Multicenter Trial With PegLiposomal Doxorubicin and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors
Primary Purpose
Mesenchymal Tumor, Carcinosarcoma, Leiomyosarcoma
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
PegLiposomal Doxorubicin
Carboplatin
Sponsored by
About this trial
This is an interventional treatment trial for Mesenchymal Tumor focused on measuring leiomyosarcoma, carcinosarcoma, mixed epithelial mesenchymal tumor, endometrial stroma sarcomas, Müllerian mixed tumors, carcinosarcoma of the uterus, mesenchymal tumors of the ovary or uterus, mixed epithelial mesenchymal tumors of the ovary or uterus
Eligibility Criteria
Inclusion Criteria:
- Histologically documented mesenchymal or mixed epithelial-mesenchymal tumor of the ovary or uterus
- Patients with a primary diagnosis of FIGO I-IV uterine carcinosarcoma and optimum debulking (postoperative residual tumor < 1cm) may be enrolled only if cisplatin-ifosfamide combination therapy is not feasible.
- Patients with metastatic uterine carcinosarcoma may be enrolled only if Ifosfamide/Paclitaxel combination therapy is not feasible.
- Patients with metastatic leiomyosarcoma may be enrolled only if gemcitabine-docetaxel combination therapy is not feasible.
- Measurable (target lesion) tumor, evaluable (non-target lesion) tumor or histological documentation
- No more than one prior chemotherapy. Any prior platinum or anthracycline- containing chemotherapy must have been completed more than 6 months previously
- Prior radiotherapy ≤ 25% of the hematopoietic system is allowed provided it took place more than 6 weeks before recruitment
- Patients are allowed to have received prior anticancer hormone therapy or specific immunotherapy. Patients must have completed these therapies at least three weeks before recruitment to the study
- All women with a theoretical possibility of pregnancy must produce a negative pregnancy test (serum or urinary) within seven days before starting treatment
- General health of 0 - 2 on the ECOG score
- At least 18 years of age
- Estimated life expectancy above 12 weeks
- At least 3 weeks since major surgery
- Appropriate hematologic, renal and hepatic function in accordance with the following definitions:
- Absolute neutrophil count (ANC) ≥ 1.5 × 109 /l
- Platelets ≥ 100 × 10 9/l
- Total bilirubin ≤ 1.25 times upper limit of normal
- Estimated GFR ≥ 50 ml/min
- LVEF > 50 %
- Informed consent must be obtained from all patients.
Exclusion Criteria:
- More than one prior chemotherapy (or radiochemotherapy)
- Active infection or other serious medical impairment liable to affect the patient's ability to receive treatment according to protocol.
- Administration of other chemotherapy drugs or other anticancer hormone treatments during the study.
- History of clinically manifest atrial or ventricular arrhythmia (> LOWN II) and congestive heart failure, even if controlled by drugs (NYHA class > II). Documented myocardial infarction within 6 months before study enrollment.
- Pregnant or breastfeeding women, or women not practicing appropriate birth control methods
- Participation in another study using experimental drugs within the last 30 days
- Any other conditions or therapies which the physician believes might put the patient at risk or impair the study objective.
- Known hypersensitivity to carboplatin or pegylated liposomal doxorubicin
Sites / Locations
- Charité, Campus Virchow Klinikum, Frauenklinik
- Malteser Krankenhaus, Gynäkologie und Geburtshilfe
- Klinikum Bremen-Mitte gGmbH, Frauenklinik
- Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
- Evangelisches Krankenhaus Düsseldorf, Frauenklinik
- Universitätsklinikum Essen, Frauenklinik
- Klinikum der J. W. Goethe-Universität, Klinik für Gynäkologie und Geburtshilfe
- University Hospital Hamburg-Eppendorf
- Gynäkologisch-onkologische Praxis
- St. Vincentius Kliniken AG, Frauenklinik
- Universitätsklinikum Giessen und Marburg GmbH, Klinik für Gynäkologie, Gynäkologische Endokrinologie und Onkologie
- Klinikum Großhadern, Frauenklinik
- Universitätsklinikum Tübingen, Frauenklinik
- Universitätsklinikum Ulm, Universitätsfrauenklinik
- Dr. Horst Schmidt Kliniken GmbH, Klinik für Gynäkologie und gynäkologische Onkologie
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
PegLiposomal Doxorubicin + Carboplatin
Arm Description
Subjects will receive PegLiposomal Doxorubicin (40mg/m²) and Carboplatin (AUC6) every 28 days. Treatment period up to 6 months (therapy can be continued in case of tumor response and benefit for the patient)
Outcomes
Primary Outcome Measures
Anticancer activity in terms of progression-free survival time (PFS)
Secondary Outcome Measures
Tolerability, i.e. type, frequency, severity and duration of adverse reactions (CTCAE,Version 3.0)
Anticancer activity in patients with measurable or evaluable disease in terms of response rates (CR, PR, SD, PD) according to RECIST criteria
Overall survival
Correlation of tumor marker CA-125 with imaging methods
Full Information
NCT ID
NCT00815945
First Posted
December 30, 2008
Last Updated
February 13, 2017
Sponsor
AGO Study Group
Collaborators
Merck Sharp & Dohme LLC
1. Study Identification
Unique Protocol Identification Number
NCT00815945
Brief Title
Multicenter Trial With PegLiposomal Doxorubicin and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors
Official Title
Phase II Study Evaluating PegLiposomal Doxorubicin (PLD) and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors
Study Type
Interventional
2. Study Status
Record Verification Date
March 2014
Overall Recruitment Status
Completed
Study Start Date
June 2008 (undefined)
Primary Completion Date
November 2011 (Actual)
Study Completion Date
January 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AGO Study Group
Collaborators
Merck Sharp & Dohme LLC
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Uterine sarcomas account for less than 5% of all carcinomas of the uterine corpus. The prognosis of these patients is extremely limited. Recurrence rates of 50-60% are reported even for early-stage disease (FIGO I/II). Median overall survival is below 12 months in patients with advanced or metastatic disease.
