Paclitaxel and Cisplatin or Topotecan With or Without Bevacizumab in Treating Patients With Stage IVB, Recurrent, or Persistent Cervical Cancer
Cervical Adenocarcinoma, Cervical Adenosquamous Carcinoma, Cervical Squamous Cell Carcinoma
About this trial
This is an interventional treatment trial for Cervical Adenocarcinoma
Eligibility Criteria
Inclusion Criteria:
- Patients must have primary stage IVB, recurrent or persistent squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix which is not amenable to curative treatment with surgery and/or radiation therapy
- All patients must have measurable disease; measurable disease is defined as at least one lesion that can be accurately measured in at least one dimension (longest dimension to be recorded); each lesion must be >= 20 mm when measured by conventional techniques, including palpation, plain x-ray, computed tomography (CT), and magnetic resonance imaging (MRI), or >= 10 mm when measured by spiral CT; biopsy confirmation is required if the lesion(s) measures < 30 mm or if the treating physician determines it is clinically indicated; patients must have at least one "target lesion" to be used to assess response on this protocol as defined by Response Evaluation Criteria in Solid Tumors (RECIST); this lesion should be the one that was biopsied if one was performed; tumors within a previously irradiated field will be designated as "non-target" lesions unless progression is documented or a biopsy is obtained to confirm persistence at least 90 days following completion of radiation therapy
- Absolute neutrophil count (ANC) >= 1500/mcl
- Platelets >= 100,000/mcl
- Serum creatinine =< upper limit of normal (ULN) (Common Toxicity Criteria [CTC] grade 0) or calculated creatinine clearance (Jeliffe formula) >= 60 ml/min
- Bilirubin =< 1.5 x institutional normal
- Serum glutamic oxaloacetic transaminase (SGOT) =< 2.5 x institutional normal
- Alkaline phosphatase =< 2.5 x institutional normal
- Prothrombin time (PT) such that international normalized ratio (INR) is =< 1.5 (or an in-range INR, usually between 2 and 3, if a patient is on a stable dose of therapeutic warfarin for management of venous thrombosis including pulmonary thrombo-embolus)
- Partial thromboplastin time (PTT) < 1.2 times the upper limit of normal
- Urine protein-creatinine ratio (UPC ratio) < 1.0
- Patients must have a GOG performance status of 0 or 1
- Patients must have recovered from the effects of surgery, radiation therapy, or chemoradiotherapy; at least six weeks must have elapsed from the last administration of chemoradiotherapy, and at least three weeks must have elapsed from the last administration of radiation therapy alone; at least six weeks must have elapsed from the time of any major surgical procedure prior to randomization
- Patients must have signed an approved informed consent and authorization permitting release of personal health information
- Patients must meet all of the pre-entry requirements, including baseline QOL questionnaire
- Patients must be free of active infection requiring antibiotics
Exclusion Criteria:
- Patients with bilateral hydronephrosis which cannot be alleviated by ureteral stents or percutaneous drainage
Patients previously treated with chemotherapy except when used concurrently with radiation therapy
- Patients who have received concurrent paclitaxel and/or concurrent topotecan with radiation therapy are ineligible
- Patients with craniospinal metastases
- Patients with a concomitant malignancy other than non-melanoma skin cancer
- Patients with a prior invasive malignancy (except non-melanoma skin cancer) who have had any evidence of disease within the last 5 years or whose prior malignancy treatment contraindicates the current protocol therapy
- Patients with serious non-healing wound, ulcer, or bone fracture; this includes history of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess for which an interval of 3 to 6 months must pass before study entry; in addition, the patient must have undergone correction (or spontaneous healing) of the perforation/fistula and/or the underlying process causing the fistula/perforation; patients with granulating incisions healing by secondary intention with no evidence of fascial dehiscence or infection are eligible but require weekly wound examinations
