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Surgery or Chemotherapy in Recurrent Ovarian Cancer (SOC 1 Trial)?

Primary Purpose

Ovarian Epithelial Cancer Recurrent, Fallopian Tube Carcinoma, Primary Peritoneal Carcinoma

Status
Unknown status
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Secondary Cytoreductive Surgery
Salvage Chemotherapy
Sponsored by
Shanghai Gynecologic Oncology Group
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Epithelial Cancer Recurrent focused on measuring secondary cytoreductive surgery, Ovarian Cancer, surgery, recurrence

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Age at recurrence ≥ 18 years
  • Patients with platinum-sensitive, first relapsed epithelial ovarian, primary peritoneal, or fallopian tube cancer (EOC, PPC, FTC), which is defined as those with treatment -free interval of 6 months or more.
  • A complete secondary cytoreduction predicting score, iMODEL [Tian WJ, Ann Surg Oncol 2012,19(2):597-604]<=4.7, including FIGO stage (0 or 0.8); residual disease after primary surgery (0 or 1.5); Progression-free interval (0 or 2.4); PS ECOG (0 or 2.4); Ca125 (0 or 1.8); and ascites at recurrence (0 or 3.0). If PI and CO-PI reach consensus that the recurrent tumor detected by PET/CT could be completely resected, the index of CA125 could be scored as 0. (Revised on 09/30/2013)
  • Assessed by the experienced surgeons, complete resection of all recurrent disease is possible. If single lesion outside the peritoneal cavity can be resected, MRI/CT or PET/CT scan should be performed to exclude simultaneous intra-abdominal lesions.
  • Patients who have given their signed and written informed consent and their consent.

Exclusion Criteria:

  • Patients with borderline tumors as well as non-epithelial tumors.
  • Patients for interval-debulking, or for second-look surgery, or palliative surgery planned.
  • Impossible to assess the resectability or evaluate the score. Radiological signs suggesting complete resection is impossible.
  • More than one prior chemotherapy.
  • Second relapse or more
  • Patients with second or other malignancies who have been treated by surgery, if the treatment might interfere with the treatment of relapsed ovarian cancer or if major impact on prognosis is expected.
  • Progression during chemotherapy or recurrence within 6 months after first-line therapy
  • Any contradiction not allowing surgery and/or chemotherapy

    1. Accompanied by hypoxia serious chronic obstructive pulmonary disease
    2. Uncontrolled hypertension, cerebrovascular accident/ Stroke, myocardial infarct, unstable angina, untreated thrombosis, chronic congestive heart failure, or serious arrhythmia in need of medicine.
    3. Severe hepatitis, history of liver disease, nephrotic syndrome, renal insufficiency
    4. Active ulcer history, abdominal wall fistula, perforation of gastrointestinal tract, or Intra-abdominal abscess, or simultaneously apply treatment/prevent ulcers therapy.
    5. Uncontrolled diabetes
    6. Uncontrolled epilepsy need long-term antiepileptic treatment.
  • Any medication induced considerable risk of surgery, e.g. estimated bleeding due to oral anticoagulating agents, or bevacizumab.

Sites / Locations

  • Sun Yat-sen University Cancer Center
  • Fudan University Cancer Hospital
  • Shanghai Zhongshan Hospital
  • Zhejiang Cancer Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

secondary cytoreductive surgery

Salvage Chemotherapy

Arm Description

SCR followed by chemotherapy

platinum-based chemotherapy

Outcomes

Primary Outcome Measures

Overall survival
from date of randomisation until death
Progression-free survival
interval between date of randomization and the date of second relapse/ progression or death, whatever occurs first

