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Gleevec and Gemzar in Patients With Epithelial Ovarian Cancer

Primary Purpose

Ovarian Cancer, Primary Peritoneal Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
imatinib mesylate by mouth
Gemcitabine Intravenous
Sponsored by
Henry M. Jackson Foundation for the Advancement of Military Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Cancer focused on measuring ovarian, cancer, peritoneal, endometrioid, mucinous, serous, clear cell

Eligibility Criteria

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

Inclusion Criteria:

  • Patients 18 years of age or greater
  • Histologically documented diagnosis of ovarian cancer or primary peritoneal cancer. Histological subtypes include: mucinous tumor, serous tumor, endometrioid tumor, and other histologies including clear cell and undifferentiated epithelial tumors.
  • At least one measurable site of disease (as defined by Southwestern Oncology Group Solid Tumor Response Criteria) or other response assessment criteria, as appropriate.
  • Patients must have relapsed after receiving at least one prior platinum-based chemotherapy.
  • Performance status of 0, 1, 2, (ECOG)
  • Adequate end organ function: Total bilirubin < 1.5 x ULN, SGOT and SGPT < 2.5 UNL, creatinine < 1.5 x UNL, ANC > 1.5 x 109/L, platelets > 100 x 109/L.
  • Patients will most likely have had their ovaries removed at the time off initial surgery. If any subjects are of childbearing potential at the time of entry, they must have negative pregnancy test within 7 days before initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Subjects of reproductive potential must agree to employ and effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of the study drug.
  • Written, voluntary informed consent.
  • Patients must be eligible for care at a military medical treatment facility.

Exclusion Criteria:

  • Patient has received prior treatment with Gemzar.
  • Patient has received any other investigational agents within 28 days of the first day of study drug dosing.
  • Patient is < 5 years free of another primary malignancy except: if the other primary malignancy is neither currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed.
  • Patient with Grade III/IV cardiac problems as defined but the New York Heart Association Criteria.
  • Patients who are pregnant or breast-feeding.
  • Patient has a severe and/or uncontrolled medical disease (i,e. uncontrolled diabetes, uncontrolled chronic renal disease, or active uncontrolled infection).
  • Patient has a known untreated or progressive brain metastasis.
  • Patient has known chronic liver diseases (i.e. chronic active hepatitis, and cirrhosis.
  • Patient has a known diagnosis of human immunodeficiency virus (HIV infection ).
  • Patient received chemotherapy within 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to study entry, unless the disease is rapidly progressing..
  • Patient previously received radiotherapy to greater than or equal to 25% of the bone marrow.
  • Patient had a major surgery within 2 weeks prior to study entry.
  • Patient with any significant history of non-compliance to medical regimens or with inability to grant reliable informed consent.

Sites / Locations

  • Madigan Army Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Oral Imatinib plus intravenous gemcitabine

Arm Description

All research subjects receive oral imatinib 400mg days 1-5 and 8-12 of a 21 day cycle. All research subjects received IV gemcitabine 1000mg/m2 days 3 and 10 of a 21-day cycle. . All subjects had epithelial ovarian cancer or primary peritoneal carcinomatosis and had failed to respond to prior chemotherapy or progressed after prior chemotherapy.

Outcomes

Primary Outcome Measures

The Cystostatic, Anti-tumor Activity of the Combination of Gleevec and Gemzar Via Progression-free Survival for at Least Six Months in Patients With Recurrent or Persistent Epithelial Ovarian or Primary Peritoneal Carcinoma.
Progression free survival at six months was assessed for all research subjects. Progression defined by SWOG criteria: Invest New Drugs. 1992 Nov;10(4):239-53. Progression is defined as > 50% increase in the sume of measured cross sectional area of areasa of measurable disease, measured from the lowest measured amount of disease. Progression is also defined as new areas of measurabe disease.
To Determine the Safety and Tolerability Via Frequency and Severity of Adverse Effect of Combination Gleevec and Gemzar in This Cohort of Patients as Assessed Byt Common Toxicity Criteria
Toxicity was assess prior to each cycle of therapy (every 3 weeks) and graded based on NCI common toxicity criteria