- Patients with active bleeding or pathologic conditions that carry high risk of bleeding, such as known bleeding disorder, coagulopathy, or tumor involving major vessels
- Patients with history or evidence upon physical examination of central nervous system (CNS) disease, including primary brain tumor, seizures not controlled with standard medical therapy, any brain metastases, or history of cerebrovascular accident (CVA, stroke), transient ischemic attack (TIA) or subarachnoid hemorrhage within six months of the first date of treatment on this study
Patients with clinically significant cardiovascular disease; this includes:
- Uncontrolled hypertension, defined as systolic > 150 mm Hg or diastolic > 90 mm Hg
- Myocardial infarction or unstable angina < 6 months prior to registration
- New York Heart Association (NYHA) grade II or greater congestive heart failure
- Serious cardiac arrhythmia requiring medication; this does not include asymptomatic, atrial fibrillation with controlled ventricular rate
- CTCAE grade 2 or greater peripheral vascular disease (at least brief [< 24 hours (hrs)]) episodes of ischemia managed non-surgically and without permanent deficit)
- History of CVA within six months
- Patients with known hypersensitivity to Chinese hamster ovary cell products or other recombinant human or humanized antibodies
Patients with or with anticipation of invasive procedures as defined below:
- Major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to the first date of bevacizumab therapy
- Major surgical procedure anticipated during the course of the study; this includes, but is not limited to abdominal surgery (laparotomy or laparoscopy) prior to disease progression, such as colostomy or enterostomy reversal, interval or secondary cytoreductive surgery, or second look surgery; please consult with the study chair prior to patient entry for any questions related to the classification of surgical procedures
- Core biopsy, within 7 days prior to randomization
- Patients who are pregnant or nursing; bevacizumab should not be administered to pregnant women; bevacizumab should not be administered to nursing women; patients of childbearing potential must agree to use contraceptive measures during study therapy and for at least six months after completion of bevacizumab therapy
- Patients who have received prior therapy with any anti-vascular endothelial growth factor (VEGF) drug, including bevacizumab
- Patients with clinical symptoms or signs of gastrointestinal obstruction and who require parenteral hydration and/or nutrition
- Patients with medical history or conditions not otherwise previously specified which in the opinion of the investigator should exclude participation in this study; the investigator should feel free to consult the Study Chair or Study Co-Chairs for uncertainty in this regard
- Patients with significant peripheral vascular disease
- Patients with pre-existing grade 2 or greater peripheral neuropathy
Sites / Locations
- University of Alabama at Birmingham Cancer Center
- University of South Alabama Mitchell Cancer Institute
- Saint Joseph's Hospital and Medical Center
- Highlands Oncology Group PA - Fayetteville
- Washington Regional Medical Center - Fayetteville
- University of Arkansas for Medical Sciences
- Alta Bates Summit Medical Center-Herrick Campus
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
- Roy and Patricia Disney Family Cancer Center
- Mills - Peninsula Hospitals
- John Muir Medical Center-Concord Campus
- City of Hope Comprehensive Cancer Center
- California Cancer Center - North Fresno
- Long Beach Memorial Medical Center-Todd Cancer Institute
- Kaiser Permanente Los Angeles Medical Center
- Los Angeles County-USC Medical Center
- USC / Norris Comprehensive Cancer Center
- UCLA / Jonsson Comprehensive Cancer Center
