Hyperthermic Intraperitoneal Chemotherapy Trial Comparing Quality of Life in Patients With Stage IIIC-IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Primary Purpose
Stage IIIC Fallopian Tube Cancer, Stage IIIC Ovarian Cancer, Stage IIIC Primary Peritoneal Cancer
Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Carboplatin
Quality-of-Life Assessment
Questionnaire Administration
Cytoreductive Surgery
Sponsored by
About this trial
This is an interventional treatment trial for Stage IIIC Fallopian Tube Cancer
Eligibility Criteria
Inclusion Criteria:
- Patients must have histologically or cytologically confirmed non-mucinous, epithelial stage 3 or 4 carcinoma of the ovary, fallopian tube or peritoneum.
- Patients must not have received treatment for another malignancy within 3 years of enrollment (patients who have received hormone therapy within 3 years of enrollment are still eligible).
- Patients must have received at least 3 but not more than 6 cycles of carboplatin-doublet based IV neoadjuvant chemotherapy and achieved at least stable disease (radiographically confirmed) at the conclusion of this therapy.
- Age ≥ 18 years.
- Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Patients must have adequate organ and marrow function as defined below (within 30 days of registration):
- Absolute neutrophil count >= 1,500/mcL (within 30 days of registration)
- Platelets >= 75,000/mcL (within 30 days of registration)
- Total bilirubin =< 1.5 mg/dL (within 30 days of registration)
- Creatinine clearance >= 50 mg/dL (within 30 days of registration)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 3 x institutional upper limit of normal (within 30 days of registration)
- Alkaline phosphatase =< 3 x institutional upper limit of normal (within 30 days of registration)
- The effects of HIPEC on the developing human fetus are unknown. For this reason, and because carboplatin doublet therapy consists of pregnancy category D agents, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
- Ability to understand and the willingness to sign an institutional review board (IRB)-approved informed consent document.
Exclusion Criteria:
- Patients may not be receiving any other investigational agents.
- Patients with extra-abdominal metastatic disease.
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to carboplatin doublet agents.
- Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
- Pregnant women are excluded from this study because carboplatin doublet therapy consists of pregnancy category D agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with carboplatin doublet therapy, breastfeeding should be discontinued.
- Men are excluded from participating due to the site specific nature of the disease being studied.
Sites / Locations
- Wake Forest University Health SciencesRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment - Carboplatin, CRS, HIPEC
Arm Description
Beginning 4-8 weeks after completion of chemotherapy, patients undergo CRS. Patients then receive carboplatin IP over 90 minutes immediately following CRS.
Outcomes
Primary Outcome Measures
Quality of life (QOL) assessed using Functional Assessment of Cancer Therapy-Ovarian questionnaire
The longitudinal data of QOL will be displayed graphically with individual trajectories. Repeated measures analysis of covariance models will be used for the primary analysis. The baseline QOL visit (as a categorical variable), randomization assignment, and a randomization by visit interaction will be included in the model. The test for the randomization effect at the 6-week post-treatment will be performed using a contrast of the 6-week randomization means. An unstructured covariance matrix will be used.
Secondary Outcome Measures
Abdominal discomfort assessed using Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Abdominal Discomfort questionnaire
Abdominal discomfort will be compared between the two treatment arms. The data will be analyzed using Poisson model with GEEs to account for the dependency between repeated measures. This approach will be treated as a sensitivity analysis.
Incidence of toxicities evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
The toxicities will be measured by the number and severity of adverse events defined by CTCAE version 5.0. The count data will be compared assuming a Poisson distribution.
Neurotoxicity assessed using Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire
Neurotoxicity will be compared between the two treatment arms. The data will be analyzed using Poisson model with generalized estimating equations (GEEs) to account for the dependency between repeated measures. This approach will be treated as a sensitivity analysis.
Progression free survival
Progression free survival will be compared between the two treatment arms using survival analysis. The follow-up time will be calculated from the date of end of treatment. Survival will be measured up to the time until progression, date of last contact, or death, whichever comes first. Kaplan-Meier survival curves will be used to estimate the survival probabilities by treatment arms. Cox proportional hazards models will be used to calculate the hazards ratio and its confidence interval for the treatment effect.
Quality of life (QOL) assessed using Functional Assessment of Cancer Therapy-Ovarian
The test for the randomization effect will be performed using contrasts.
