Study of Nimotuzumab, Radiation Therapy and Cisplatin Versus Radiation Therapy and Cisplatin for Treatment of Stage IB e IVA UCC(CORUS)
Carcinoma, Adenocarcinoma, Uterine Cervix Adenosquamous Carcinoma
About this trial
This is an interventional treatment trial for Carcinoma focused on measuring carcinoma or adenocarcinoma or uterine cervix adenosquamous carcinoma
Eligibility Criteria
Inclusion Criteria:
- Age > 18 years;
- Diagnosis of histologically confirmed stages IB2 (> 4 cm) to IVA prickle-cell carcinoma or adenocarcinoma or uterine cervix adenosquamous carcinoma, according to FIGO system,7 (see Appendix A for guidance about staging);
- Measurable disease according to RECIST 1.139 or at least disease evaluable through imaging methods and/or gynecological examination (magnetic resonance imaging (MRI) scans within six weeks prior to randomization will be accepted, computed tomography will accepted in case MRI is contraindicated);
- Indication of definitive treatment with chemotherapy and radiation therapy, at the investigator's discretion;
- Performance status < 2, according to the Eastern Cooperative Oncology Group criteria 40 (ECOG; see Appendix C);
- Adequate body functions, indicated by:Serum creatinine < 1.2 mg/100 mL; Creatinine clearance > 60 mL/min (estimate); Bilirubin up to 1.5-fold the upper limit of normal (ULN) and transaminases, alkaline phosphatase and gamma-glutamyltransferase up to 2.5-fold the ULN; Leucocytes > 3,000/μL; Neutrophils > 1,500/μL; Hemoglobin > 10 g/dL; Platelets > 80,000/μL;
- Signed informed consent form.
Exclusion Criteria:
- Para-aortic lymph nodes involvement through radiological and/or surgical staging, at investigator's discretion;
- Current severe comorbidity that, in the investigator's opinion, would put the patient at a significantly higher risk or will jeopardize protocol compliance;
- Current bowel inflammatory disease;
- Current major neurological or psychiatric disease, including clinically significant dementia and seizures, at the investigator's discretion;
- Known hypersensitivity or allergic reactions to study treatment;
- Current uncontrolled hypercalcemia (> 11,5 mg/dL, that is, grade > 1 according to Common Terminology Criteria for Adverse Events [CTCAE] v4.02, of US National Cancer Institute)41;
- Know HIV positive status (enrollment of patients with hepatitis B or C is at the investigator's discretion);
- Pregnancy or lactation;
- Female patients, as well as their partners, who wish to become pregnant or are unwilling to use an appropriate contraceptive method throughout the study period.
Sites / Locations
- Centro de Pesquisa Clínica da Liga Norte Riograndense contra o Câncer
- Hospital de Caridade de Ijui - ONCOSITE Centro de Pesquisa Clínica em Oncologia
- Hospital Santa Rita - Núcleo de Novos Tratamentos em Câncer
- Caism - Unicamp
- Centro de Pesquisas Clínicas da Fundação Amaral Carvalho
- ICESP
- Hospital Santa Marcelina
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Radiation therapy and Cisplatin
Nimotuzumab and
Cisplatin, 40 mg/m2, IV - Weekly doses for 6 weeks Pelvic radiation therapy, 45 Gy External, Fractions of 1.8 Gy per day, 5 days a week Dose boosts,15 Gy ± 5%, External, Daily fractions of 1.8 Gy or 2 Gy per day, 5 days a week Brachytherapy (if indicaed), 40 Gy at spot A(low dose rate), Intracavitary 1 or 2 separate fractions for 1 to 3 weeks. 28 Gy at spot A, (high dose rate) Intracavitary,4 fractions of 7.0 Gy once or twice a week.
Cisplatin, 40 mg/m2, IV, Weekly doses for 6 weeks. Nimotuzumab, 200 mg, Diluted into 250 mL of sodium chloride sterile solution 0.9% in intravenous infusion for 30 minutes, Weekly doses for 14 weeks. Pelvic radiation therapy, 45 Gy, External, Fractions of 1.8 Gy per day, 5 days a week. Dose boosts, 15 Gy ± 5%, External,Daily fractions of 1.8 Gy or 2 Gy per day, 5 days a week Brachytherapy (In case there is indication, should it be performed, not to be longer than the expected 70 days for the entire radiation therapy), 40 Gy at spot A (low dose rate) Intracavitary 1 or 2 separate fractions for 1 to 3 weeks 28 Gy at spot A (high dose rate), Intracavitary, 4 fractions of 7.0 Gy once or twice a week.