- Palo Alto Medical Foundation-Gynecologic Oncology
- Sutter Cancer Research Consortium
- Saint Joseph Hospital - Orange
- UC Irvine Health/Chao Family Comprehensive Cancer Center
- Stanford Cancer Institute
- University of California Davis Comprehensive Cancer Center
- University of California San Diego
- UCSF Medical Center-Mount Zion
- California Pacific Medical Center-Pacific Campus
- Olive View-University of California Los Angeles Medical Center
- Sutter Solano Medical Center/Cancer Center
- John Muir Medical Center-Walnut Creek
- Colorado Gynecologic Oncology Group
- The Medical Center of Aurora
- University of Colorado Cancer Center - Anschutz Cancer Pavilion
- Boulder Community Hospital
- Penrose-Saint Francis Healthcare
- Porter Adventist Hospital
- Exempla Saint Joseph Hospital
- Presbyterian - Saint Lukes Medical Center - Health One
- Rose Medical Center
- Colorado Cancer Research Program CCOP
- Rocky Mountain Gynecologic Oncology PC
- Swedish Medical Center
- Poudre Valley Hospital
- Front Range Cancer Specialists
- Saint Mary's Hospital and Regional Medical Center
- North Colorado Medical Center
- Saint Anthony Hospital
- Littleton Adventist Hospital
- Sky Ridge Medical Center
- Longmont United Hospital
- McKee Medical Center
- Parker Adventist Hospital
- Saint Mary Corwin Medical Center
- North Suburban Medical Center
- Exempla Lutheran Medical Center
- Hartford Hospital
- Saint Francis Hospital and Medical Center
- The Hospital of Central Connecticut
- Beebe Medical Center
- Christiana Care Health System-Christiana Hospital
- Washington Hospital Center
- Broward Health Medical Center
- Florida Gynecologic Oncology
- Memorial Healthcare System - Joe DiMaggio Children's Hospital
- Mayo Clinic in Florida
- Lakeland Regional Cancer Center
- Florida Hospital Orlando
- UF Cancer Center at Orlando Health
- Sarasota Memorial Hospital
- Moffitt Cancer Center
- Grady Health System
- Piedmont Hospital
- Emory University/Winship Cancer Institute
- Atlanta Regional CCOP
- Northside Hospital
- Saint Joseph's Hospital of Atlanta
- Georgia Regents University Medical Center
- Well Star Cobb Hospital
- John B Amos Cancer Center
- Dekalb Medical Center
- Piedmont Fayette Hospital
- Northeast Georgia Medical Center
- Gwinnett Medical Center
- Central Georgia Gynecologic Oncology
- Wellstar Kennestone Hospital
- Southern Regional Medical Center
- Harbin Clinic Medical Oncology and Clinical Research
- Memorial University Medical Center
- Pali Momi Medical Center
- Oncare Hawaii Inc-POB II
- Queen's Medical Center
- Straub Clinic and Hospital
- University of Hawaii Cancer Center
- Oncare Hawaii Inc-Kuakini
- The Cancer Center of Hawaii-Liliha
- Kapiolani Medical Center for Women and Children
- Wilcox Memorial Hospital and Kauai Medical Clinic
- Maui Memorial Medical Center
- Pacific Cancer Institute of Maui
- Saint Alphonsus Cancer Care Center-Boise
- Saint Joseph Medical Center
- Illinois CancerCare-Bloomington
- Graham Hospital Association
- Illinois CancerCare-Canton
- Illinois CancerCare-Carthage
- Memorial Hospital
- Mount Sinai Hospital Medical Center
- Northwestern University
- John H Stroger Jr Hospital of Cook County
- Rush University Medical Center
- Swedish Covenant Hospital
- University of Chicago Comprehensive Cancer Center
- Decatur Memorial Hospital
- Eureka Hospital
- Illinois CancerCare-Eureka
- Saint Francis Hospital
- Illinois CancerCare Galesburg
- Illinois CancerCare-Havana
- Mason District Hospital
- Sudarshan K Sharma MD Limted-Gynecologic Oncology
- Joliet Oncology-Hematology Associates Limited
- Presence Saint Mary's Hospital
- Illinois CancerCare-Kewanee Clinic
- Illinois CancerCare-Macomb
- Mcdonough District Hospital
- Loyola University Medical Center
- Holy Family Medical Center
- Illinois CancerCare-Monmouth
- Bromenn Regional Medical Center
- Community Cancer Center Foundation
- Illinois CancerCare-Community Cancer Center
- Advocate Christ Medical Center
- Illinois CancerCare-Ottawa Clinic
- Ottawa Regional Hospital and Healthcare Center
- Advocate Lutheran General Hospital.