Quality of life (QOL) in patients with advanced ovarian cancer assessed using Functional Assessment of Cancer Therapy-Ovarian
The test for the randomization effect will be performed using contrasts.
Response rates evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
The best response using RECIST criteria will be compared between the two treatment arms over time using GEEs to account for the dependency between repeated measures. Logit link and binomial distribution will be applied. The randomization assignment, visit (as a categorical variable), and interaction between randomization and visit will be included in the model. Contrasts will be used to compare the best response at each time point.
Full Information
NCT ID
NCT03188432
First Posted
June 13, 2017
Last Updated
October 9, 2023
Sponsor
Wake Forest University Health Sciences
Collaborators
National Cancer Institute (NCI)
1. Study Identification
Unique Protocol Identification Number
NCT03188432
Brief Title
Hyperthermic Intraperitoneal Chemotherapy Trial Comparing Quality of Life in Patients With Stage IIIC-IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
Official Title
A Phase II Trial Comparing Quality of Life After HIPEC in Patients With Stage IIIC and IV Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 13, 2017 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
April 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences
Collaborators
National Cancer Institute (NCI)
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This phase II trial studies how well hyperthermic intraperitoneal chemotherapy works in improving quality of life in patients with stage IIIC-IV ovarian, fallopian tube, or primary peritoneal cancer. In hyperthermic intraperitoneal chemotherapy, the chemotherapy is warmed before being used and may help the drugs get into the cancer cells better, minimize the toxicity of the drugs on normal cells, and help to kill any cancer cells left over after surgery.
Detailed Description
PRIMARY OBJECTIVES:
I. To compare quality of life in patients with advanced ovarian cancer treated with standard of care (SOC) neoadjuvant chemotherapy (NAC) followed by cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) at 6 weeks post-treatment versus quality of life (QOL) patients treatment with intravenous-therapy (IV) chemotherapy.
SECONDARY OBJECTIVES:
I. To describe quality of life in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC at 3 and 6 months post-treatment.
II. To describe neurotoxicity in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC.
III. To describe abdominal discomfort in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC.
IV. To describe toxicities in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC.
V. To describe the response rate in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC.
VI. To describe progression-free survival (PFS) in patients with advanced ovarian cancer treated with NAC followed by CRS with HIPEC.
OUTLINE: Beginning 4-8 weeks after completion of chemotherapy, patients undergo CRS. Patients then receive carboplatin intraperitoneally (IP) over 90 minutes immediately following CRS.
After completion of chemotherapy, patients are followed up at 30 days, and 3, 6, and 12 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stage IIIC Fallopian Tube Cancer, Stage IIIC Ovarian Cancer, Stage IIIC Primary Peritoneal Cancer, Stage IV Fallopian Tube Cancer, Stage IV Ovarian Cancer, Stage IV Primary Peritoneal Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment - Carboplatin, CRS, HIPEC
Arm Type
Experimental
Arm Description
Beginning 4-8 weeks after completion of chemotherapy, patients undergo CRS. Patients then receive carboplatin IP over 90 minutes immediately following CRS.
Intervention Type
Drug
Intervention Name(s)
Carboplatin
Other Intervention Name(s)
Blastocarb, Carboplat, Carboplatin Hexal, Carboplatino, Carbosin, Carbosol, Carbotec, CBDCA, Displata, Ercar, JM-8, Nealorin, Novoplatinum, Paraplatin, Paraplatin AQ, Paraplatine, Platinwas, Ribocarbo
Intervention Description
Given IV and IP
Intervention Type
Other
Intervention Name(s)
Quality-of-Life Assessment
Other Intervention Name(s)
Quality of Life Assessment
Intervention Description
Ancillary studies
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Intervention Type
Procedure
Intervention Name(s)
Cytoreductive Surgery
Other Intervention Name(s)
Operation, Surgery, Surgical, Surgical Interventions, Surgical Procedure, Surgical Procedures
Intervention Description
Undergo CRS
Primary Outcome Measure Information:
Title
Quality of life (QOL) assessed using Functional Assessment of Cancer Therapy-Ovarian questionnaire
Description
The longitudinal data of QOL will be displayed graphically with individual trajectories. Repeated measures analysis of covariance models will be used for the primary analysis. The baseline QOL visit (as a categorical variable), randomization assignment, and a randomization by visit interaction will be included in the model. The test for the randomization effect at the 6-week post-treatment will be performed using a contrast of the 6-week randomization means. An unstructured covariance matrix will be used.
