search
Back to results

A Study of Bevacizumab to Prevent Malignant Ascites

Primary Purpose

Malignant Ascites

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Bevacizumab
Sponsored by
Baylor College of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Malignant Ascites focused on measuring malignant ascites, bevacizumab, vascular endothelial growth factor (VEGF), paracentesis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Persistent or symptomatic ascites with positive cytology secondary to any histologically confirmed tumor type not amenable to cytoreductive surgery or additional chemotherapy
  • Patients may enroll in this study irrespective of previous therapy including diuretics, surgery, chemotherapy, immunotherapy and radiation therapy
  • Must have received a minimum of two paracentesis procedures and a trial of diuretic therapy within 60 days of study entry
  • Age Restrictions: 18 years and older
  • Life Expectancy: 12 weeks or more
  • ECOG Performance Status: 0 -3
  • Able and willing to provide informed consent and comply with study and/or follow-up procedures
  • Normal organ and marrow function as defined by: Leukocytes >/= 3,000/mcL; Absolute neutrophil count >/= 1,500/mcL; Platelets >/= 100,000/mcL; Total bilirubin within normal institutional limits; AST (SGOT)/ALT(SGPT) </= 2.5 X institutional upper limit of normal (ULN); Creatinine within normal institutional limits OR Creatinine clearance >/+ 60 mL/min for patients with creatinine levels above the institutional normal; Serum Potassium within normal institutional limits; Serum Sodium within normal institutional limits

Exclusion Criteria:

  • Patients having received Bevacizumab as part of the treatment of their malignancy within 60 days prior to study entry
  • Current, recent (within 30 days of the first infusion of this study) or planned administration of chemotherapy (including all routes of administration), immunotherapy, biologic therapy, radiation therapy or any other anti-VEGF therapy (e.g., tyrosine kinase inhibitors)
  • Current, recent (within 30 days of the first infusion of this study), or planned participation in any other experimental drug study
  • Pregnant women; A serum pregnancy test will be given to females of childbearing potential prior to study enrollment and the participant must agree to use adequate contraception (barrier or hormonal methods) prior to study entry and for the duration of study participation.
  • Un-controlled hypertension (defined as systolic blood pressure > 150 mmHg and/or diastolic blood pressure > 100 mmHg
  • History of hypertensive crisis or hypertensive encephalopathy
  • New York Heart Association (NYHA) Grade II or greater congestive heart failure
  • History of myocardial infarction, unstable angina, stroke or transient ischemic attack within 6 months prior to study entry
  • Known CNS disease, except for treated brain metastasis.
  • Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to study entry
  • History of hemoptysis (>/= 1/2 teaspoon of bright red blood per episode) within 1 month prior to study entry
  • Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation)
  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study entry or anticipation of need for major surgical procedure during the course of the study
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device or paracentesis/thoracentesis, within 7 days prior to study entry
  • History of abdominal fistula or gastrointestinal perforation within 6 months prior to study entry
  • Any bowel obstruction that has not fully recovered despite medical or surgical intervention prior to study entry
  • Evidence of bowel wall thickening outside the site of the known primary malignancy on baseline radiographs
  • Serious, non-healing wound, active ulcer, or untreated bone fracture
  • Proteinuria as demonstrated by a Urine Protein/Creatinine ration >/= 1.0 at screening
  • Known hypersensitivity to any component of bevacizumab
  • Intrathoracic lung carcinoma of squamous cell histology.

Sites / Locations

  • Baylor College of Medicine
  • Ben Taub General Hospital
  • Michael E. DeBakey Veterans Affairs Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bevacizumab IV

Arm Description

All subjects will be treated with an intravenous infusion of the experimental drug (Bevacizumab 15 mg/kg) every 3 weeks for a total of twelve (12) weeks on study.

Outcomes

Primary Outcome Measures

To determine the repeat paracentesis response rate defined as a doubling of the patient's baseline time to repeat paracentesis.

Secondary Outcome Measures

To assess the time to the need for the first repeat abdominal paracentesis after the start of Bevacizumab therapy as compared with historical control data.
To analyze the mean number of paracentesis procedures required in each patient over the course of three months.
To assess the effect of anti-VEGF therapy on quality of life in patients with malignant ascites.