- Illinois CancerCare-Pekin
- Pekin Cancer Treatment Center
- Methodist Medical Center of Illinois
- Proctor Hospital
- Illinois CancerCare-Peoria
- Illinois Oncology Research Association CCOP
- OSF Saint Francis Medical Center
- Illinois CancerCare-Peru
- Illinois Valley Hospital
- Illinois CancerCare-Princeton
- Perry Memorial Hospital
- Illinois CancerCare-Spring Valley
- Memorial Medical Center
- Cadence Cancer Center in Warrenville
- Saint Francis Hospital and Health Centers
- Elkhart Clinic
- Michiana Hematology Oncology PC-Elkhart
- Elkhart General Hospital
- Fort Wayne Medical Oncology and Hematology Inc-Parkview
- Indiana University/Melvin and Bren Simon Cancer Center
- Franciscan Saint Francis Health-Indianapolis
- Gynecologic Oncology of Indiana
- Saint Vincent Hospital and Health Services
- Saint Vincent Oncology Center
- Community Howard Regional Health
- IU Health La Porte Hospital
- Michiana Hematology Oncology PC-Mishawaka
- Saint Joseph Regional Medical Center-Mishawaka
- The Community Hospital
- Michiana Hematology Oncology PC-Plymouth
- Reid Hospital and Health Care Services
- Memorial Hospital of South Bend
- Michiana Hematology Oncology PC-South Bend
- South Bend Clinic
- Northern Indiana Cancer Research Consortium CCOP
- Michiana Hematology Oncology-PC Westville
- McFarland Clinic PC-William R Bliss Cancer Center
- Medical Oncology and Hematology Associates-West Des Moines
- Mercy Capitol
- Iowa Methodist Medical Center
- Iowa Oncology Research Association CCOP
- Medical Oncology and Hematology Associates-Des Moines
- Medical Oncology and Hematology Associates-Laurel
- Mercy Medical Center - Des Moines
- Iowa Lutheran Hospital
- University of Iowa/Holden Comprehensive Cancer Center
- Mercy Medical Center-Sioux City
- Saint Luke's Regional Medical Center
- Hospital District Sixth of Harper County
- Cancer Center of Kansas - Chanute
- Cancer Center of Kansas - Dodge City
- Cancer Center of Kansas - El Dorado
- Cancer Center of Kansas - Fort Scott
- Cancer Center of Kansas-Independence
- University of Kansas Cancer Center
- Cancer Center of Kansas-Kingman
- Lawrence Memorial Hospital
- Cancer Center of Kansas-Liberal
- Cancer Center of Kansas - McPherson
- Cancer Center of Kansas - Newton
- Menorah Medical Center
- Saint Luke's South Hospital
- Cancer Center of Kansas - Parsons
- Kansas City CCOP
- Cancer Center of Kansas - Pratt
- Cancer Center of Kansas - Salina
- Shawnee Mission Medical Center
- Cancer Center of Kansas - Wellington
- Associates In Womens Health
- Cancer Center of Kansas-Wichita Medical Arts Tower
- Cancer Center of Kansas - Main Office
- Via Christi Regional Medical Center
- Wichita CCOP
- Cancer Center of Kansas - Winfield
- Saint Elizabeth Medical Center South
- Baptist Health Lexington
- University of Kentucky/Markey Cancer Center
- Norton Hospital Pavilion and Medical Campus
- Doctors Carrol, Sheth, Raghavan
- Pikeville Medical Center
- Hematology/Oncology Clinic LLP
- Woman's Hospital
- Tulane University Health Sciences Center
- Ochsner Medical Center Jefferson
- Louisiana State University Health Sciences Center Shreveport
- Highland Clinic
- Maine Medical Center-Bramhall Campus
- University of Maryland/Greenebaum Cancer Center
- Greater Baltimore Medical Center
- Sinai Hospital of Baltimore
- Franklin Square Hospital Center
- Union Hospital of Cecil County
- Tufts Medical Center
- Massachusetts General Hospital Cancer Center
- Brigham and Women's Hospital
- Dana-Farber Cancer Institute
- Baystate Medical Center
- University of Massachusetts Memorial Health Care
- Saint Joseph Mercy Hospital
- Michigan Cancer Research Consortium CCOP
- Bronson Battle Creek
- Spectrum Health Big Rapids Hospital
- Oakwood Hospital and Medical Center
- Wayne State University/Karmanos Cancer Institute
- Henry Ford Hospital