Time Frame
At 6 weeks
Secondary Outcome Measure Information:
Title
Abdominal discomfort assessed using Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Abdominal Discomfort questionnaire
Description
Abdominal discomfort will be compared between the two treatment arms. The data will be analyzed using Poisson model with GEEs to account for the dependency between repeated measures. This approach will be treated as a sensitivity analysis.
Time Frame
Up to 6 months
Title
Incidence of toxicities evaluated according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Description
The toxicities will be measured by the number and severity of adverse events defined by CTCAE version 5.0. The count data will be compared assuming a Poisson distribution.
Time Frame
Up to 1 year after surgery
Title
Neurotoxicity assessed using Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity questionnaire
Description
Neurotoxicity will be compared between the two treatment arms. The data will be analyzed using Poisson model with generalized estimating equations (GEEs) to account for the dependency between repeated measures. This approach will be treated as a sensitivity analysis.
Time Frame
Up to 6 months
Title
Progression free survival
Description
Progression free survival will be compared between the two treatment arms using survival analysis. The follow-up time will be calculated from the date of end of treatment. Survival will be measured up to the time until progression, date of last contact, or death, whichever comes first. Kaplan-Meier survival curves will be used to estimate the survival probabilities by treatment arms. Cox proportional hazards models will be used to calculate the hazards ratio and its confidence interval for the treatment effect.
Time Frame
Up to 3 years
Title
Quality of life (QOL) assessed using Functional Assessment of Cancer Therapy-Ovarian
Description
The test for the randomization effect will be performed using contrasts.
Time Frame
At 3 months
Title
Quality of life (QOL) in patients with advanced ovarian cancer assessed using Functional Assessment of Cancer Therapy-Ovarian
Description
The test for the randomization effect will be performed using contrasts.
Time Frame
At 6 months
Title
Response rates evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
Description
The best response using RECIST criteria will be compared between the two treatment arms over time using GEEs to account for the dependency between repeated measures. Logit link and binomial distribution will be applied. The randomization assignment, visit (as a categorical variable), and interaction between randomization and visit will be included in the model. Contrasts will be used to compare the best response at each time point.
Time Frame
Up to 1 year post surgery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must have histologically or cytologically confirmed non-mucinous, epithelial stage 3 or 4 carcinoma of the ovary, fallopian tube or peritoneum.
Patients must not have received treatment for another malignancy within 3 years of enrollment (patients who have received hormone therapy within 3 years of enrollment are still eligible).
Patients must have received at least 3 but not more than 6 cycles of carboplatin-doublet based IV neoadjuvant chemotherapy and achieved at least stable disease (radiographically confirmed) at the conclusion of this therapy.
Age ≥ 18 years.
Eastern Cooperative Oncology Group (ECOG) performance status =< 2
Patients must have adequate organ and marrow function as defined below (within 30 days of registration):
Absolute neutrophil count >= 1,500/mcL (within 30 days of registration)
Platelets >= 75,000/mcL (within 30 days of registration)
Total bilirubin =< 1.5 mg/dL (within 30 days of registration)
Creatinine clearance >= 50 mg/dL (within 30 days of registration)
Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) =< 3 x institutional upper limit of normal (within 30 days of registration)
Alkaline phosphatase =< 3 x institutional upper limit of normal (within 30 days of registration)
The effects of HIPEC on the developing human fetus are unknown. For this reason, and because carboplatin doublet therapy consists of pregnancy category D agents, women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
Ability to understand and the willingness to sign an institutional review board (IRB)-approved informed consent document.
Exclusion Criteria:
Patients may not be receiving any other investigational agents.
Patients with extra-abdominal metastatic disease.
History of allergic reactions attributed to compounds of similar chemical or biologic composition to carboplatin doublet agents.
Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Pregnant women are excluded from this study because carboplatin doublet therapy consists of pregnancy category D agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with carboplatin doublet therapy, breastfeeding should be discontinued.
Men are excluded from participating due to the site specific nature of the disease being studied.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Kelly
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael G. Kelly
Phone
336-716-4389
Email
mgkelly@wakehealth.edu
First Name & Middle Initial & Last Name & Degree
Michael G. Kelly
12. IPD Sharing Statement
Learn more about this trial
Hyperthermic Intraperitoneal Chemotherapy Trial Comparing Quality of Life in Patients With Stage IIIC-IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
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