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A Phase II Combined Modality Protocol of Debulking Surgery With HIPEC Followed by Intraperitoneal Chemotherapy for the Treatment of Recurrent Ovarian, Primary Peritoneal & Fallopian Tube Cancers (HIPEC)

Primary Purpose

Recurrent Ovarian Cancer, Fallopian Tube Cancer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cisplatin
Doxorubicin
Sponsored by
Columbia University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Ovarian Cancer focused on measuring Primary peritoneal

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must have histologically confirmed ovarian, primary peritoneal or fallopian tube carcinoma.
  2. Patients must have measurable evidence of recurrent intraabdominal disease based on Computed tomography (CT scan) findings.
  3. Patients must fulfill the following with regard to prior chemotherapy:

    1. 4 weeks or greater since conclusion of prior chemotherapy;
    2. Prior intraperitoneal chemotherapy with cisplatin is acceptable; and,
    3. Prior systemic chemotherapy is acceptable.
  4. Patients must have a Karnofsky Performance Status of > 70%
  5. Patients must have an estimated life expectancy of at least 16 weeks.
  6. Patient assurance of study compliance and geographic proximity that allows for adequate follow-up.
  7. Patients must have adequate organ function at the screening visit as defined by the following laboratory values:

    Absolute neutrophil count (ANC) ≥1.5 x 109/L Platelet count ≥100 x 109/L Hemoglobin ≥8 g/dL Albumin ≥ 2 g/dL Total Bilirubin ≤ 2.5 x ULN* Alkaline phosphatase ≤ 3.0 x ULN* Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 3.0 x ULN Creatinine ≤ 1.5 x ULN

  8. Patient must have signed informed consent
  9. Patient must be at least 18 years of age
  10. Following cytoreductive surgery, patient's residual disease should be no larger than 1cm to Receive HIPEC and continue with normothermic IP chemotherapy

Exclusion criteria:

  1. Have active peripheral neuropathy of Grade 2 or greater intensity, as defined by the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE; Version 4).
  2. Have experienced myocardial infarction within 6 months prior to enrollment or have New York Hospital Association (NYHA) Class III or IV heart failure (see section 16.4), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities.
  3. Prior radiation therapy within 4 weeks of enrollment.
  4. Have uncontrolled active systemic infection requiring therapy.
  5. Have a history of allergic reaction attributable to compounds containing boron or mannitol or hypersensitivity reactions to drugs formulated with polysorbate 80.
  6. Have had a serious concomitant systemic disorders (including oncologic emergencies) incompatible with the study (at the discretion of the investigator).
  7. Have had a "currently active" second malignancy other than non-melanoma skin cancer or carcinoma in situ of the cervix are not to be registered. Patients who are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse.
  8. Have had any investigational agent within 4 weeks before enrollment into the study.
  9. Have a history of a serious medical or psychiatric illness preventing informed consent or, in the opinion of the investigator, would make the patient a poor study candidate.
  10. Evidence of extraabdominal metastasis on preinclusion thoracic computed tomography (CT) scans (i.e. brain or chest disease).

Sites / Locations

  • Columbia University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Out-Patient Intraperitoneal Chemotherapy

Arm Description

Intraoperative (hyperthermic) cisplatin followed by 4 courses of intraperitoneal cisplatin and doxorubicin given on days 1 & 8 during a 3 week cycle.

Outcomes

Primary Outcome Measures

Adverse Event Rate and/or Laboratory Changes
The adverse event rate and laboratory changes will be used to investigate the safety of surgical debulking with heated intraperitoneal chemotherapy (HIPEC) combined with repeated intraperitoneal chemotherapy.
Toxicity Rating Based on NCI Common Toxicity Criteria
Patients will be rated for toxicity prior to each cycle using the NCI Common Toxicity Criteria (NCICTC; see the CTCAE, Version 4.0).

Secondary Outcome Measures

Time to Serum Ca-125 Nadir and/or CT Response (RECIST Criteria)
Efficacy of surgical resection with HIPEC combined with repeated intraperitoneal chemotherapy: The end point will be the objective response rate and progression-free survival as well as the overall survival, if feasible. We will analyze the time to serum Ca 125 nadir and/or CT response based on Recist criteria.
Kaplan-Meier Curves for Patient Overall Survival
Kaplan-Meier analysis will be done using PROC LIFETEST in Statistical Application Software (SAS).

Full Information

First Posted
July 10, 2012
Last Updated
January 30, 2017
Sponsor
Columbia University
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1. Study Identification

