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Hyperthermic Intraperitoneal Chemotherapy for Treatment of Relapsed Ovarian Cancer

Primary Purpose

Ovarian Cancer Recurrent

Status
Unknown status
Phase
Not Applicable
Locations
Sweden
Study Type
Interventional
Intervention
radical surgery with HIPEC
Sponsored by
Uppsala University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Ovarian Cancer Recurrent

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Patients with diagnosis of recurrent epithelial ovarian carcinoma, peritoneal carcinoma, or fallopian tube carcinoma after 6 month since platinum-based chemotherapy (first recurrence) and are scheduled for secondary surgical evaluation/cytoreduction
  • ECOG/WHO Performance score of 0 to 1
  • Adequate respiratory, hepatic, cardiac, kidney and bone marrow function ( Hb >= 8 g/dl, absolute neutrophil count > 1500/mm3, platelets > 100,000/mm3, creatinine clearance > 60 mL/min according to Cockroft formula)
  • Adequate renal function Creatinine ≤ 1.5 mg/dl, and adequate hepatic function Bilirubin ≤ 1.5 mg/dl and AST and ALT ≤ 80 IU/L
  • Histological types feature would be serous, endometrioid, clear cell, undifferentiated carcinomas, transitional cell carcinoma, or mixed epithelial carcinoma
  • No end organ function
  • Patients must have less than or equal to 2.5 mm residual disease at the completion of the cytoreductive surgery to be eligible for the study
  • Patient-compliant and psychologically able to follow the trial procedures, signature of informed consent.

Exclusion Criteria:

  • Evidence of extensive retroperitoneal lymph node disease
  • Neuropsychiatric disorders;
  • Pregnancy or breast feeding.
  • Subjects who have received prior radiotherapy to any portion of the abdominal cavity or pelvis are excluded
  • Subjects with invasive malignancies or had any evidence of the other cancer present within the last 3 years. Prior radiation for localized cancer of the breast, head and neck, or skin are permitted, provided that it was completed more than 3 years prior to enrollment, and the subject remains free of recurrent or metastatic disease
  • Subjects with active infection that requires parenteral antibiotics
  • Tumors of low malignant potential, or non-invasive borderline tumors
  • Patients with any underlying cardiac, pulmonary, metabolic, renal, hepatic or gastrointestinal conditions, chronic or latent infectious diseases, immune deficiency, or history, which in the opinion of the investigator, places the patient at an unacceptable risk for participation in the study
  • Patient with extra-abdominal metastatic disease
  • Known platinum (carboplatin or cisplatin) allergy
  • Life expectancy < 3 months
  • Still, it will not be considered for the HIPEC protocol those patients with unresectable disease (presence of invasive peritoneal implants inoperable or at high risk for resection in critical locations such as hepatic hilum, the mesenteric root, trunk celiac, mesentery, and several small implants the serosa of the small intestine) and / or with residual disease after cytoreduction greater than or equal to 2.5 mm (CC-2 and CC-3).

Sites / Locations

  • Uppsala University HopsitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Complete cytoreductive surgery plus HIPEC with cis-platinum100mg/m2 for 90 min

Arm Description

Outcomes

Primary Outcome Measures

Treatment-related toxicities
Registration of the effects according to NCI CTCAEv4.0 guidelines.

Secondary Outcome Measures

Assessment of quality of life
EORTC C30 quality of life questionnaire
Assessment of quality of life in relation to ovarian cancer
EORTC OV28 quality of life questionnaire
Assessment of quality of Life in relation to eventually performed intestinal surgery
EORTC CR29 quality of life questionnaire
Morbidity
Rate of the high-grade 3 and 4 complications, according to the Clawien-Dindo scale
Mortality
Number of participants with lethal outcome

Full Information

First Posted
October 8, 2018
Last Updated
October 1, 2021
Sponsor
Uppsala University Hospital
Collaborators
Uppsala University, The Netherlands Cancer Institute
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1. Study Identification

Unique Protocol Identification Number
NCT03717610
Brief Title
Hyperthermic Intraperitoneal Chemotherapy for Treatment of Relapsed Ovarian Cancer
Official Title
Feasibility of Intraoperative Given Hyperthermic Intraperitoneal Chemotherapy (HIPEC) With Cisplatin During a Cytoreductive Surgery in Patients With Recurrent Ovarian, Peritoneal or Fallopian Tube Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Unknown status
Study Start Date
October 4, 2018 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
December 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Uppsala University Hospital
Collaborators
Uppsala University, The Netherlands Cancer Institute

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a feasibility single-center study to investigate the tolerability, toxicity, quality of life, morbidity, mortality of the HIPEC treatment following cytoreductive surgery for treatment of recurrent ovarian, peritoneal, and fallopian tube cancers.
Detailed Description
Ovarian cancer is the leading cause of gynecological cancer mortality; it is in 75% of cases detected at advanced stages. The standard treatment is cytoreductive surgery with removal of macroscopic tumor, and intravenous chemotherapy. Three randomized trials observed survival gain for ovarian cancer patients that received intraperitoneal chemotherapy after the optimal cytoreduction, however catheter-related complications made the procedure not feasible. A "one-time" hyperthermic intraperitoneal chemotherapy, HIPEC, is an established for peritoneal carcinosis in colorectal cancer, and recently two phase III randomised clinical studies observe survival gain also for ovarian cancer patients after surgery with HIPEC. Here the investigators, plan to investigate the HIPEC procedure following cytoreductive surgery for recurrent ovarian cancer, a progressed disease without any standard treatment established.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer Recurrent

