Availability & Effect of Post-OP Ketorolac on Ovarian, Fallopian Tube or Primary Peritoneal Cancer

New Mexico Cancer Care Alliance

Status and phase: Completed; Early Phase 1

Conditions: Fallopian Tube Cancer; Peritoneal Cavity Cancer; Ovarian Cancer

Treatments: Drug: Ketorolac

Study type: Interventional

Funder types: Other

Identifiers

NCT01670799

INST 1115

NCI-2012-00917 (Registry Identifier)

Details and patient eligibility

About

The purpose of this study is to evaluate the anti-cancer effect of a pain medication called ketorolac (Toradol) on ovarian cancer cells in the abdominal (peritoneal) cavity after surgery for ovarian, fallopian tube or primary peritoneal cancer.

Full description

Ovarian cancer is the sixth most common cancer and the seventh most common cause of cancer deaths in women across the globe. The majority of women, nearly 70%, will present with advanced stage disease that heralds a poor prognosis.

Despite aggressive treatment that still favors initial debulking surgery followed by a platinum and taxane based chemotherapy regimen, most patients relapse after achieving a complete clinical response.

Our group has shown that the ketorolac can inhibit gene activity which inhibits cell proliferation and migration.Ketorolac will be used in this study with the goal of producing specific inhibition of cell adhesion and migration in ovarian cancer cells retrieved within the peritoneal cavity after cytoreductive surgery.

Enrollment: 29 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

(PRE-OPERATIVE [OP])

• Patients must be suspected of having a diagnosis of ovarian, fallopian tube or primary peritoneal cancer with a planned cytoreductive surgery
• Borderline ovarian cancer with ascites
• Eastern Cooperative Oncology Group (ECOG)/Zubrod/ Southwest Oncology Group (SWOG) performance status < 2 (Karnofsky performance status >= 70%)
• Ability to provide informed consent
• Absolute neutrophil count > 1000/uL
• Platelet count > 100'000/uL
• Serum creatinine =< 1.5 x upper limit of normal (ULN)
• Bilirubin =< 1.5 x normal
• Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) or serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase [ALT]) levels =< 2 x ULN
• No known bleeding disorders
• No known sensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs)
• No active peptic ulcer disease
• No active bleeding
• SECONDARY ELIGIBILITY
• Histologic diagnosis of epithelial ovarian, fallopian tube or primary peritoneal cancer on frozen section diagnosis
• Placement of an intraperitoneal port at the time of surgery for anticipated use for adjuvant chemotherapy or management of post-operative ascites
• If epidural catheter was used - the catheter must be removed prior to treatment
• No active bleeding

Exclusion criteria

• Non-epithelial ovarian cancer or metastatic cancer to the ovaries
• Borderline ovarian cancer without ascites
• Presumed early stage ovarian cancer
• No clinical indication for a peritoneal port
• Active use of an epidural catheter
• Uncontrolled or unstable medical conditions
• Off study use of ketorolac or other NSAIDs prior to study administration
• Active bleeding or high risk of bleeding
• Active therapeutic anticoagulation
• Known hypersensitivity to NSAIDs
• Chronic or acute renal insufficiency as defined by a preoperative serum creatinine greater than 1.5mg/dL or creatinine clearance of < 60 ml/min
• Any co-morbid condition that' in the view of the attending physician' renders the patient at high risk from treatment complications

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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29 participants in 1 patient group

Ketorolac

Experimental group

Description:

All patients will receive a single dose of IV ketorolac for pain management for the indication of post-operative pain control. Patients less than 65 years of age and in otherwise good health will receive a 30mg IV single dose. Patients 65 years of age or greater, or who have mild renal insufficiency or are of low weight (as per section 3.2) will receive a single 15 mg dose IV ketorolac. In patients who have a clinical pain response and have no contraindications to multi-dose (every 6 hours over 24 hours), additional doses will be given per physician discretion based on clinical indication. Patients receiving 24 hour dosing will be eligible for sample time points after 24 hour dosing.

Treatment:

Drug: Ketorolac