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NeoAdjuvant Chemotherapy Followed by Radical Hysterectomy (OP) Versus Primary Chemo-RADiation in Cervical Cancer FIGO Stage IB2 and IIB (NACOPRAD)

Primary Purpose

Cervical Cancer

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
hysterectomy
Radiation
Cisplatin
Paclitaxel
Carboplatin
Ifosfamide
Sponsored by
Charite University, Berlin, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cervical Cancer focused on measuring neoadjuvant chemotherapy, FIGO IB2, FIGO IIB, chemo-radiation, dose dense chemotherapy, cisplatin, paclitaxel, carboplatin, ifosfamide

Eligibility Criteria

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

Inclusion Criteria:

  • >18 years
  • cervical cancer FIGO IB2, IIB,
  • squamous cell, adeno or adenosquamous cell carcinoma
  • informed consent

Exclusion Criteria:

  • small cell/neuroendocrine component
  • previous radiation, previous cancer
  • pregnancy
  • HIV
  • severe co-morbidities

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Other

    Arm Label

    Arm A: NACT+radical hysterectomy

    Arm B: Chemoradiation

    Arm Description

    Arm A includes patients for dose dense chemotherapy using TP (paclitaxel, carboplatin) or TIP (cisplatin, paclitaxel, ifosfamide) weekly for six cycles. Radical hysterectomy is performed after the 6th week + lymphadenectomy

    Arm B includes patients undergoing primary cisplatin based chemo-radiation

    Outcomes

    Primary Outcome Measures

    disease free survival
    DFS

    Secondary Outcome Measures

    overall survival
    local control
    local control rate at 5 years
    quality of life
    Qol questionnaire EORTC Qol C30 and Cervical Cancer Module EORTC QLQ-CX24

    Full Information

    First Posted
    February 11, 2015
    Last Updated
    April 20, 2015
    Sponsor
    Charite University, Berlin, Germany
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02422563
    Brief Title
    NeoAdjuvant Chemotherapy Followed by Radical Hysterectomy (OP) Versus Primary Chemo-RADiation in Cervical Cancer FIGO Stage IB2 and IIB
    Acronym
    NACOPRAD
    Official Title
    Multicenter Prospective Randomized Study on NeoAdjuvant Chemotherapy Followed by Radical Hysterectomy (OP) Versus Primary Chemo-RADiation in Patients With Cervical Cancer FIGO Stage IB2 and IIB
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2015
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 2015 (undefined)
    Primary Completion Date
    October 2020 (Anticipated)
    Study Completion Date
    October 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Charite University, Berlin, Germany

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Randomized comparison of neoadjuvant chemotherapy followed by radical hysterectomy with pelvic ± para-aortic lymphonodectomy (LNE) versus primary cisplatin-based chemo-radiation in patients with cervical cancer FIGO IB2 and IIB.
    Detailed Description
    The optimal treatment for patients with cervical cancer on FIGO stage IB2 and IIB is controversial. There is no randomized comparison of a dose-dense NACT (TP or TIP-schedule) followed by hysterectomy and LNE (investigational Arm A) versus primary chemo-radiation (standard arm B). Primary endpoint is the DFS at 5 years, secondary endpoints local control at 5 years, OS at 5 years, QOL, questionnaires on sexual activity/QOL.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Cervical Cancer
    Keywords
    neoadjuvant chemotherapy, FIGO IB2, FIGO IIB, chemo-radiation, dose dense chemotherapy, cisplatin, paclitaxel, carboplatin, ifosfamide

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Arm A: NACT+radical hysterectomy
    Arm Type
    Experimental
    Arm Description
    Arm A includes patients for dose dense chemotherapy using TP (paclitaxel, carboplatin) or TIP (cisplatin, paclitaxel, ifosfamide) weekly for six cycles. Radical hysterectomy is performed after the 6th week + lymphadenectomy
    Arm Title
    Arm B: Chemoradiation
    Arm Type
    Other
    Arm Description
    Arm B includes patients undergoing primary cisplatin based chemo-radiation
    Intervention Type
    Procedure
    Intervention Name(s)
    hysterectomy
    Intervention Description
    radical hysterectomy
    Intervention Type
    Radiation
    Intervention Name(s)
    Radiation
    Intervention Type
    Drug
    Intervention Name(s)
    Cisplatin
    Intervention Type
    Drug
    Intervention Name(s)
    Paclitaxel
    Intervention Type
    Drug
    Intervention Name(s)
    Carboplatin
    Intervention Type
    Drug
    Intervention Name(s)
    Ifosfamide
    Primary Outcome Measure Information:
    Title
    disease free survival
    Description
    DFS
    Time Frame
    5 years
    Secondary Outcome Measure Information:
    Title
    overall survival
    Time Frame
    5 years
    Title
    local control
    Description
    local control rate at 5 years
    Time Frame
    5 years
    Title
    quality of life
    Description
    Qol questionnaire EORTC Qol C30 and Cervical Cancer Module EORTC QLQ-CX24
    Time Frame
    5 years