Full Information

First Posted
May 21, 2009
Last Updated
June 2, 2015
Sponsor
Baylor College of Medicine
Collaborators
Genentech, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT00908219
Brief Title
A Study of Bevacizumab to Prevent Malignant Ascites
Official Title
A Prospective, Phase II Trial of Intravenous Bevacizumab (Avastin) for the Prevention of Recurrent Malignant Ascites
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Withdrawn
Why Stopped
Accrual closed by sponsor due to lack of accrual and study progress
Study Start Date
July 2009 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
February 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Baylor College of Medicine
Collaborators
Genentech, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the effectiveness of using Bevacizumab in the prevention of recurrent malignant ascites. Ascites is a debilitating and unpleasant complication of several types of cancer. Animal and laboratory studies have shown that tumor cell production and/or increases in the amount of Vascular Endothelial Growth Factor (VEGF) is a major cause of the formation of malignant ascites. Therefore, giving patients with malignant ascites a drug that targets and neutralizes VEGF should prevent the recurrence of malignant ascites following paracentesis (a procedure to remove fluid from the abdominal cavity).
Detailed Description
All subjects will be treated with an intravenous infusion of the experimental drug (Bevacizumab 15 mg/kg) every 3 weeks for a total of twelve (12) weeks on study. The primary endpoint will be time to the need for repeat abdominal paracentesis after the start of therapy. Secondary endpoints will include an analysis of the mean number of paracenteses required in each subject over the course of 3 months, determination of the repeat paracentesis response rate (proportion of subjects who have a doubling in baseline time to repeat paracentesis) and an assessment of the effect of treatment on quality of life using a subject questionnaire.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Malignant Ascites
Keywords
malignant ascites, bevacizumab, vascular endothelial growth factor (VEGF), paracentesis

