Bevacizumab, Radiation Therapy, and Cisplatin in Treating Patients With Previously Untreated Locally Advanced Cervical Cancer
Cervical Adenocarcinoma, Cervical Adenosquamous Carcinoma, Cervical Squamous Cell Carcinoma, Not Otherwise Specified
About this trial
This is an interventional treatment trial for Cervical Adenocarcinoma
Eligibility Criteria
Inclusion Criteria: Histologically confirmed squamous cell, adenocarcinoma, or adenosquamous cell carcinoma of the uterine cervix, meeting 1 of the following stage criteria: Stage IIB-IIIB lymph nodes Stage IB-IIA disease with biopsy-proven pelvic node metastases and/or tumor size >= 5 cm No positive para-aortic lymph nodes Zubrod performance status 0-2 WBC >= 3,000/mm^3 Absolute granulocyte count >= 1,500/mm^3 Platelet count >= 100,000/mm^3 INR < 1.5 Total bilirubin =< 1.5 mg/dL Serum creatinine =< 1.5 mg/dL AST and ALT =< 2.5 times upper limit of normal (ULN) Serum calcium =< 1.3 times ULN Hemoglobin >= 10 g/dL (transfusion allowed) Urine protein:creatinine ratio ? 0.5 OR urine protein < 1,000 mg by 24-hour urine collection Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception None of the following illnesses or conditions: Medical illness preventing the use of full-dose chemotherapy Evidence of bleeding diathesis or coagulopathy Prior medical or psychiatric illness that would prevent informed consent or limit survival to < 6 months History of aneurysms, cerebrovascular accident, or arteriovenous malformations Active gastrointestinal (GI) ulcers, GI bleeding, or active inflammatory bowel disease Serious, nonhealing wound, ulcer, or current healing fracture History of any type of fistula or GI perforation Intra-abdominal abscess within the past 6 months No prior invasive malignancy (except nonmelanomatous skin cancer) unless disease free for >= 3 years No significant traumatic injury within the past 28 days No clinically significant cardiovascular disease, such as the following: Uncontrolled hypertension (blood pressure > 160/90 mm Hg on medication) Myocardial infarction within the past 12 months Unstable angina within the past 12 months New York Heart Association class II-IV congestive heart failure Unstable symptomatic arrhythmia requiring medication (i.e., chronic atrial arrhythmia, atrial fibrillation, or paroxysmal supraventricular tachycardia) Arterial thromboembolic events, including transient ischemic attack or clinically significant peripheral artery disease, within the past 6 months Arterial thromboembolic events, including transient ischemic attack or clinically significant peripheral artery disease, within the past 6 months No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies No known HIV No prior organ transplant No prior surgery for carcinoma of the cervix other than biopsy No prior surgical debulking of pelvic or para-aortic nodes No prior pelvic radiotherapy, including transvaginal irradiation to control bleeding No prior systemic chemotherapy No major surgical procedure or open biopsy within the past 28 days or anticipation of need for major surgical procedure during the course of the study No fine needle aspirations or core biopsies within the past 7 days No concurrent major surgical procedure No concurrent epoetin alfa or Hypericum perforatum (St. John's wort) No concurrent intensity-modulated radiotherapy No concurrent transvaginal irradiation to control bleeding
Sites / Locations
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
- University of California Davis Comprehensive Cancer Center
- Penrose-Saint Francis Healthcare
- University of Colorado
- Integrated Community Oncology Network-Florida Cancer Center Beaches
- Baptist MD Anderson Cancer Center
- Integrated Community Oncology Network-Southside Cancer Center
- University of Florida Health Science Center - Jacksonville
- Baptist Medical Center South
- 21st Century Oncology-Orange Park
- UF Cancer Center at Orlando Health