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: >18 years cervical cancer FIGO IB2, IIB, squamous cell, adeno or adenosquamous cell carcinoma informed consent Exclusion Criteria: small cell/neuroendocrine component previous radiation, previous cancer pregnancy HIV severe co-morbidities
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Simone Marnitz, MD
    Email
    simone.marnitz@charite.de

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    2428700
    Citation
    Sardi JE, di Paola GR, Cachau A, Ortiz OC, Sananes C, Giaroli A, Martins D, Peluffo M. A possible new trend in the management of the carcinoma of the cervix uteri. Gynecol Oncol. 1986 Oct;25(2):139-49. doi: 10.1016/0090-8258(86)90095-8.
    Results Reference
    background
    PubMed Identifier
    11773168
    Citation
    Benedetti-Panici P, Greggi S, Colombo A, Amoroso M, Smaniotto D, Giannarelli D, Amunni G, Raspagliesi F, Zola P, Mangioni C, Landoni F. Neoadjuvant chemotherapy and radical surgery versus exclusive radiotherapy in locally advanced squamous cell cervical cancer: results from the Italian multicenter randomized study. J Clin Oncol. 2002 Jan 1;20(1):179-88. doi: 10.1200/JCO.2002.20.1.179.
    Results Reference
    background
    PubMed Identifier
    1699851
    Citation
    Sardi J, Sananes C, Giaroli A, Maya G, di Paola G. Neoadjuvant chemotherapy in locally advanced carcinoma of the cervix uteri. Gynecol Oncol. 1990 Sep;38(3):486-93. doi: 10.1016/0090-8258(90)90096-4.
    Results Reference
    background
    PubMed Identifier
    1709686
    Citation
    Souhami L, Gil RA, Allan SE, Canary PC, Araujo CM, Pinto LH, Silveira TR. A randomized trial of chemotherapy followed by pelvic radiation therapy in stage IIIB carcinoma of the cervix. J Clin Oncol. 1991 Jun;9(6):970-7. doi: 10.1200/JCO.1991.9.6.970.
    Results Reference
    background
    PubMed Identifier
    24096111
    Citation
    Gadducci A, Sartori E, Maggino T, Zola P, Cosio S, Zizioli V, Lapresa M, Piovano E, Landoni F. Pathological response on surgical samples is an independent prognostic variable for patients with Stage Ib2-IIb cervical cancer treated with neoadjuvant chemotherapy and radical hysterectomy: an Italian multicenter retrospective study (CTF Study). Gynecol Oncol. 2013 Dec;131(3):640-4. doi: 10.1016/j.ygyno.2013.09.029. Epub 2013 Oct 3.
    Results Reference
    background
    PubMed Identifier
    19181826
    Citation
    Lissoni AA, Colombo N, Pellegrino A, Parma G, Zola P, Katsaros D, Chiari S, Buda A, Landoni F, Peiretti M, Dell'anna T, Fruscio R, Signorelli M, Grassi R, Floriani I, Fossati R, Torri V, Rulli E. A phase II, randomized trial of neo-adjuvant chemotherapy comparing a three-drug combination of paclitaxel, ifosfamide, and cisplatin (TIP) versus paclitaxel and cisplatin (TP) followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the Snap-02 Italian Collaborative Study. Ann Oncol. 2009 Apr;20(4):660-5. doi: 10.1093/annonc/mdn690. Epub 2009 Jan 30.
    Results Reference
    background
    PubMed Identifier
    15961761
    Citation
    Buda A, Fossati R, Colombo N, Fei F, Floriani I, Gueli Alletti D, Katsaros D, Landoni F, Lissoni A, Malzoni C, Sartori E, Scollo P, Torri V, Zola P, Mangioni C. Randomized trial of neoadjuvant chemotherapy comparing paclitaxel, ifosfamide, and cisplatin with ifosfamide and cisplatin followed by radical surgery in patients with locally advanced squamous cell cervical carcinoma: the SNAP01 (Studio Neo-Adjuvante Portio) Italian Collaborative Study. J Clin Oncol. 2005 Jun 20;23(18):4137-45. doi: 10.1200/JCO.2005.04.172.
    Results Reference
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    PubMed Identifier
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    Citation
    Landoni F, Sartori E, Maggino T, Zola P, Zanagnolo V, Cosio S, Ferrari F, Piovano E, Gadducci A. Is there a role for postoperative treatment in patients with stage Ib2-IIb cervical cancer treated with neo-adjuvant chemotherapy and radical surgery? An Italian multicenter retrospective study. Gynecol Oncol. 2014 Mar;132(3):611-7. doi: 10.1016/j.ygyno.2013.12.010. Epub 2013 Dec 14.
    Results Reference
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    NeoAdjuvant Chemotherapy Followed by Radical Hysterectomy (OP) Versus Primary Chemo-RADiation in Cervical Cancer FIGO Stage IB2 and IIB

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