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Complete cytoreductive surgery plus HIPEC with cis-platinum100mg/m2 for 90 min
Arm Type
Experimental
Intervention Type
Procedure
Intervention Name(s)
radical surgery with HIPEC
Intervention Description
Straight after macroscopic radical cytoreductive surgery, an intraperitoneal hyperthermic perfusion using the open-abdomen technique will be performed with a single dose of cisplatin 100 mg/m2 administered for 90 minutes in the hyperthermic phase (41°C-43°C).
Primary Outcome Measure Information:
Title
Treatment-related toxicities
Description
Registration of the effects according to NCI CTCAEv4.0 guidelines.
Time Frame
3 months after surgery
Secondary Outcome Measure Information:
Title
Assessment of quality of life
Description
EORTC C30 quality of life questionnaire
Time Frame
before surgery, and 4 weeks, 3 months and 6 months after surgery
Title
Assessment of quality of life in relation to ovarian cancer
Description
EORTC OV28 quality of life questionnaire
Time Frame
before surgery, and 4 weeks, 3 months and 6 months after surgery
Title
Assessment of quality of Life in relation to eventually performed intestinal surgery
Description
EORTC CR29 quality of life questionnaire
Time Frame
before surgery, and 4 weeks, 3 months and 6 months after surgery
Title
Morbidity
Description
Rate of the high-grade 3 and 4 complications, according to the Clawien-Dindo scale
Time Frame
30 days after surgery
Title
Mortality
Description
Number of participants with lethal outcome
Time Frame
90 days after surgery

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patients with diagnosis of recurrent epithelial ovarian carcinoma, peritoneal carcinoma, or fallopian tube carcinoma after 6 month since platinum-based chemotherapy (first recurrence) and are scheduled for secondary surgical evaluation/cytoreduction ECOG/WHO Performance score of 0 to 1 Adequate respiratory, hepatic, cardiac, kidney and bone marrow function ( Hb >= 8 g/dl, absolute neutrophil count > 1500/mm3, platelets > 100,000/mm3, creatinine clearance > 60 mL/min according to Cockroft formula) Adequate renal function Creatinine ≤ 1.5 mg/dl, and adequate hepatic function Bilirubin ≤ 1.5 mg/dl and AST and ALT ≤ 80 IU/L Histological types feature would be serous, endometrioid, clear cell, undifferentiated carcinomas, transitional cell carcinoma, or mixed epithelial carcinoma No end organ function Patients must have less than or equal to 2.5 mm residual disease at the completion of the cytoreductive surgery to be eligible for the study Patient-compliant and psychologically able to follow the trial procedures, signature of informed consent. Exclusion Criteria: Evidence of extensive retroperitoneal lymph node disease Neuropsychiatric disorders; Pregnancy or breast feeding. Subjects who have received prior radiotherapy to any portion of the abdominal cavity or pelvis are excluded Subjects with invasive malignancies or had any evidence of the other cancer present within the last 3 years. Prior radiation for localized cancer of the breast, head and neck, or skin are permitted, provided that it was completed more than 3 years prior to enrollment, and the subject remains free of recurrent or metastatic disease Subjects with active infection that requires parenteral antibiotics Tumors of low malignant potential, or non-invasive borderline tumors Patients with any underlying cardiac, pulmonary, metabolic, renal, hepatic or gastrointestinal conditions, chronic or latent infectious diseases, immune deficiency, or history, which in the opinion of the investigator, places the patient at an unacceptable risk for participation in the study Patient with extra-abdominal metastatic disease Known platinum (carboplatin or cisplatin) allergy Life expectancy < 3 months Still, it will not be considered for the HIPEC protocol those patients with unresectable disease (presence of invasive peritoneal implants inoperable or at high risk for resection in critical locations such as hepatic hilum, the mesenteric root, trunk celiac, mesentery, and several small implants the serosa of the small intestine) and / or with residual disease after cytoreduction greater than or equal to 2.5 mm (CC-2 and CC-3).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marta Lomnytska, MD, PhD
Phone
018-611 00 00
Ext
+46
Email
marta.lomnytska@akademiska.se
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marta Lomnytska, MD, PhD
Organizational Affiliation
Uppsala University, Sweden
Official's Role
Principal Investigator
Facility Information:
Facility Name
Uppsala University Hopsital
City
Uppsala
ZIP/Postal Code
75185
Country
Sweden
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marta Lomnytska, PhD
Phone
018-611 00 00
Ext
+46
Email
marta.lomnytska@akademiska.se
First Name & Middle Initial & Last Name & Degree
Ilvars Silins, PhD
Phone
018-611 00 00
Ext
+46
Email
ilvars.silins@akademiska.se
First Name & Middle Initial & Last Name & Degree
Wilhelm Graf, Professor

12. IPD Sharing Statement

Plan to Share IPD
No

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Hyperthermic Intraperitoneal Chemotherapy for Treatment of Relapsed Ovarian Cancer

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