Unique Protocol Identification Number
NCT01659554
Brief Title
A Phase II Combined Modality Protocol of Debulking Surgery With HIPEC Followed by Intraperitoneal Chemotherapy for the Treatment of Recurrent Ovarian, Primary Peritoneal & Fallopian Tube Cancers
Acronym
HIPEC
Official Title
A Phase II Combined Modality Protocol of Debulking Surgery With Heated Intraoperative Chemotherapy (HIPEC) Followed by Intraperitoneal Chemotherapy for the Treatment of Recurrent Ovarian, Primary Peritoneal and Fallopian Tube Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Terminated
Why Stopped
Principal Investigator left institution
Study Start Date
March 2012 (undefined)
Primary Completion Date
April 2014 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Columbia University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to investigate the feasibility, tolerability and safety of surgical debulking and resection with heated intraoperative chemotherapy (HIPEC) followed by repeated intraperitoneal chemotherapy for treatment of recurrent ovarian, primary peritoneal, and fallopian tube carcinomas.
Detailed Description
This is a phase II , open label, single center study of surgery followed by heated intraoperative cisplatin in patients with recurrent ovarian, primary peritoneal or fallopian tube cancers. Approximately twenty patients will receive surgery and intraoperative (hyperthermic) cisplatin followed by four consecutive courses of outpatient intraperitoneal cisplatin and doxorubicin given on days 1 and 8 during a 3 week cycle.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Out-Patient Intraperitoneal Chemotherapy
Arm Type
Experimental
Arm Description
Intraoperative (hyperthermic) cisplatin followed by 4 courses of intraperitoneal cisplatin and doxorubicin given on days 1 & 8 during a 3 week cycle.
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
cis-diamminedichloroplatinum(II) (CDDP), Platinol, Platinol-AQ
Intervention Description
Cisplatin (75 mg/m2) prepared in 2L normal saline.
Intervention Type
Drug
Intervention Name(s)
Doxorubicin
Other Intervention Name(s)
hydroxyldaunorubicin, Adriamycin
Intervention Description
Doxorubicin (25 mg flat dose) prepared in 500 ml dialysis fluid (glucose or icodextrin-based).
Primary Outcome Measure Information:
Title
Adverse Event Rate and/or Laboratory Changes
Description
The adverse event rate and laboratory changes will be used to investigate the safety of surgical debulking with heated intraperitoneal chemotherapy (HIPEC) combined with repeated intraperitoneal chemotherapy.
Time Frame
5 years
Title
Toxicity Rating Based on NCI Common Toxicity Criteria
Description
Patients will be rated for toxicity prior to each cycle using the NCI Common Toxicity Criteria (NCICTC; see the CTCAE, Version 4.0).
Time Frame
Up to 5 years
Secondary Outcome Measure Information:
Title
Time to Serum Ca-125 Nadir and/or CT Response (RECIST Criteria)
Description
Efficacy of surgical resection with HIPEC combined with repeated intraperitoneal chemotherapy: The end point will be the objective response rate and progression-free survival as well as the overall survival, if feasible. We will analyze the time to serum Ca 125 nadir and/or CT response based on Recist criteria.
Time Frame
Up to 5 years (survival)
Title
Kaplan-Meier Curves for Patient Overall Survival
Description
Kaplan-Meier analysis will be done using PROC LIFETEST in Statistical Application Software (SAS).
Time Frame
Up to 5 years, survival

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must have histologically confirmed ovarian, primary peritoneal or fallopian tube carcinoma. Patients must have measurable evidence of recurrent intraabdominal disease based on Computed tomography (CT scan) findings. Patients must fulfill the following with regard to prior chemotherapy: 4 weeks or greater since conclusion of prior chemotherapy; Prior intraperitoneal chemotherapy with cisplatin is acceptable; and, Prior systemic chemotherapy is acceptable. Patients must have a Karnofsky Performance Status of > 70% Patients must have an estimated life expectancy of at least 16 weeks. Patient assurance of study compliance and geographic proximity that allows for adequate follow-up. Patients must have adequate organ function at the screening visit as defined by the following laboratory values: Absolute neutrophil count (ANC) ≥1.5 x 109/L Platelet count ≥100 x 109/L Hemoglobin ≥8 g/dL Albumin ≥ 2 g/dL Total Bilirubin ≤ 2.5 x ULN* Alkaline phosphatase ≤ 3.0 x ULN* Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 3.0 x ULN Creatinine ≤ 1.5 x ULN Patient must have signed informed consent Patient must be at least 18 years of age Following cytoreductive surgery, patient's residual disease should be no larger than 1cm to Receive HIPEC and continue with normothermic IP chemotherapy Exclusion criteria: Have active peripheral neuropathy of Grade 2 or greater intensity, as defined by the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events (CTCAE; Version 4). Have experienced myocardial infarction within 6 months prior to enrollment or have New York Hospital Association (NYHA) Class III or IV heart failure (see section 16.4), uncontrolled angina, severe uncontrolled ventricular arrhythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior radiation therapy within 4 weeks of enrollment. Have uncontrolled active systemic infection requiring therapy. Have a history of allergic reaction attributable to compounds containing boron or mannitol or hypersensitivity reactions to drugs formulated with polysorbate 80. Have had a serious concomitant systemic disorders (including oncologic emergencies) incompatible with the study (at the discretion of the investigator). Have had a "currently active" second malignancy other than non-melanoma skin cancer or carcinoma in situ of the cervix are not to be registered. Patients who are not considered to have a "currently active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse. Have had any investigational agent within 4 weeks before enrollment into the study. Have a history of a serious medical or psychiatric illness preventing informed consent or, in the opinion of the investigator, would make the patient a poor study candidate. Evidence of extraabdominal metastasis on preinclusion thoracic computed tomography (CT) scans (i.e. brain or chest disease).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharyn Lewin, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase II Combined Modality Protocol of Debulking Surgery With HIPEC Followed by Intraperitoneal Chemotherapy for the Treatment of Recurrent Ovarian, Primary Peritoneal & Fallopian Tube Cancers

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