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

Gynecologic Oncology Group (GOG)

Status: Unknown

Conditions: Stage II Ovarian Cancer AJCC v6 and v7; Stage I Ovarian Cancer AJCC v6 and v7; Stage IIIA Fallopian Tube Cancer AJCC v7; Stage IB Fallopian Tube Cancer AJCC v6 and v7; Stage IIIC Fallopian Tube Cancer AJCC v7; Stage IC Fallopian Tube Cancer AJCC v6 and v7; Stage IV Ovarian Cancer AJCC v6 and v7; Stage IV Fallopian Tube Cancer AJCC v6 and v7; Stage IIC Fallopian Tube Cancer AJCC v6 and v7; Stage IA Fallopian Tube Cancer AJCC v6 and v7; Stage III Primary Peritoneal Cancer AJCC v7; Stage III Ovarian Cancer AJCC v6 and v7; Stage IIB Fallopian Tube Cancer AJCC v6 and v7; Stage IV Primary Peritoneal Cancer AJCC v7; Stage IIIB Fallopian Tube Cancer AJCC v7; Stage IIA Fallopian Tube Cancer AJCC v6 and v7

Treatments: Drug: Carboplatin; Other: Pharmacological Study; Other: Quality-of-Life Assessment; Biological: Filgrastim; Other: Questionnaire Administration; Drug: Paclitaxel; Procedure: Assessment of Therapy Complications

Study type: Observational

Funder types: NETWORK; NIH

Identifiers

NCT01366183

NCI-2011-02900 (Registry Identifier)

GOG-0273 (Other Identifier)

U10CA101165 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

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.

Full description

PRIMARY OBJECTIVES:

l. To determine whether the score on Instrumental Activities of Daily Living (IADL) obtained prior to treatment is associated with the ability of patients to complete four cycles of chemotherapy without dose reduction or a more than 7-day delay.

II. To estimate by regimen the percentage of patients who are able to complete four cycles of chemotherapy regardless of dose reductions and delays.

III. To compare actual and calculated carboplatin area under the curve (AUC) in this patient population.

SECONDARY OBJECTIVES:

I. To describe the percentage of patients who are entered after primary surgery versus those entered to receive primary or neoadjuvant chemotherapy, the percentage of patients who are treated with each allowed regimen, and the percentage of patients who eventually receive surgery in the primary chemotherapy group.

II. To determine whether the need for assistance with IADLs at time of registration is associated with choice of chemotherapy regimen (in both primary chemotherapy and primary surgery patients).

III. To explore whether age, baseline scores on the geriatric measures (functional status, nutritional status, or co-morbidity) and quality-of-life (QOL) are correlated with likelihood of completing four courses of chemotherapy without dose reduction or a more than 7-day delay.

IV. To explore reasons for and timing of dose reductions and delays. V. To describe toxicities, pre-/post-chemotherapy QOL, and pre-/post-chemotherapy scores on geriatric measures in this patient population.

TERTIARY OBJECTIVES:

I. To explore potential relationships of carboplatin AUC, paclitaxel clearance, and paclitaxel time above a plasma concentration of 0.05 mcM to nadir neutrophil and platelet counts during course 1 of treatment.

II. To explore the association between baseline IADL and survival. III. To explore the association between IADL and the functional well-being (FWB) subscale in the Functional Assessment of Cancer Therapy ? Ovary (FACT-O).

OUTLINE:

Patients receive chemotherapy comprising carboplatin, paclitaxel, and filgrastim (regimen 1) or carboplatin alone (regimen 2) every 21 days for 4 courses according to their physicians and/or patients' choice. Patients may undergo surgery and/or further chemotherapy at the discretion of treating physician. Patients undergo blood sample collection at baseline and periodically during course 1 for pharmacokinetic studies.

Patients' quality of life is assessed by the FACT-O, the Functional Assessment of Cancer Treatment ? Neurotoxicity (FACT-Ntx subscale), the IADL, and the Ability to Complete Social Activity questionnaires at baseline, prior to courses 1 and 3, and then 3-6 weeks after completion of course 4. Nutritional status, such as body mass index and weight loss, and comorbidity and hearing impairment are also assessed.

Enrollment: 290 estimated patients

Sex: All

Ages: 75+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Eligible patients must have a histologically or cytologically confirmed diagnosis of adenocarcinoma of the ovary, peritoneum, or fallopian tube either by surgery, biopsy, fine-needle aspiration (FNA), paracentesis, or thoracentesis; a diagnosis of a mucinous cancer must be made by biopsy only
• International Federation of Gynecology and Obstetrics (FIGO) stage I, II, III, and IV are eligible
• Patients must have received no previous treatment for this malignancy other than surgery
• Patients must be entered within eight weeks of confirmation of disease diagnosis by surgery, biopsy, FNA, paracentesis or thoracentesis if there is no primary surgery, and within twelve weeks of primary or staging surgery if patient received primary surgery
• Absolute neutrophil count (ANC) greater than or equal to 1,500/mcl
• Platelets greater than or equal to 100,000/mcl
• Bilirubin less than or equal upper limit of normal (ULN)
• Creatinine less than or equal to 1.5 x ULN
• Patients must have a Gynecologic Oncology Group (GOG) performance status of 0, 1, 2 or 3
• Effective XX/XX/2014, only patients 75 years of age or older are eligible for enrollment; (04/23/2012) (08/12/2013)
• Patients must have recovered from the effects of recent surgery
• Patients must be free of active infection requiring antibiotics
• Patients must have signed an approved informed consent and Health Insurance Portability and Accountability Act (HIPAA)
• Patient and physician agree that they plan to conduct treatment according to Regimen 3
• Patient can read and understand sufficient English to be able to respond to questions posed by the study instruments

Exclusion criteria

• Patients who have received previous treatment for this malignancy other than surgery
• Patients with other invasive malignancies whose previous cancer treatment contraindicates this protocol therapy
• ?Borderline tumors? (tumors of low malignant potential) by surgery or biopsy are excluded
• Patients with medical conditions that in the opinion of the investigator render treatment on this protocol unsafe should be excluded

Trial design

290 participants in 1 patient group

Observational (quality of life questionnaire)

Description:

Patients receive chemotherapy comprising carboplatin, paclitaxel, and filgrastim (regimen 1) or carboplatin alone (regimen 2) every 21 days for 4 courses according to their physicians and/or patients' choice. Patients may undergo surgery and/or further chemotherapy at the discretion of treating physician. Patients undergo blood sample collection at baseline and periodically during course 1 for pharmacokinetic studies. Patients' quality of life is assessed by the FACT-O, the FACT-Ntx subscale, the IADL, and the Ability to Complete Social Activity questionnaires at baseline, prior to courses 1 and 3, and then 3-6 weeks after completion of course 4. Nutritional status, such as body mass index and weight loss, and comorbidity and hearing impairment are also assessed.

Treatment:

Procedure: Assessment of Therapy Complications

Drug: Paclitaxel

Other: Pharmacological Study

Other: Questionnaire Administration

Biological: Filgrastim

Other: Quality-of-Life Assessment

Drug: Carboplatin