Second-Line Treatment for Patients With Platinum-Sensitive Ovarian Cancer

NCT00090610CompletedPHASE2INTERVENTIONAL

Summary

Key Facts

Lead Sponsor

Duke University

Enrollment

150

Start Date

2003-10-01

Completion Date

2009-03-01

Study Type

INTERVENTIONAL

Official Title

Multicenter, Randomized, Phase II Comparative Study to Compare Efficacy & Safety of Taxotere®/Carboplatin Combination Therapy vs Sequential Therapy w/ Taxotere® Then Carboplatin as Second-line Treatment of Patients w/ Relapsed, Platinum-sensitive Ovarian Cancer

Interventions

DocetaxelCarboplatin

Conditions

Ovarian Cancer

Eligibility

Age Range

18 Years+

Sex

FEMALE

Inclusion Criteria:

* Pathologically confirmed epithelial ovarian cancer, peritoneal serous cancer, or tubal carcinoma.
* The patient's tumor is platinum-sensitive, which means that the patient had a complete response to front-line treatment with a platinum compound and had a treatment-free interval without clinical evidence of progressive disease for greater than 6 months.
* The patient has received one and only one prior chemotherapy regimen for the treatment of this malignancy. Prior treatment with paclitaxel and/or a platinum compound is allowed. Patients who have received consolidation treatment are allowed. Prior treatment with Taxotere® is not allowed.

  o Consolidation therapy is allowed including a different cytotoxic agent than the agent used in the front-line regimen, intraperitoneal therapy, biologic therapy, and immunotherapy.
* Patients may have received one prior regimen with a biologic therapy, either combined with cytotoxic therapy in the front-line setting, or as a single-agent for this recurrence. The biologic therapy must be discontinued at least three weeks prior to registration.
* Measurable or evaluable disease either by radiologic imaging, or physical exam, or by measurement of CA125 \< 70 on two occasions at least one week apart.
* At least 3 weeks since radiotherapy, with full recovery. The measurable disease must be completely outside the radiation portal.
* At least 3 weeks since major surgery, with full recovery. Patients who have undergone a secondary tumor debulking or cytoreductive surgery for this malignancy are excluded.
* Eastern Cooperative Oncology Group (ECOG) performance status \< 2.
* Age \> 18 years.
* Absolute neutrophil count \> 1,500/mm3; platelet count \> 100,000/mm3; Hemoglobin \> 8.0 g/dl
* Serum bilirubin Within Normal Limits (WNL); AST or ALT and Alkaline Phosphatase must be within the range allowing for eligibility.
* If there is childbearing potential, a serum pregnancy test must be negative.
* Patients of childbearing potential must be willing to consent to using effective contraception while on treatment and for three months following the completion of treatment.
* Informed consent has been obtained.

Exclusion Criteria:

* Prior treatment with Taxotere®.
* Concurrent immunotherapy or hormonal therapy for the specific purpose of treatment for the disease. Any hormonal therapy directed at the malignant tumor must be discontinued at least one week prior to enrollment in order for the patient to be eligible to participate in this trial. Continuation of Hormone Replacement therapy is permitted.
* Serious concurrent medical or psychiatric illness, including serious active infection.
* Peripheral neuropathy \> grade 2.
* History of other malignancy within the last 5 years, except for basal cell skin carcinoma.
* The patient is pregnant or nursing.
* Patients with a history of severe hypersensitivity reaction to cisplatin, carboplatin, mannitol, or drugs formulated with Polysorbate 80.
* Secondary debulking for this recurrence.

Outcome Measures

Primary Outcomes

Progression-free Survival (PFS)

Progression in measurable disease is defined as any of the following: At least a 20% increase in the sum of the longest diameter target lesions; appearance of one or more new lesions; Death due to disease without prior objective documentation of progression; deterioration in health status attributable to the disease requiring a change in therapy without objective documentation of progression Progression in non-measurable disease according to CA125 levels is defined as any of the following: CA125 that begins in normal range increases to twice the upper limit of normal; CA125 level that begins elevated increases 25% over two previous samples, a 50% increase over three previous samples, or a persistent elevation over 100 U/ml for more than 2 months without a 50% decrease.

Time frame: Every 6 months, to 18 months

Secondary Outcomes

Objective Response Rate

Complete response rate plus partial response rate, where: Complete response (CR) is defined as disappearance of all target and non-target lesions and no evidence of new lesions documented by two disease assessments at least 4 weeks apart and normalization of elevated CA125 in cases of ovarian cancer; Partial response (PR) for measurable disease is defined \>= 30% decrease in the sum of the longest dimensions of all target measurable lesions with no unequivocal progression of non-target lesions as well as no new lesions, with documentation by two disease assessments at least four weeks apart. PR according to CA125 levels is defined as a 50% decrease in CA125 levels where two initial samples were elevated and the sample that shows the 50% is confirmed by a fourth sample 28 days after the prior sample. OR = CR + PR

Time frame: Every 6 months, starting at 12 months to 24 months

Quality of Life

Quality of Life was measured using the Trial Outcome Index (TOI) score of the Functional Assessment of Cancer Therapy-Ovarian (FACT-O) instrument, version 4. The TOI portion of the FACT-O included questions related to Physical well-being (PWB), Social/Family well-being (FWB), and an ovarian cancer specific module (OCS). The PWB score range is from 0-28; the FWB score range is from 0-28; the OCS score range is from 0-44; this gives the TOI a score range from 0-100. (TOI = PWB + FWB + OCS) With these instruments, a higher score indicates better health-related quality of life.

Time frame: Baseline performed 14 days before first dose, then every other cycle and at study termination

Recurrence-Free Survival

Recurrence-free survival is based on measurable disease using Kaplan-Meier estimates for the intent to treat (ITT) Population who achieved a complete response.

Time frame: Every 6 months starting at 12 months, to 24 months

Median Overall Survival

Time frame: Every 6 months starting at 12 months, to 24 months

Locations

Florida Gynecologic Oncology, Fort Myers, United States

Jupiter Medical Center-Gynecology Oncology and Gynecology, Jupiter, United States

Florida Hospital/Gyn/Onc Department, Orlando, United States

Hematology-Onc. Assoc. of The Quad Cities, Bettendorf, United States

University of Iowa, Iowa City, United States

Franklin Square Hospital Center/MedStar Health-Section of Hematology/Oncology, Baltimore, United States

Cancer Center at Hackensack, Hackensack, United States

Columbia University College of Physicians and Surg, New York, United States

Hope: A Woman's Cancer Center, Asheville, United States

University of North Carolina/ Division of Gyn Oncology, Chapel Hill, United States

Carolinas Medical Center/Gyn Oncology Department, Charlotte, United States

Duke University/Division of Gynecologic Oncology, Durham, United States

Forsyth Regional Cancer Center, Winston-Salem, United States

Gynecologic Oncology and Surgery, Oklahoma City, United States

PA Hematology/Oncology Associates, Philadelphia, United States

Western Pennsylvania Hospital, Pittsburgh, United States

MUSC-Div of Gyn/Oncology, Charleston, United States

The West Cancer Clinic, Memphis, United States

Southwest Regional Cancer Center, Austin, United States