Combination Chemotherapy Plus Radiation Therapy in Treating Patients With Stage III or Stage IV Endometrial Cancer

Gynecologic Oncology Group (GOG)

Status and phase: Completed; Phase 1

Conditions: Stage IV Uterine Corpus Cancer; Endometrial Serous Adenocarcinoma; Endometrial Clear Cell Adenocarcinoma; Stage III Uterine Corpus Cancer

Treatments: Radiation: Radiation Therapy; Drug: Cisplatin; Drug: Paclitaxel

Study type: Interventional

Funder types: NETWORK; NIH

Identifiers

NCT00005840

U10CA027469 (U.S. NIH Grant/Contract)

NCI-2012-02334 (Registry Identifier)

CDR0000067856

GOG-9907 (Other Identifier)

Details and patient eligibility

About

This phase I trial is studying the side effects and best dose of combination chemotherapy when given with radiation therapy in treating patients with stage III or stage IV endometrial cancer. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells.

Full description

OBJECTIVES:

I. Determine the safety and maximum tolerated doses of paclitaxel and cisplatin when administered with radiotherapy in patients with stage III or IV endometrial cancer.

II. Assess the time to disease progression and overall survival of patients treated with this regimen.

OUTLINE: This is a dose-escalation study of paclitaxel and cisplatin.

Patients receive paclitaxel IV over 1 hour and cisplatin IV on days 1, 8, 15, 22, 29, and 36. Patients also undergo whole abdominal radiotherapy for 5 consecutive days weekly for 6 weeks.

Cohorts of 3-6 patients receive escalating doses of paclitaxel and cisplatin until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, additional patients are treated at that dose level.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 3-48 patients will be accrued for part I and 14-20 patients will be accrued for part II of this study.

Enrollment: 35 patients

Sex: Female

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• Histologically confirmed surgical stage III or IV endometrial cancer

• Any stage clear or serous papillary endometrial cancer

• Positive para-aortic lymph nodes allowed

• Tumor must be surgically reduced to 2 cm or less within 8 weeks of study

  • Must have had hysterectomy and bilateral salpingo-oophorectomy

• No recurrent disease

• No metastases to lung or liver parenchyma or inguinal or scalene lymph nodes

• Performance status - GOG 0-2

• Absolute neutrophil count greater than 2,000/mm^3

• Platelet count at least 100,000/mm^3

• Bilirubin no greater than 1.5 times upper limit of normal (ULN)

• SGOT no greater than 3 times ULN

• Creatinine no greater than 1.5 times ULN

• No other prior or concurrent malignancy in the past 5 years except non-melanoma skin cancer

• No prior chemotherapy

• No prior radiotherapy

• See Disease Characteristics

• No more than 8 weeks since prior surgery

• No prior anticancer therapy that would preclude study

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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35 participants in 1 patient group

Treatment (paclitaxel, cisplatin, abdominal radiotherapy)

Experimental group

Description:

Patients receive paclitaxel IV over 1 hour and cisplatin IV on days 1, 8, 15, 22, 29, and 36. Patients also undergo whole abdominal radiotherapy for 5 consecutive days weekly for 6 weeks. Cohorts of 3-6 patients receive escalating doses of paclitaxel and cisplatin until the MTD is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, additional patients are treated at that dose level.

Treatment:

Drug: Paclitaxel

Drug: Cisplatin

Radiation: Radiation Therapy