Ovarian carcinosarcoma is extremely rare among ovarian malignancies (< 2%). That is why there is insufficient data as a basis for establishing a gold standard. As a result, these cases tend to be treated in the same way as uterine sarcomas or epithelial ovarian malignancies in clinical practice.
On the basis of data published to date on the treatment of mixed mesenchymal-epithelial tumors, it is clear that the treatments commonly used to date have limited activity while producing clinically relevant toxicity. The regimes verified so far (Cisplatin / Ifosfamide, Ifosfamide/Paclitaxel and Gemcitabine/Docetaxel) exhibit a considerable side effect spectrum and are only rarely feasible on clinical everyday life conditions, so e. g. the rate of withdrawals due to toxicity was in a study collective of selected females treated with the last combination at 40 %. The physician has to check in every individual case if one of the above mentioned combinations is feasible. The search for alternative effective and better tolerated treatment options is essential. The toxicity data on the carboplatin-PLD combination are known, and efficacy has been identified in small cohorts.
The objective of this study is to explore the efficacy of combination PLD-carboplatin treatment in a larger patient population.
Detailed Description
This study in patients with mesenchymal or mixed epithelial mesenchymal tumors of the ovary or uterus is designed as a prospective single-arm, open - label, multicenter phase II study to evaluate the efficacy of PegLiposomal Doxorubicin and Carboplatin combination chemotherapy.
40 patients will be recruited to receive PegLiposomal Doxorubicin (PLD) in a continuous i. v. infusion of at least 60 minutes at a dose of 40 mg/m2 on Day 1, followed by a 30-minute i. v. carboplatin infusion according to AUC 6 (formula devised by Calvert et al).
Patients will get outpatients treatment. At screening the patients' eligibility will be assessed, their baseline and demographic characteristics obtained, and baseline values for the effect variables collected. Patients with measurable lesions, non-measurable lesions or histological documentation will be included into this trial. Measurable lesion and non-measurable lesions will be documented by x-ray, ultrasound, computed tomography or MRI.
The patients' safety will be monitored during therapy until recovery of toxicities.
In patients with measurable lesions at baseline, the (post)-treatment values for effect according to the RECIST criteria will be collected as shown in table 6. CR, PR and SD have to be confirmed by a repeat measurement after an interval of at least four weeks.
Follow-up is scheduled every three months during the first two years after the end of treatment.
As from year 3 the follow-up takes place outside the study in the context of general aftercare.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mesenchymal Tumor, Carcinosarcoma, Leiomyosarcoma
Keywords
leiomyosarcoma, carcinosarcoma, mixed epithelial mesenchymal tumor, endometrial stroma sarcomas, Müllerian mixed tumors, carcinosarcoma of the uterus, mesenchymal tumors of the ovary or uterus, mixed epithelial mesenchymal tumors of the ovary or uterus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
41 (Actual)
8. Arms, Groups, and Interventions
Arm Title
PegLiposomal Doxorubicin + Carboplatin
Arm Type
Experimental
Arm Description
Subjects will receive PegLiposomal Doxorubicin (40mg/m²) and Carboplatin (AUC6) every 28 days. Treatment period up to 6 months (therapy can be continued in case of tumor response and benefit for the patient)
Intervention Type
Drug
Intervention Name(s)
PegLiposomal Doxorubicin
Other Intervention Name(s)
Caelyx
Intervention Description
PegLiposomal Doxorubicin, intravenous, 40mg/m², every 28 days for up to 6 months
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Intervention Description
Carboplatin, intravenous, AUC 6, every 28 days for up to 6 months
Primary Outcome Measure Information:
Title
Anticancer activity in terms of progression-free survival time (PFS)
Time Frame
every 3 months
Secondary Outcome Measure Information:
Title
Tolerability, i.e. type, frequency, severity and duration of adverse reactions (CTCAE,Version 3.0)
Time Frame
until recovery of toxicities
Title
Anticancer activity in patients with measurable or evaluable disease in terms of response rates (CR, PR, SD, PD) according to RECIST criteria
Time Frame
six months
Title
Overall survival
Time Frame
30 months
Title
Correlation of tumor marker CA-125 with imaging methods
Time Frame
six months
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically documented mesenchymal or mixed epithelial-mesenchymal tumor of the ovary or uterus
Patients with a primary diagnosis of FIGO I-IV uterine carcinosarcoma and optimum debulking (postoperative residual tumor < 1cm) may be enrolled only if cisplatin-ifosfamide combination therapy is not feasible.