- Saint John Hospital and Medical Center
- Green Bay Oncology - Escanaba
- Hurley Medical Center
- Genesys Regional Medical Center-West Flint Campus
- Grand Rapids Clinical Oncology Program
- Mercy Health Saint Mary's
- Spectrum Health at Butterworth Campus
- Green Bay Oncology - Iron Mountain
- Allegiance Health
- Borgess Medical Center
- Bronson Methodist Hospital
- West Michigan Cancer Center
- Sparrow Hospital
- Saint Mary Mercy Hospital
- Mid-Michigan Medical Center - Midland
- Mercy Health Mercy Campus
- Michiana Hematology Oncology PC-Niles
- Saint Joseph Mercy Oakland
- Saint Joseph Mercy Port Huron
- William Beaumont Hospital-Royal Oak
- Saint Mary's of Michigan
- Lakeland Hospital
- Marie Yeager Cancer Center
- Providence Hospital
- Munson Medical Center
- Saint John Macomb-Oakland Hospital
- Metro Health Hospital
- Fairview Ridges Hospital
- Mercy Hospital
- Fairview-Southdale Hospital
- Unity Hospital
- Hutchinson Area Health Care
- Minnesota Oncology Hematology PA-Maplewood
- Saint John's Hospital - Healtheast
- Abbott-Northwestern Hospital
- Hennepin County Medical Center
- University of Minnesota Medical Center-Fairview
- North Memorial Medical Health Center
- Mayo Clinic
- Metro-Minnesota NCI Community Oncology Research Program
- Park Nicollet Clinic - Saint Louis Park
- Regions Hospital
- United Hospital
- Saint Francis Regional Medical Center
- Lakeview Hospital
- Ridgeview Medical Center
- Rice Memorial Hospital
- Minnesota Oncology and Hematology PA-Woodbury
- University of Mississippi Medical Center
- Singing River Hospital
- Truman Medical Center
- Saint Luke's Cancer Institute
- Saint Luke's Hospital of Kansas City
- Saint Joseph Health Center
- North Kansas City Hospital
- Heartland Hematology and Oncology Associates Incorporated
- Research Medical Center
- Saint Luke's East - Lee's Summit
- Liberty Hospital
- Liberty Radiation Oncology Center
- Phelps County Regional Medical Center
- Heartland Regional Medical Center
- Saint Joseph Oncology Inc
- Saint Louis University Hospital
- Mercy Hospital Springfield
- Ozark Health Ventures LLC-Cancer Research for The Ozarks Springfield
- CoxHealth South Hospital
- Montana Cancer Consortium CCOP
- Northern Rockies Radiation Oncology Center
- Saint Vincent Healthcare
- Frontier Cancer Center and Blood Institute-Billings
- Billings Clinic Cancer Center
- Bozeman Deaconess Cancer Center
- Bozeman Deaconess Hospital
- Saint James Community Hospital and Cancer Treatment Center
- Benefis Healthcare- Sletten Cancer Institute
- Berdeaux, Donald MD (UIA Investigator)
- Great Falls Clinic
- Northern Montana Hospital
- Saint Peter's Community Hospital
- Glacier Oncology PLLC
- Kalispell Medical Oncology
- Kalispell Regional Medical Center
- Community Medical Hospital
- Montana Cancer Specialists
- Saint Patrick Hospital - Community Hospital
- Guardian Oncology and Center for Wellness
- Nebraska Methodist Hospital
- University of Nebraska Medical Center
- Women's Cancer Center of Nevada
- Center of Hope at Renown Medical Center
- Renown Regional Medical Center
- Dartmouth Hitchcock Medical Center
- Cooper Hospital University Medical Center
- Morristown Memorial Hospital
- Fox Chase Cancer Center at Virtua Memorial Hospital of Burlington County
- Jersey Shore Medical Center
- Rutgers Cancer Institute of New Jersey
- UMDNJ - New Jersey Medical School
- The Women's Institute for Gynecologic Cancer and Special Pelvic Surgery
- Valley Hospital
- Overlook Hospital
- Inspira Medical Center Vineland
- Virtua West Jersey Hospital Voorhees
- Southwest Gynecologic Oncology Associates Inc
- University of New Mexico Cancer Center
- Women's Cancer Care Associates LLC
- Island Gynecologic Oncology
- Montefiore Medical Center-Einstein Campus
- State University of New York Downstate Medical Center
