test

Paclitaxel and Carboplatin or Ifosfamide in Treating Patients With Newly Diagnosed Persistent or Recurrent Uterine, Ovarian, Fallopian Tube, or Peritoneal Cavity Cancer

Conditions

Ovarian Carcinosarcoma | Recurrent Fallopian Tube Carcinoma | Recurrent Ovarian Carcinoma | Recurrent Primary Peritoneal Carcinoma | Recurrent Uterine Corpus Sarcoma | Stage I Ovarian Cancer | Stage IA Fallopian Tube Cancer | Stage IA Ovarian Cancer | Stage IA Uterine Sarcoma | Stage IB Fallopian Tube Cancer | Stage IB Ovarian Cancer | Stage IB Uterine Sarcoma | Stage IC Fallopian Tube Cancer | Stage IC Ovarian Cancer | Stage IC Uterine Sarcoma | Stage II Ovarian Cancer | Stage IIA Fallopian Tube Cancer | Stage IIA Ovarian Cancer | Stage IIA Uterine Sarcoma | Stage IIB Fallopian Tube Cancer | Stage IIB Ovarian Cancer | Stage IIB Uterine Sarcoma | Stage IIC Fallopian Tube Cancer | Stage IIC Ovarian Cancer | Stage IIIA Fallopian Tube Cancer | Stage IIIA Ovarian Cancer | Stage IIIA Primary Peritoneal Cancer | Stage IIIA Uterine Sarcoma | Stage IIIB Fallopian Tube Cancer | Stage IIIB Ovarian Cancer | Stage IIIB Primary Peritoneal Cancer | Stage IIIB Uterine Sarcoma | Stage IIIC Fallopian Tube Cancer | Stage IIIC Ovarian Cancer | Stage IIIC Primary Peritoneal Cancer | Stage IIIC Uterine Sarcoma | Stage IV Fallopian Tube Cancer | Stage IV Ovarian Cancer | Stage IV Primary Peritoneal Cancer | Stage IVA Uterine Sarcoma | Stage IVB Uterine Sarcoma | Uterine Carcinosarcoma

Trial Phase

Phase 3

Trial Purpose and Description

Trial Purpose

This randomized phase III trial studies paclitaxel and carboplatin see how well it works compared with paclitaxel and ifosfamide in treating patients with newly diagnosed persistent or recurrent uterine, ovarian, fallopian tube, or peritoneal cavity cancer. Drugs used in chemotherapy, such as paclitaxel, carboplatin, and ifosfamide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether paclitaxel is more effective when given with carboplatin or ifosfamide in treating patients with uterine, ovarian, fallopian tube, or peritoneal cavity cancer.


Trial Description

PRIMARY OBJECTIVES:

I. To determine if treatment with combination paclitaxel and carboplatin (TC) chemotherapy does not result in an inferior death rate when compared to ifosfamide, mesna, and paclitaxel chemotherapy.

SECONDARY OBJECTIVES:

I. To determine if treatment with combination paclitaxel and carboplatin (TC) chemotherapy does not result in an inferior progression-free survival when compared to ifosfamide, mesna, and paclitaxel chemotherapy.

II. To determine if acute toxicity, specifically physician-assessed neurotoxicity and infection, associated with combination paclitaxel and carboplatin chemotherapy is reduced compared to that of ifosfamide, mesna, and paclitaxel chemotherapy.

III. To determine if treatment with combination paclitaxel and carboplatin chemotherapy is associated with superior patient-reported quality of life and neurotoxicity scores compared to that of ifosfamide, mesna, and paclitaxel chemotherapy.

TERTIARY OBJECTIVES:

I. To bank formalin-fixed, paraffin-embedded (FFPE) tumor tissue and deoxyribonucleic acid (DNA) extracted from whole blood for future research.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive paclitaxel intravenously (IV) over 3 hours and carboplatin IV over 30-60 minutes on day 1.

ARM II: Patients receive paclitaxel as in arm I and ifosfamide IV over 1 hour on days 1-3.

In both arms, treatment repeats every 21 days for 6-10 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.