Secondary Outcome Measures

Accumulating Treatment-free survival (TFSa)
the time of OS minus each treatment period after randomization, including surgery and chemotherapy
Overall survival after the adjustment of one-way treatment switching
OS adjusted by statistical models for crossover
30-day post-operative complications
MSKCC surgical complications grading method and CTCAE v4.03 criteria will be adopted for evaluating the perioperative complications
Validation of iMODEL
iMODEL score to predict complete resection
Patient compliance
compliance with protocol
Quality of life assessments
The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) Functional Assessment of Cancer Therapy- Ovary (FACT-O)
Time to first subsequent anticancer therapy
From date of randomization until the date of first recurrent anticancer therapy
Time to second subsequent anticancer therapy
From date of randomization until the date of secondary recurrent anticancer therapy

Full Information

First Posted
May 30, 2012
Last Updated
June 7, 2021
Sponsor
Shanghai Gynecologic Oncology Group
Collaborators
Fudan University, Zhejiang Cancer Hospital, Shanghai Zhongshan Hospital, Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT01611766
Brief Title
Surgery or Chemotherapy in Recurrent Ovarian Cancer (SOC 1 Trial)?
Official Title
Evaluation of Secondary Cytoreductive Surgery in Platinum-Sensitive Recurrent Ovarian Cancer: A Phase III, Multicenter, Randomized Trial
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Unknown status
Study Start Date
July 19, 2012 (Actual)
Primary Completion Date
December 2019 (Actual)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Gynecologic Oncology Group
Collaborators
Fudan University, Zhejiang Cancer Hospital, Shanghai Zhongshan Hospital, Sun Yat-sen University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the role of secondary cytoreduction (SCR) and validate the risk model of patient selection criteria in platinum-sensitive recurrent ovarian cancer.
Detailed Description
The primary objective is to determine whether secondary cytoreduction followed by chemotherapy is superior to chemotherapy alone in improving progression-free survival (PFS) and overall survival (OS) in patients with platinum-sensitive recurrent ovarian cancer

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Epithelial Cancer Recurrent, Fallopian Tube Carcinoma, Primary Peritoneal Carcinoma
Keywords
secondary cytoreductive surgery, Ovarian Cancer, surgery, recurrence

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
356 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
secondary cytoreductive surgery
Arm Type
Experimental
Arm Description
SCR followed by chemotherapy
Arm Title
Salvage Chemotherapy
Arm Type
Active Comparator
Arm Description
platinum-based chemotherapy
Intervention Type
Procedure
Intervention Name(s)
Secondary Cytoreductive Surgery
Other Intervention Name(s)
Maximum effort cytoreductive surgery
Intervention Description
Complete Cytoreduction
Intervention Type
Drug
Intervention Name(s)
Salvage Chemotherapy
Other Intervention Name(s)
second line chemotherapy
Intervention Description
6 cycles of postoperative chemotherapy
Primary Outcome Measure Information:
Title
Overall survival
Description
from date of randomisation until death
Time Frame
Up to 60 months after last patient randomized
Title
Progression-free survival
Description
interval between date of randomization and the date of second relapse/ progression or death, whatever occurs first
Time Frame
Up to 24 months after last patient randomized
Secondary Outcome Measure Information:
Title
Accumulating Treatment-free survival (TFSa)
Description
the time of OS minus each treatment period after randomization, including surgery and chemotherapy
Time Frame
Up to 60 months after last patient randomized
Title
Overall survival after the adjustment of one-way treatment switching
Description
OS adjusted by statistical models for crossover
Time Frame
Up to 60 months after last patient randomized
Title
30-day post-operative complications
Description
MSKCC surgical complications grading method and CTCAE v4.03 criteria will be adopted for evaluating the perioperative complications
Time Frame
From the operation until after 30 days
Title
Validation of iMODEL
Description
iMODEL score to predict complete resection
Time Frame
From randomization to operation
Title
Patient compliance
Description
compliance with protocol
Time Frame
Up to 60 months after last patient randomized
Title
Quality of life assessments
Description
The EORTC core quality of life questionnaire (QLQ-C30, version 3.0) Functional Assessment of Cancer Therapy- Ovary (FACT-O)
Time Frame
Study entry; 6 months; 12 months; 24 months and 60 months after randomization
Title
Time to first subsequent anticancer therapy
Description
From date of randomization until the date of first recurrent anticancer therapy
Time Frame
Up to 60 months after last patient randomized
Title
Time to second subsequent anticancer therapy
Description
From date of randomization until the date of secondary recurrent anticancer therapy
Time Frame
Up to 60 months after last patient randomized