- Queens Hospital Center
- North Shore University Hospital
- North Shore-LIJ Health System CCOP
- Orange Regional Medical Center
- Long Island Jewish Medical Center
- North Shore-LIJ Health System/Center for Advanced Medicine
- Beth Israel Medical Center
- New York University Langone Medical Center
- Saint Luke's Roosevelt Hospital Center - Saint Luke's Division
- Columbia University Medical Center
- Memorial Sloan-Kettering Cancer Center
- Weill Medical College of Cornell University
- Stony Brook University Medical Center
- State University of New York Upstate Medical University
- Randolph Hospital
- Hope Women's Cancer Centers-Asheville
- Cone Health Cancer Center at Alamance Regional
- University of North Carolina at Chapel Hill
- Carolinas Medical Center
- Novant Health Presbyterian Medical Center
- Wayne Memorial Hospital
- Cone Health Cancer Center
- Kinston Medical Specialists PA
- Annie Penn Memorial Hospital
- Rutherford Hospital
- Wake Forest University Health Sciences
- Mid Dakota Clinic
- Saint Alexius Medical Center
- Sanford Bismarck Medical Center
- Summa Akron City Hospital/Cooper Cancer Center
- Akron General Medical Center
- Mary Rutan Hospital
- Aultman Health Foundation
- Adena Regional Medical Center
- Good Samaritan Hospital - Cincinnati
- University of Cincinnati
- Case Western Reserve University
- MetroHealth Medical Center
- Cleveland Clinic Cancer Center/Fairview Hospital
- Cleveland Clinic Foundation
- Ohio State University Comprehensive Cancer Center
- Riverside Methodist Hospital
- Columbus CCOP
- Grant Medical Center
- Mount Carmel Health Center West
- Doctors Hospital
- Grandview Hospital
- Good Samaritan Hospital - Dayton
- Miami Valley Hospital
- Samaritan North Health Center
- Dayton CCOP
- Grady Memorial Hospital
- Blanchard Valley Hospital
- Atrium Medical Center-Middletown Regional Hospital
- Wayne Hospital
- Kettering Medical Center
- Fairfield Medical Center
- Saint Rita's Medical Center
- Marietta Memorial Hospital
- Hillcrest Hospital Cancer Center
- Lake University Ireland Cancer Center
- Knox Community Hospital
- Licking Memorial Hospital
- Southern Ohio Medical Center
- Springfield Regional Medical Center
- Upper Valley Medical Center
- Saint Ann's Hospital
- Clinton Memorial Hospital
- Greene Memorial Hospital
- Genesis HealthCare System
- University of Oklahoma Health Sciences Center
- Tulsa Cancer Institute
- Abington Memorial Hospital
- Lehigh Valley Hospital-Cedar Crest
- Saint Luke's University Hospital-Bethlehem Campus
- Bryn Mawr Hospital
- Penn State Milton S Hershey Medical Center
- Paoli Memorial Hospital
- Pennsylvania Hospital
- Fox Chase Cancer Center
- Temple University Hospital
- UPMC-Magee Womens Hospital
- West Penn Hospital
- Reading Hospital
- Lankenau Medical Center
- Mainline Health CCOP
- Women and Infants Hospital
- AnMed Health Cancer Center
- AnMed Health Hospital
- Medical University of South Carolina
- South Carolina Oncology Associates PA
- Greenville Health System Cancer Institute-Easley
- McLeod Regional Medical Center
- Saint Francis Hospital
- Greenville Health System Cancer Institute-Andrews
- Greenville Health System Cancer Institute-Butternut
- Greenville Health System Cancer Institute-Faris
- Greenville Memorial Hospital
- Greenville Health System Cancer Institute-Eastside
- Self Regional Healthcare
- Cancer Centers of the Carolinas-Greer Medical Oncology
- Greenville Health System Cancer Institute-Greer
- Greenville Health System Cancer Institute-Seneca
- Spartanburg Medical Center
- Upstate Carolina CCOP
- Greenville Health System Cancer Institute-Spartanburg
- Black Hills Obstetrics and Gynecology
- Sanford Cancer Center-Oncology Clinic
- Avera Cancer Institute
- Medical X-Ray Center
- Sanford USD Medical Center - Sioux Falls
- Wellmont Holston Valley Hospital and Medical Center