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bevacizumab IV
Arm Type
Experimental
Arm Description
All subjects will be treated with an intravenous infusion of the experimental drug (Bevacizumab 15 mg/kg) every 3 weeks for a total of twelve (12) weeks on study.
Intervention Type
Drug
Intervention Name(s)
Bevacizumab
Other Intervention Name(s)
Avastin; RO4876646
Intervention Description
Bevacizumab is given as an IV infusion of 15 mg/kg every three weeks for 12 weeks.
Primary Outcome Measure Information:
Title
To determine the repeat paracentesis response rate defined as a doubling of the patient's baseline time to repeat paracentesis.
Time Frame
12 weeks after initiation of study treatment
Secondary Outcome Measure Information:
Title
To assess the time to the need for the first repeat abdominal paracentesis after the start of Bevacizumab therapy as compared with historical control data.
Time Frame
Unspecified - depends upon when subject will need repeat paracentesis
Title
To analyze the mean number of paracentesis procedures required in each patient over the course of three months.
Time Frame
12 weeks after the initiation of study treatment
Title
To assess the effect of anti-VEGF therapy on quality of life in patients with malignant ascites.
Time Frame
Every three weeks while on-study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Persistent or symptomatic ascites with positive cytology secondary to any histologically confirmed tumor type not amenable to cytoreductive surgery or additional chemotherapy Patients may enroll in this study irrespective of previous therapy including diuretics, surgery, chemotherapy, immunotherapy and radiation therapy Must have received a minimum of two paracentesis procedures and a trial of diuretic therapy within 60 days of study entry Age Restrictions: 18 years and older Life Expectancy: 12 weeks or more ECOG Performance Status: 0 -3 Able and willing to provide informed consent and comply with study and/or follow-up procedures Normal organ and marrow function as defined by: Leukocytes >/= 3,000/mcL; Absolute neutrophil count >/= 1,500/mcL; Platelets >/= 100,000/mcL; Total bilirubin within normal institutional limits; AST (SGOT)/ALT(SGPT) </= 2.5 X institutional upper limit of normal (ULN); Creatinine within normal institutional limits OR Creatinine clearance >/+ 60 mL/min for patients with creatinine levels above the institutional normal; Serum Potassium within normal institutional limits; Serum Sodium within normal institutional limits Exclusion Criteria: Patients having received Bevacizumab as part of the treatment of their malignancy within 60 days prior to study entry Current, recent (within 30 days of the first infusion of this study) or planned administration of chemotherapy (including all routes of administration), immunotherapy, biologic therapy, radiation therapy or any other anti-VEGF therapy (e.g., tyrosine kinase inhibitors) Current, recent (within 30 days of the first infusion of this study), or planned participation in any other experimental drug study Pregnant women; A serum pregnancy test will be given to females of childbearing potential prior to study enrollment and the participant must agree to use adequate contraception (barrier or hormonal methods) prior to study entry and for the duration of study participation. Un-controlled hypertension (defined as systolic blood pressure > 150 mmHg and/or diastolic blood pressure > 100 mmHg History of hypertensive crisis or hypertensive encephalopathy New York Heart Association (NYHA) Grade II or greater congestive heart failure History of myocardial infarction, unstable angina, stroke or transient ischemic attack within 6 months prior to study entry Known CNS disease, except for treated brain metastasis. Significant vascular disease (e.g., aortic aneurysm, requiring surgical repair or recent peripheral arterial thrombosis) within 6 months prior to study entry History of hemoptysis (>/= 1/2 teaspoon of bright red blood per episode) within 1 month prior to study entry Evidence of bleeding diathesis or significant coagulopathy (in the absence of therapeutic anticoagulation) Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study entry or anticipation of need for major surgical procedure during the course of the study Core biopsy or other minor surgical procedure, excluding placement of a vascular access device or paracentesis/thoracentesis, within 7 days prior to study entry History of abdominal fistula or gastrointestinal perforation within 6 months prior to study entry Any bowel obstruction that has not fully recovered despite medical or surgical intervention prior to study entry Evidence of bowel wall thickening outside the site of the known primary malignancy on baseline radiographs Serious, non-healing wound, active ulcer, or untreated bone fracture Proteinuria as demonstrated by a Urine Protein/Creatinine ration >/= 1.0 at screening Known hypersensitivity to any component of bevacizumab Intrathoracic lung carcinoma of squamous cell histology.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Martha P Mims, MD, PhD
Organizational Affiliation
Baylor College of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Ben Taub General Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Michael E. DeBakey Veterans Affairs Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Citations:
Citation
Braunwald, et al. Harrison's Principles of Internal Medicine, 15th Ed. (McGraw-Hill 2001) 517
Results Reference
background
PubMed Identifier
15175435
Citation
Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, Baron A, Griffing S, Holmgren E, Ferrara N, Fyfe G, Rogers B, Ross R, Kabbinavar F. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004 Jun 3;350(23):2335-42. doi: 10.1056/NEJMoa032691.
Results Reference
background
PubMed Identifier
12708713
Citation
Smith EM, Jayson GC. The current and future management of malignant ascites. Clin Oncol (R Coll Radiol). 2003 Apr;15(2):59-72. doi: 10.1053/clon.2002.0135.
Results Reference
background
PubMed Identifier
10675474
Citation
Xu L, Yoneda J, Herrera C, Wood J, Killion JJ, Fidler IJ. Inhibition of malignant ascites and growth of human ovarian carcinoma by oral administration of a potent inhibitor of the vascular endothelial growth factor receptor tyrosine kinases. Int J Oncol. 2000 Mar;16(3):445-54. doi: 10.3892/ijo.16.3.445.
Results Reference
background
PubMed Identifier
10769648
Citation
Yukita A, Asano M, Okamoto T, Mizutani S, Suzuki H. Suppression of ascites formation and re-accumulation associated with human ovarian cancer by an anti-VPF monoclonal antibody in vivo. Anticancer Res. 2000 Jan-Feb;20(1A):155-60.
Results Reference
background
PubMed Identifier
10379858
Citation
Zebrowski BK, Liu W, Ramirez K, Akagi Y, Mills GB, Ellis LM. Markedly elevated levels of vascular endothelial growth factor in malignant ascites. Ann Surg Oncol. 1999 Jun;6(4):373-8. doi: 10.1007/s10434-999-0373-0.
Results Reference
background
PubMed Identifier
10804091
Citation
Verheul HM, Hoekman K, Jorna AS, Smit EF, Pinedo HM. Targeting vascular endothelial growth factor blockade: ascites and pleural effusion formation. Oncologist. 2000;5 Suppl 1:45-50. doi: 10.1634/theoncologist.5-suppl_1-45.
Results Reference
background
PubMed Identifier
9635584
Citation
Luo JC, Toyoda M, Shibuya M. Differential inhibition of fluid accumulation and tumor growth in two mouse ascites tumors by an antivascular endothelial growth factor/permeability factor neutralizing antibody. Cancer Res. 1998 Jun 15;58(12):2594-600.
Results Reference
background
PubMed Identifier
10589746
Citation
Zebrowski BK, Yano S, Liu W, Shaheen RM, Hicklin DJ, Putnam JB Jr, Ellis LM. Vascular endothelial growth factor levels and induction of permeability in malignant pleural effusions. Clin Cancer Res. 1999 Nov;5(11):3364-8.
Results Reference
background
PubMed Identifier
6823562
Citation
Senger DR, Galli SJ, Dvorak AM, Perruzzi CA, Harvey VS, Dvorak HF. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science. 1983 Feb 25;219(4587):983-5. doi: 10.1126/science.6823562.
Results Reference
background
PubMed Identifier
16797681
Citation
Numnum TM, Rocconi RP, Whitworth J, Barnes MN. The use of bevacizumab to palliate symptomatic ascites in patients with refractory ovarian carcinoma. Gynecol Oncol. 2006 Sep;102(3):425-8. doi: 10.1016/j.ygyno.2006.05.018. Epub 2006 Jun 23.
Results Reference
background
PubMed Identifier
16790519
Citation
Pichelmayer O, Gruenberger B, Zielinski C, Raderer M. Bevacizumab is active in malignant effusion. Ann Oncol. 2006 Dec;17(12):1853. doi: 10.1093/annonc/mdl143. Epub 2006 Jun 21. No abstract available.
Results Reference
background
PubMed Identifier
16514715
Citation
Ozcan C, Wong SJ, Hari P. Reversible posterior leukoencephalopathy syndrome and bevacizumab. N Engl J Med. 2006 Mar 2;354(9):980-2; discussion 980-2. No abstract available.
Results Reference
background
PubMed Identifier
16118771
Citation
Scappaticci FA, Fehrenbacher L, Cartwright T, Hainsworth JD, Heim W, Berlin J, Kabbinavar F, Novotny W, Sarkar S, Hurwitz H. Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol. 2005 Sep 1;91(3):173-80. doi: 10.1002/jso.20301.
Results Reference
background
PubMed Identifier
17167137
Citation
Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A, Lilenbaum R, Johnson DH. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006 Dec 14;355(24):2542-50. doi: 10.1056/NEJMoa061884. Erratum In: N Engl J Med. 2007 Jan 18;356(3):318.
Results Reference
background
PubMed Identifier
15681523
Citation
Miller KD, Chap LI, Holmes FA, Cobleigh MA, Marcom PK, Fehrenbacher L, Dickler M, Overmoyer BA, Reimann JD, Sing AP, Langmuir V, Rugo HS. Randomized phase III trial of capecitabine compared with bevacizumab plus capecitabine in patients with previously treated metastatic breast cancer. J Clin Oncol. 2005 Feb 1;23(4):792-9. doi: 10.1200/JCO.2005.05.098.
Results Reference
background
PubMed Identifier
15173063
Citation
Karp JE, Gojo I, Pili R, Gocke CD, Greer J, Guo C, Qian D, Morris L, Tidwell M, Chen H, Zwiebel J. Targeting vascular endothelial growth factor for relapsed and refractory adult acute myelogenous leukemias: therapy with sequential 1-beta-d-arabinofuranosylcytosine, mitoxantrone, and bevacizumab. Clin Cancer Res. 2004 Jun 1;10(11):3577-85. doi: 10.1158/1078-0432.CCR-03-0627.
Results Reference
background
PubMed Identifier
16391297
Citation
Wedam SB, Low JA, Yang SX, Chow CK, Choyke P, Danforth D, Hewitt SM, Berman A, Steinberg SM, Liewehr DJ, Plehn J, Doshi A, Thomasson D, McCarthy N, Koeppen H, Sherman M, Zujewski J, Camphausen K, Chen H, Swain SM. Antiangiogenic and antitumor effects of bevacizumab in patients with inflammatory and locally advanced breast cancer. J Clin Oncol. 2006 Feb 10;24(5):769-77. doi: 10.1200/JCO.2005.03.4645. Epub 2006 Jan 3.
Results Reference
background
PubMed Identifier
16192597
Citation
D'Adamo DR, Anderson SE, Albritton K, Yamada J, Riedel E, Scheu K, Schwartz GK, Chen H, Maki RG. Phase II study of doxorubicin and bevacizumab for patients with metastatic soft-tissue sarcomas. J Clin Oncol. 2005 Oct 1;23(28):7135-42. doi: 10.1200/JCO.2005.16.139.
Results Reference
background

Learn more about this trial

A Study of Bevacizumab to Prevent Malignant Ascites

We'll reach out to this number within 24 hrs