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age at recurrence ≥ 18 years Patients with platinum-sensitive, first relapsed epithelial ovarian, primary peritoneal, or fallopian tube cancer (EOC, PPC, FTC), which is defined as those with treatment -free interval of 6 months or more. A complete secondary cytoreduction predicting score, iMODEL [Tian WJ, Ann Surg Oncol 2012,19(2):597-604]<=4.7, including FIGO stage (0 or 0.8); residual disease after primary surgery (0 or 1.5); Progression-free interval (0 or 2.4); PS ECOG (0 or 2.4); Ca125 (0 or 1.8); and ascites at recurrence (0 or 3.0). If PI and CO-PI reach consensus that the recurrent tumor detected by PET/CT could be completely resected, the index of CA125 could be scored as 0. (Revised on 09/30/2013) Assessed by the experienced surgeons, complete resection of all recurrent disease is possible. If single lesion outside the peritoneal cavity can be resected, MRI/CT or PET/CT scan should be performed to exclude simultaneous intra-abdominal lesions. Patients who have given their signed and written informed consent and their consent. Exclusion Criteria: Patients with borderline tumors as well as non-epithelial tumors. Patients for interval-debulking, or for second-look surgery, or palliative surgery planned. Impossible to assess the resectability or evaluate the score. Radiological signs suggesting complete resection is impossible. More than one prior chemotherapy. Second relapse or more Patients with second or other malignancies who have been treated by surgery, if the treatment might interfere with the treatment of relapsed ovarian cancer or if major impact on prognosis is expected. Progression during chemotherapy or recurrence within 6 months after first-line therapy Any contradiction not allowing surgery and/or chemotherapy Accompanied by hypoxia serious chronic obstructive pulmonary disease Uncontrolled hypertension, cerebrovascular accident/ Stroke, myocardial infarct, unstable angina, untreated thrombosis, chronic congestive heart failure, or serious arrhythmia in need of medicine. Severe hepatitis, history of liver disease, nephrotic syndrome, renal insufficiency Active ulcer history, abdominal wall fistula, perforation of gastrointestinal tract, or Intra-abdominal abscess, or simultaneously apply treatment/prevent ulcers therapy. Uncontrolled diabetes Uncontrolled epilepsy need long-term antiepileptic treatment. Any medication induced considerable risk of surgery, e.g. estimated bleeding due to oral anticoagulating agents, or bevacizumab.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rongyu Zang, MD,PhD
Organizational Affiliation
Shanghai Gynecologic Oncology Group
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sun Yat-sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510060
Country
China
Facility Name
Fudan University Cancer Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Facility Name
Shanghai Zhongshan Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200032
Country
China
Facility Name
Zhejiang Cancer Hospital
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310022
Country
China

12. IPD Sharing Statement

Citations:
PubMed Identifier
33705695
Citation
Shi T, Zhu J, Feng Y, Tu D, Zhang Y, Zhang P, Jia H, Huang X, Cai Y, Yin S, Jiang R, Tian W, Gao W, Liu J, Yang H, Cheng X, Zang R. Secondary cytoreduction followed by chemotherapy versus chemotherapy alone in platinum-sensitive relapsed ovarian cancer (SOC-1): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol. 2021 Apr;22(4):439-449. doi: 10.1016/S1470-2045(21)00006-1. Epub 2021 Mar 8.
Results Reference
derived
Links:
URL
http://www.ShanghaiGOG.org
Description
Shanghai Gynecologic Oncology Group

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Surgery or Chemotherapy in Recurrent Ovarian Cancer (SOC 1 Trial)?

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