- University of Tennessee - Knoxville
- Tennessee Oncology PLLC- Centennial Medical Center
- Meharry Medical College
- Vanderbilt University/Ingram Cancer Center
- University Medical Center Brackenridge
- Parkland Memorial Hospital
- Zale Lipshy University Hospital
- Clements University Hospital
- UT Southwestern/Simmons Cancer Center-Dallas
- Brooke Army Medical Center
- Baylor All Saints Medical Center at Fort Worth
- University of Texas Medical Branch at Galveston
- Lyndon Baines Johnson General Hospital
- Baylor College of Medicine
- Ben Taub General Hospital
- M D Anderson Cancer Center
- Methodist Hospital
- Saint Luke's Episcopal Hospital
- Veterans Administration Medical Center
- Wilford Hall Medical Center
- Scott and White Memorial Hospital
- American Fork Hospital
- Sandra L Maxwell Cancer Center
- Logan Regional Hospital
- Intermountain Medical Center
- McKay-Dee Hospital Center
- Utah Valley Regional Medical Center
- Dixie Medical Center Regional Cancer Center
- Intermountain Health Care
- Utah Cancer Specialists-Salt Lake City
- Huntsman Cancer Institute/University of Utah
- LDS Hospital
- Fletcher Allen Health Care-Medical Center
- University of Virginia
- Southwest VA Regional Cancer Center
- Virginia Commonwealth University/Massey Cancer Center
- Carilion Clinic Gynecological Oncology
- Providence Regional Cancer System-Centralia
- Saint Francis Hospital
- Saint Clare Hospital
- Providence - Saint Peter Hospital
- MultiCare Good Samaritan Hospital
- MultiCare Allenmore Hospital
- Northwest CCOP
- Saint Joseph Medical Center
- Multicare Health System
- Langlade Hospital and Cancer Center
- Marshfield Clinic-Chippewa Center
- Marshfield Clinic Cancer Center at Sacred Heart
- Green Bay Oncology at Saint Vincent Hospital
- Saint Vincent Hospital
- Green Bay Oncology Limited at Saint Mary's Hospital
- Saint Mary's Hospital
- Gundersen Lutheran Medical Center
- University of Wisconsin Hospital and Clinics
- Holy Family Memorial Hospital
- Bay Area Medical Center
- Marshfield Clinic
- Saint Joseph's Hospital
- Aurora Saint Luke's Medical Center
- Froedtert and the Medical College of Wisconsin
- Aurora Sinai Medical Center
- Marshfield Clinic-Minocqua Center
- D N Greenwald Center
- Oconomowoc Memorial Hospital-ProHealth Care Inc
- Green Bay Oncology - Oconto Falls
- Marshfield Clinic at James Beck Cancer Center
- Marshfield Clinic-Rice Lake Center
- Marshfield Clinic Cancer Care at Saint Michael's Hospital
- Saint Michael's Hospital
- Green Bay Oncology - Sturgeon Bay
- Vince Lombardi Cancer Clinic
- Waukesha Memorial Hospital
- Aspirus Regional Cancer Center
- Aurora West Allis Medical Center
- Marshfield Clinic - Weston Center
- Marshfield Clinic - Wisconsin Rapids Center
- Rocky Mountain Oncology
- Welch Cancer Center
- Vall d'Hebron University Hospital
- Hospital Reina Sofia
- Hospital Universitari de Girona Doctor Josep Trueta
- Hospital Universitario Gregorio Maranon
- M D Anderson International Spain
- Hospital Universitario La Paz
- Hospital Son Llatzer
- Instituto Valenciano de Oncologia
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Experimental
Experimental
Arm I (paclitaxel and cisplatin)
Arm II (paclitaxel, cisplatin, bevacizumab)
Arm III (topotecan hydrochloride and paclitaxel)
Arm IV (topotecan hydrochloride, paclitaxel, bevacizumab)
Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV on day 1 or 2.
Patients receive paclitaxel IV over 3 hours or 24 hours on day 1 and cisplatin IV and bevacizumab IV over 30-90 minutes on day 1 or 2.
Patients receive paclitaxel IV over 3 hours on day 1 and topotecan hydrochloride IV over 30 minutes on days 1-3.
Patients receive paclitaxel IV over 3 hours and bevacizumab IV over 30-90 minutes on day 1 and topotecan hydrochloride IV over 30 minutes on days 1-3.