Active clinical trials for "Ovarian Neoplasms"

Tumours require a blood supply to provide them with oxygen and nutrients and to enable spread of cancer through blood vessels to other organs (metastasis). The formation of new blood vessels is known as angiogenesis, which is controlled by a growth factor (like a hormone) called Vascular Endothelial Growth Factor (VEGF). Many drugs have been developed that block VEGF and, in most tumour types, including ovarian cancer, the addition of VEGF inhibitors (VEGFi) to conventional anti-cancer therapy postpones recurrence of the disease. In ovarian cancer, VEGFi improve the overall outcome from the cancer in patients who have advanced stage and high-risk disease. VEGFi are now widely used in cancer medicine, yet until now there have not been any biomarkers (tests) that could be used to tell patients and their doctors whether the drugs were working or not. This is important, as VEGFi have side effects that are unpleasant for the patient. Additionally, VEGFi treatments are expensive. The VALTIVE team has discovered the first biomarker that informs doctors whether a VEGFi is blocking a tumour's blood supply. The test involves measuring a protein in the blood called Tie2, which can be measured from routine blood tests that patients have when going to the hospital. If the test shows that the amount of Tie2 decreases in the blood, it means that tumour blood vessels are blocked by VEGFi; if, on the contrary, the level increases, the blood vessels have escaped the control of VEGFi. The investigators have shown that the Tie2 test works in their initial studies in ovarian and bowel cancer. In these studies, the Tie2 blood test was based in the research laboratories. The investigators now wish to establish the test in the Christie Hospital NHS Biochemistry laboratory in Manchester so that it can be used in clinical practice rather than just as a research tool. The investigators wish to measure the relationship between loss of control of VEGF inhibitors as measured by TIE 2 and other standard ways of measuring loss of control of the tumour like increases on CT scans. There are several reasons why this test is needed for patients with ovarian cancer: VEGFi are effective during a patient's first or subsequent treatments for advanced ovarian cancer, but it is not clear which individuals are benefitting from treatment whilst they are on treatment. Patients who have already had one course of VEGFi can be re-treated successfully. Patients can avoid needless side effects, if there is a way of demonstrating that the treatment is of no benefit to them. This test will help doctors choose the best drug to control ovarian cancer and how long to continue treatment. This is very important, since other maintenance therapies are now available and the optimal duration of VEGFi therapy is well known. Around the world many teams are developing new combination treatments including VEGFi. If these new combinations prove effective, it would be possible to use them as efficiently as possible, as they will be very expensive and may therefore be less accessible to patients. These issues highlight the critical need to establish a test in the NHS that tells patients and their doctors when VEGFi are working and when they stop working. In VALTIVE1 study, blood samples will be taken from patients who are receiving a VEGFi called bevacizumab for ovarian cancer. Patients' management will not change during their participation to the trial. The analysis of the blood sample will support the hypothesis that patients whose Tie2 level decreases in response to bevacizumab will have ovarian cancer that is controlled for much longer than those where the Tie2 level does not decrease. These results will be used to design a second trial where the investigators will prove conclusively the value of the Tie2 test. The purpose of VALTIVE1 is to optimise sample acquisition time points and analytical algorithms to support the design of VALTIVE2, a randomised discontinuation trial. In VALTIVE2, Tie2-defined, vascular non-responding patients will be randomly allocated to stop bevacizumab after 9 weeks, by when a response can be detected, or to continue bevacizumab for the conventional year of treatment. Both VALTIVE 1 and VALTIVE2 will test the theory that there is no advantage in continuing bevacizumab in a patient whose Tie2 level does not reduce in response to VEGFi.

Monitored therapy of olaparib concentrations in the blood of diabetic population probably will assess the need for individual dosing of the drug. The project concerns on the monitored therapy of olaparib in a population of patients with DM, hyperglycemia and normal glucose level. Currently, there are no studies assessing the effect of comorbidities and of the administered drugs on the pharmacokinetics of olaparib.

