; Gynecologic Oncology Group (GOG)*. Survival in women with grade 1 serous ovarian carcinoma. Obstet Gynecol. 2013 Aug;122(2 Pt 1):225-232. doi: 10.1097/AOG.0b013e31829ce7ec.
Results Reference
derived

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Combination Chemotherapy in Treating Patients With Stage III or Stage IV Ovarian Epithelial Cancer or Primary Peritoneal Cancer

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