Secondary Outcome Measures

Tumor Response Rates Using Modified SWOG Criteria to the Combination of Gleevec and Gemzar in Patients With Relapsed Ovarian Cancer Who Have Failed at Least One Prior Chemotherapy Treatment.
Best response to thearpy was assessed using modified SWOG criteria (same as for outcome masure #1). Subjects were assess as "complete response", "partial response", "stable disease", and "progressive disease" after 2 cycles (6 weeks) of beginning treatment and every 6 weeks afterward until progression of disease, unacceptable toxicity, or subject withdrawl from study. the measurement reported is the number of patients who met the criteria for partial response.
To Determine the Distribution of the Overall Survival
All subjects were followed after treatment was complete to assess overall survival.
To Estimate the Clinical Response Rate(Partial and Complete Response as Defined Under the SWOG Criterial)
Using SWOG criteria for response of measurable disease, subject best response was assessed. First assessment was 6 weeks after starting treatment. Subjequent evaluations were every 6 weeks in patients who remained on study. Repsonse rate was the sum of Complete Repsonse and Partial Response.
To Assess the Effects of Prognostic Variables; Initial Performance Status; Platinum Sensitivity, and Mucinous (or Clear Cell)Histology on Progression-free Survival Overall.
The study was stopped after 8 subjects. It was not possible to perform meaningful analysis on prognostic variables. this outcome measure was not done.

Full Information

First Posted
June 25, 2009
Last Updated
October 20, 2014
Sponsor
Henry M. Jackson Foundation for the Advancement of Military Medicine
Collaborators
Novartis
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1. Study Identification

Unique Protocol Identification Number
NCT00928642
Brief Title
Gleevec and Gemzar in Patients With Epithelial Ovarian Cancer
Official Title
A Phase II Trial of Gleevec and Gemzar in Patients With Epithelial Ovarian Cancer Who Have Failed at Least Two Prior Therapies
Study Type
Interventional

2. Study Status

Record Verification Date
October 2014
Overall Recruitment Status
Completed
Study Start Date
June 2009 (undefined)
Primary Completion Date
November 2010 (Actual)
Study Completion Date
November 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Henry M. Jackson Foundation for the Advancement of Military Medicine
Collaborators
Novartis

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate the efficacy and tolerability of the combination of Gleevec and Gemzar in patients with ovarian cancer, who have progressed after receiving at least one prior chemotherapy treatment. Gleevec is an oral chemotherapy drug used is this study and Gemzar is an IV chemotherapy drug used. Participation in the treatment portion of the study will continue as long as the patient's tumors shrink or remain stable and as long as the patient is able to tolerate the study drug. The follow-up portion of the study will last for 5 years.
Detailed Description
Each 21 day period will be considered a cycle. Disease status will be assessed with a Cancer Antigen (CA)-125 prior to the start of each new cycle with an assessment of measurable diseased by either CT or MRI every 6 weeks. Treatment will continue until disease progression, unacceptable toxicities, or the patient elects to withdraw from the study. All patients will be followed until disease progression or study withdraw. In addition, following disease progression, patients will be monitored for delayed toxicity and survival for a period of 5 years, unless consent is withdrawn.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Cancer, Primary Peritoneal Cancer
Keywords
ovarian, cancer, peritoneal, endometrioid, mucinous, serous, clear cell