Homologous recombination deficiency (HRD) is an important molecular biomarker for Poly (ADP-ribose) polymerase inhibitors (PARPi) which is a significant progress in the treatment of ovarian cancer. However, the proportion of HRD positive in real world and relationship of HRD status with PARPi in Chinese ovarian cancer patients remains unknown.

This trial studies the chemotherapy toxicity on quality of life in older patients with stage I, stage II, stage III, or stage IV ovarian epithelial, primary peritoneal cavity, or fallopian tube cancer. Learning about the side effects of chemotherapy in older patients may help doctors plan better ways to treat cancer.

Adjuvant chemotherapy was introduced in patients with early-stage ovarian cancer. The benefit of standard chemotherapeutic regimens including taxane has not been established. This study was conducted to investigate the influences of regimens of front-line chemotherapy on on recurrence and survival for early-stage ovarian adenocarcinoma. Further, the study will analyze cost-effectiveness of different regimens

The main goal of this study is to employ a novel proteomic approach to identify predictive tumor biomarkers that will increase the efficacy of insulin-like growth factor (IGF1R) targeted therapy in epithelial ovarian cancer. It is expected that these predictive biomarkers will be applied to increase the response rate in selected groups of patients.

MIRRORS "Minimally Invasive Robotic Surgery, Role in Optimal Debulking Ovarian Cancer, Recovery & Survival" is a new United Kingdom based prospective feasibility study the purpose of which is to establish the feasibility of launching a British multicentre randomised control trial of Robotic interval debulking surgery for ovarian cancer (including cancer of the fallopian tube & peritoneum) in the future. This initial feasibility study will focus on the ability to recruit patients, acceptability, quality of life, the rate at which it is possible to remove all visible tumour and the rate of conversion to open surgery. Ultimately the investigators would like to determine whether, in selected patients, robotic surgery offers improved quality of life and recovery with equivalent overall and progression free survival. Robotic surgery is unlikely to be suitable in all cases of ovarian cancer, particularly those with large pelvic masses or extensive disease around the upper part of the abdomen, however, it has the potential to provide significant recovery and quality of life benefits to a selected group of patients. MIRRORS - ICG "Peritoneal angiography / perfusion assessment using Indocyanine green (ICG) in patients with advanced ovarian cancers" is a ancillary study within MIRRORS. Using ICG dye, the investigators aim to observe whether there are any changes in the blood vessel pattern associated with the tumour deposits the investigators remove that makes them distinctive. The ICG will not be used to guide where biopsies are taken or tissue is removed. Participation in this ancillary research is not required for participation in the trial.

The purpose of the study is to understand why there are differences between individuals in the way they respond to paclitaxel chemotherapy.

The ability of different methods to discriminate between benign and malignant adnexal masses has been compared in a meta-analysis showing that the IOTA Simple Rules and the IOTA logistic regression model LR2 were superior to RMI and to all other methods for predicting malignancy in an adnexal mass included in the meta-analysis. However, a fair comparison of methods requires them to be applied on the same tumor population. The general objective of this study is to prospectively validate the Simple Rules, ADNEX, the Simple Rules risk model, LR2, and RMI on a large multicenter dataset to allow direct comparison of these tools. IOTA7 is an international multicenter prospective observational study including different types of ultrasound centers and examiners with different levels of ultrasound experience. In total, about 1700 adnexal masses with histological outcome will be included in IOTA 7.

This is an observational prospective study. Patients diagnosed with advanced epithelial ovarian cancer (stage IC or higher) since 2008 will be asked to participate in this study by signing an informed consent. Tumour samples will be reviewed to confirm the diagnosis and to select the best regions for tissue sampling to perform the following molecular studies: array-based Comparative Genomic Hybridization and Next Generation Sequencing. Detected mutations will be analysed by Sanger sequencing. FISH probes will be designed and tested on the samples.