- 21st Century Oncology-Palatka
- Bay Medical Center
- Integrated Community Oncology Network-Flager Cancer Center
- Grady Health System
- Emory University Hospital/Winship Cancer Institute
- Northwest Community Hospital
- Northwestern University
- John H Stroger Jr Hospital of Cook County
- Franciscan St. James Health-Olympia Fields Campus
- Methodist Medical Center of Illinois
- Saint Vincent Anderson Regional Hospital/Cancer Center
- Franciscan Saint Francis Health-Beech Grove
- Saint Vincent Hospital and Health Care Center
- Reid Health
- Providence Medical Center
- Lawrence Memorial Hospital
- Menorah Medical Center
- Radiation Oncology Practice Corporation Southwest
- Saint Luke's South Hospital
- Shawnee Mission Medical Center-KCCC
- Baptist Health Lexington
- Norton Suburban Hospital and Medical Campus
- Brigham and Women's Hospital
- Boston Medical Center
- University of Michigan Comprehensive Cancer Center
- Borgess Medical Center
- Bronson Methodist Hospital
- West Michigan Cancer Center
- Cape Radiation Oncology
- Centerpoint Medical Center LLC
- Truman Medical Center
- Saint Luke's Hospital of Kansas City
- Radiation Oncology Practice Corporation South
- Saint Joseph Health Center
- North Kansas City Hospital
- Research Medical Center
- Radiation Oncology Practice Corporation - North
- Saint Luke's East - Lee's Summit
- Liberty Radiation Oncology Center
- Heartland Regional Medical Center
- CHI Health Good Samaritan
- University Medical Center of Southern Nevada
- Saint Barnabas Medical Center
- Monmouth Medical Center
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
- Rutgers Cancer Institute of New Jersey
- Newark Beth Israel Medical Center
- New York-Presbyterian/Brooklyn Methodist Hospital
- Roswell Park Cancer Institute
- Highland Hospital
- University of Rochester
- Wake Forest University Health Sciences
- Summa Akron City Hospital/Cooper Cancer Center
- Summa Barberton Hospital
- Grandview Hospital
- Good Samaritan Hospital - Dayton
- Miami Valley Hospital
- Samaritan North Health Center
- Veteran Affairs Medical Center
- Blanchard Valley Hospital
- Atrium Medical Center-Middletown Regional Hospital
- Kettering Medical Center
- Cancer Care Center, Incorporated
- Upper Valley Medical Center
- Clinton Memorial Hospital
- Cancer Treatment Center
- Wright-Patterson Medical Center
- Greene Memorial Hospital
- Bryn Mawr Hospital
- Paoli Memorial Hospital
- Einstein Medical Center Philadelphia
- Reading Hospital
- Lankenau Medical Center
- Main Line Health NCORP
- Wellmont Holston Valley Hospital and Medical Center
- M D Anderson Cancer Center
- American Fork Hospital / Huntsman Intermountain Cancer Center
- Sandra L Maxwell Cancer Center
- Logan Regional Hospital
- Cottonwood Hospital Medical Center
- Intermountain Medical Center
- McKay-Dee Hospital Center
- Utah Valley Regional Medical Center
- Dixie Medical Center Regional Cancer Center
- Intermountain Health Care
- Utah Cancer Specialists-Salt Lake City
- Huntsman Cancer Institute/University of Utah
- LDS Hospital
- Southwest VA Regional Cancer Center
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
- Gundersen Lutheran Medical Center
- Froedtert and the Medical College of Wisconsin
- London Regional Cancer Program
- McGill University Department of Oncology
- Allan Blair Cancer Centre
Arms of the Study
Arm 1
Experimental
Treatment (radiation therapy, bevacizumab, cisplatin)
Patients undergo pelvic EBRT once daily, 5 days a week, for 5 weeks for a total of 45 Gy. Some patients also undergo low-dose rate brachytherapy twice, 1-3 weeks apart, beginning >= 4 weeks after initiating EBRT or high-dose rate brachytherapy 5 times, >= 48 hours apart, beginning >= 2 weeks after initiating EBRT. EBRT and chemotherapy are halted on the day of high-dose rate brachytherapy. Patients receive bevacizumab IV over 30-90 minutes on days 1, 15, and 29 and cisplatin IV over 60 minutes on days 1, 8, 15, 22, 29, and 35.