Participation Guidelines

Age:
18 Years - N/A
Gender:
Female

Eligibility Criteria


Inclusion Criteria:

- Patients must have newly diagnosed stage I-IV, persistent or recurrent (including
unstaged) uterine carcinosarcoma (malignant mixed mullerian tumor-MMMT or with
ovarian, fallopian tube or peritoneal carcinosarcoma and an enrollment date prior to
10/21/2013; pathology confirmed by site/institutional pathologist prior to
enrollment) and be chemotherapy naïve as directed against their carcinosarcoma;
unstaged patients (patients who have not had hysterectomy or ovarian surgery) are
eligible and should be included as "unstaged" if the only histologic (pathology)
documentation of the disease is a biopsy or curettage of the uterus; if these
patients have documented metastatic disease, it should be assigned the appropriate
stage (III/IV)

- Patients may have received prior adjuvant external beam radiation therapy and/or
vaginal brachytherapy; patients should be at least 4 weeks from the completion of
external beam radiotherapy prior to beginning protocol chemotherapy; patients do not
need to be delayed if receiving vaginal brachytherapy only

- Gynecologic Oncology Group (GOG) performance status 0, 1, or 2

- Patients must have recovered from the effects of recent surgery, radiotherapy, or
other therapy

- Patients must be free of active infection requiring antibiotics

- Any hormonal therapy directed at the malignant tumor must be discontinued at least
one week prior to beginning protocol chemotherapy; continuation of hormone
replacement therapy is permitted

- Platelet count greater than or equal to 100,000/mcL

- Absolute neutrophil count (ANC) greater than or equal to 1,500/mcL equivalent to
Common Terminology Criteria for Adverse Events (CTCAE) v3.0 grade 1

- Creatinine less than or equal to 1.5 times upper limit of normal (ULN), CTCAE v3.0
grade 1

- Bilirubin less than or equal to 1.5 times ULN (CTCAE v3.0 grade 1)

- Serum glutamic oxaloacetic transaminase (SGOT) less than or equal to 2.5 times ULN
(CTCAE v3.0 grade 1)

- Alkaline phosphatase less than or equal to 2.5 times ULN (CTCAE v3.0 grade 1)

- Serum albumin should be equal to or greater than 3 g/dL

- Neuropathy (sensory and motor) less than or equal to CTCAE v3.0 grade 1

- Patients must have signed an approved informed consent and authorization permitting
release of personal health information

- Patients of childbearing potential must have a negative serum pregnancy test prior to
study entry and be practicing an effective form of contraception

- Patients may have measurable disease or non-measurable disease; measurable disease is
defined as at least one lesion that can be accurately measured in at least one
dimension (longest dimension to be recorded); each lesion must be >= 20 mm when
measured by conventional techniques, including palpation, plain x-ray, computed
tomography (CT), and magnetic resonance imaging (MRI), or >= 10 mm when measured by
spiral CT; measurable disease patients must have at least one "target lesion" to be
used to assess progression on this protocol as defined by Response Evaluation
Criteria In Solid Tumors (RECIST); tumors within a previously irradiated field will
be designated as "non-target" lesions unless progression is documented or a biopsy is
obtained to confirm persistence at least 90 days following completion of radiation
therapy

Exclusion Criteria:

- Patients who have received prior cytotoxic chemotherapy for management of uterine or
ovarian carcinosarcoma

- Patients with a history of other invasive malignancies or with a concomitant invasive
malignancy, with the exception of non-melanoma skin cancer, if there is any evidence
of other malignancy being present within the last five years; patients are also
ineligible if their previous cancer treatment contraindicates this protocol therapy

- Patients for whom radiotherapy is planned after or during chemotherapy prior to
progression of cancer

- Patients with known hypersensitivity to E. coli-derived drug preparations
(pegfilgrastim and filgrastim [G-CSF])

- Patients with a known hypersensitivity to mesna or other thiol compounds

- For enrollment prior to 10/21/2013, patients who are not biopsy proven to have
carcinosarcoma of the uterus, fallopian tube, peritoneum or ovary; for enrollment
after 10/21/2013, patients who are not biopsy proven to have carcinosarcoma of the
uterus
Sponsor:
Gynecologic Oncology Group
National Cancer Institute (NCI)
Dates:
August 2009
Last Updated:
December 23, 2014
Study HIC#:

Clinicaltrials.gov ID: NCT00954174