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Oral Imatinib plus intravenous gemcitabine
Arm Type
Experimental
Arm Description
All research subjects receive oral imatinib 400mg days 1-5 and 8-12 of a 21 day cycle. All research subjects received IV gemcitabine 1000mg/m2 days 3 and 10 of a 21-day cycle. . All subjects had epithelial ovarian cancer or primary peritoneal carcinomatosis and had failed to respond to prior chemotherapy or progressed after prior chemotherapy.
Intervention Type
Drug
Intervention Name(s)
imatinib mesylate by mouth
Other Intervention Name(s)
Gleevec
Intervention Description
imatinib mesylate - 400mg orally, daily on Days 1-5 and 8-12 of a 21 day cycle.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine Intravenous
Other Intervention Name(s)
Gemzar
Intervention Description
Gemcitabine - 1000 mg/m2 IV on Day 3 and Day 10 of a 21 day cycle
Primary Outcome Measure Information:
Title
The Cystostatic, Anti-tumor Activity of the Combination of Gleevec and Gemzar Via Progression-free Survival for at Least Six Months in Patients With Recurrent or Persistent Epithelial Ovarian or Primary Peritoneal Carcinoma.
Description
Progression free survival at six months was assessed for all research subjects. Progression defined by SWOG criteria: Invest New Drugs. 1992 Nov;10(4):239-53. Progression is defined as > 50% increase in the sume of measured cross sectional area of areasa of measurable disease, measured from the lowest measured amount of disease. Progression is also defined as new areas of measurabe disease.
Time Frame
Time to progression was measured from enrollment in study until documented disease progression over a period not greater than 2 years.
Title
To Determine the Safety and Tolerability Via Frequency and Severity of Adverse Effect of Combination Gleevec and Gemzar in This Cohort of Patients as Assessed Byt Common Toxicity Criteria
Description
Toxicity was assess prior to each cycle of therapy (every 3 weeks) and graded based on NCI common toxicity criteria
Time Frame
Until disease progression or unacceptable toxicity
Secondary Outcome Measure Information:
Title
Tumor Response Rates Using Modified SWOG Criteria to the Combination of Gleevec and Gemzar in Patients With Relapsed Ovarian Cancer Who Have Failed at Least One Prior Chemotherapy Treatment.
Description
Best response to thearpy was assessed using modified SWOG criteria (same as for outcome masure #1). Subjects were assess as "complete response", "partial response", "stable disease", and "progressive disease" after 2 cycles (6 weeks) of beginning treatment and every 6 weeks afterward until progression of disease, unacceptable toxicity, or subject withdrawl from study. the measurement reported is the number of patients who met the criteria for partial response.
Time Frame
Subjects treated until progression of disease or unacceptable toxicity. no maximum dose was specified
Title
To Determine the Distribution of the Overall Survival
Description
All subjects were followed after treatment was complete to assess overall survival.
Time Frame
Until death
Title
To Estimate the Clinical Response Rate(Partial and Complete Response as Defined Under the SWOG Criterial)
Description
Using SWOG criteria for response of measurable disease, subject best response was assessed. First assessment was 6 weeks after starting treatment. Subjequent evaluations were every 6 weeks in patients who remained on study. Repsonse rate was the sum of Complete Repsonse and Partial Response.
Time Frame
until disease progression or unacceptable toxicity
Title
To Assess the Effects of Prognostic Variables; Initial Performance Status; Platinum Sensitivity, and Mucinous (or Clear Cell)Histology on Progression-free Survival Overall.
Description
The study was stopped after 8 subjects. It was not possible to perform meaningful analysis on prognostic variables. this outcome measure was not done.
Time Frame
Until disease progression

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients 18 years of age or greater Histologically documented diagnosis of ovarian cancer or primary peritoneal cancer. Histological subtypes include: mucinous tumor, serous tumor, endometrioid tumor, and other histologies including clear cell and undifferentiated epithelial tumors. At least one measurable site of disease (as defined by Southwestern Oncology Group Solid Tumor Response Criteria) or other response assessment criteria, as appropriate. Patients must have relapsed after receiving at least one prior platinum-based chemotherapy. Performance status of 0, 1, 2, (ECOG) Adequate end organ function: Total bilirubin < 1.5 x ULN, SGOT and SGPT < 2.5 UNL, creatinine < 1.5 x UNL, ANC > 1.5 x 109/L, platelets > 100 x 109/L. Patients will most likely have had their ovaries removed at the time off initial surgery. If any subjects are of childbearing potential at the time of entry, they must have negative pregnancy test within 7 days before initiation of study drug dosing. Postmenopausal women must be amenorrheic for at least 12 months to be considered of non-childbearing potential. Subjects of reproductive potential must agree to employ and effective barrier method of birth control throughout the study and for up to 3 months following discontinuation of the study drug. Written, voluntary informed consent. Patients must be eligible for care at a military medical treatment facility. Exclusion Criteria: Patient has received prior treatment with Gemzar. Patient has received any other investigational agents within 28 days of the first day of study drug dosing. Patient is < 5 years free of another primary malignancy except: if the other primary malignancy is neither currently clinically significant nor requiring active intervention, or if other primary malignancy is a basal cell skin cancer or a cervical carcinoma in situ. Existence of any other malignant disease is not allowed. Patient with Grade III/IV cardiac problems as defined but the New York Heart Association Criteria. Patients who are pregnant or breast-feeding. Patient has a severe and/or uncontrolled medical disease (i,e. uncontrolled diabetes, uncontrolled chronic renal disease, or active uncontrolled infection). Patient has a known untreated or progressive brain metastasis. Patient has known chronic liver diseases (i.e. chronic active hepatitis, and cirrhosis. Patient has a known diagnosis of human immunodeficiency virus (HIV infection ). Patient received chemotherapy within 4 weeks (6 weeks for nitrosourea or mitomycin-C) prior to study entry, unless the disease is rapidly progressing.. Patient previously received radiotherapy to greater than or equal to 25% of the bone marrow. Patient had a major surgery within 2 weeks prior to study entry. Patient with any significant history of non-compliance to medical regimens or with inability to grant reliable informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David McCune, MD, MPH
Organizational Affiliation
Madigan Army Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Madigan Army Medical Center
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98431
Country
United States

12. IPD Sharing Statement

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Gleevec and Gemzar in Patients With Epithelial Ovarian Cancer

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