Patients with metastatic uterine carcinosarcoma may be enrolled only if Ifosfamide/Paclitaxel combination therapy is not feasible.
Patients with metastatic leiomyosarcoma may be enrolled only if gemcitabine-docetaxel combination therapy is not feasible.
Measurable (target lesion) tumor, evaluable (non-target lesion) tumor or histological documentation
No more than one prior chemotherapy. Any prior platinum or anthracycline- containing chemotherapy must have been completed more than 6 months previously
Prior radiotherapy ≤ 25% of the hematopoietic system is allowed provided it took place more than 6 weeks before recruitment
Patients are allowed to have received prior anticancer hormone therapy or specific immunotherapy. Patients must have completed these therapies at least three weeks before recruitment to the study
All women with a theoretical possibility of pregnancy must produce a negative pregnancy test (serum or urinary) within seven days before starting treatment
General health of 0 - 2 on the ECOG score
At least 18 years of age
Estimated life expectancy above 12 weeks
At least 3 weeks since major surgery
Appropriate hematologic, renal and hepatic function in accordance with the following definitions:
Absolute neutrophil count (ANC) ≥ 1.5 × 109 /l
Platelets ≥ 100 × 10 9/l
Total bilirubin ≤ 1.25 times upper limit of normal
Estimated GFR ≥ 50 ml/min
LVEF > 50 %
Informed consent must be obtained from all patients.
Exclusion Criteria:
More than one prior chemotherapy (or radiochemotherapy)
Active infection or other serious medical impairment liable to affect the patient's ability to receive treatment according to protocol.
Administration of other chemotherapy drugs or other anticancer hormone treatments during the study.
History of clinically manifest atrial or ventricular arrhythmia (> LOWN II) and congestive heart failure, even if controlled by drugs (NYHA class > II). Documented myocardial infarction within 6 months before study enrollment.
Pregnant or breastfeeding women, or women not practicing appropriate birth control methods
Participation in another study using experimental drugs within the last 30 days
Any other conditions or therapies which the physician believes might put the patient at risk or impair the study objective.
Known hypersensitivity to carboplatin or pegylated liposomal doxorubicin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philipp Harter, MD
Organizational Affiliation
Klinikum Essen Mitte
Official's Role
Principal Investigator
Facility Information:
Facility Name
Charité, Campus Virchow Klinikum, Frauenklinik
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Malteser Krankenhaus, Gynäkologie und Geburtshilfe
City
Bonn
ZIP/Postal Code
53123
Country
Germany
Facility Name
Klinikum Bremen-Mitte gGmbH, Frauenklinik
City
Bremen
ZIP/Postal Code
28177
Country
Germany
Facility Name
Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Evangelisches Krankenhaus Düsseldorf, Frauenklinik
City
Duesseldorf
ZIP/Postal Code
40217
Country
Germany
Facility Name
Universitätsklinikum Essen, Frauenklinik
City
Essen
ZIP/Postal Code
45122
Country
Germany
Facility Name
Klinikum der J. W. Goethe-Universität, Klinik für Gynäkologie und Geburtshilfe
City
Frankfurt
ZIP/Postal Code
60590
Country
Germany
Facility Name
University Hospital Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20251
Country
Germany
Facility Name
Gynäkologisch-onkologische Praxis
City
Hannover
ZIP/Postal Code
30177
Country
Germany
Facility Name
St. Vincentius Kliniken AG, Frauenklinik
City
Karlsruhe
ZIP/Postal Code
76135
Country
Germany
Facility Name
Universitätsklinikum Giessen und Marburg GmbH, Klinik für Gynäkologie, Gynäkologische Endokrinologie und Onkologie
City
Marburg
ZIP/Postal Code
35043
Country
Germany
Facility Name
Klinikum Großhadern, Frauenklinik
City
München
ZIP/Postal Code
81377
Country
Germany
Facility Name
Universitätsklinikum Tübingen, Frauenklinik
City
Tübingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Universitätsklinikum Ulm, Universitätsfrauenklinik
City
Ulm
ZIP/Postal Code
89075
Country
Germany
Facility Name
Dr. Horst Schmidt Kliniken GmbH, Klinik für Gynäkologie und gynäkologische Onkologie
City
Wiesbaden
ZIP/Postal Code
65199
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Multicenter Trial With PegLiposomal Doxorubicin and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors
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