Intraperitoneal Therapy For Ovarian Cancer With Carboplatin Trial (iPocc)

Gynecologic Oncology Trial & Investigation Consortium

Status and phase

Completed

Phase 3

Phase 2

Conditions

Epithelial Ovarian Cancer

Primary Peritoneal Carcinoma

Fallopian Tube Cancer

Treatments

Drug: Paclitaxel(intravenous) + Carboplatin(intraperitoneal)

Drug: Paclitaxel(intravenous) + Carboplatin(intravenous)

Study type

Interventional

Funder types

Other

NETWORK

Identifiers

NCT01506856

jRCTs031180141 (Other Grant/Funding Number)

GOTIC-001/JGOG3019

UMIN000003670 (Other Grant/Funding Number)

Details and patient eligibility

About

The purpose of this study is:

Phase A: To confirm the feasibility of paclitaxel administered by intravenous (IV) infusion weekly plus concurrent carboplatin administered by intraperitoneal (IP) injection once every 3 weeks (dd-TCip therapy).

Phase B: To compare the efficacy and safety of the following two treatment regimens as first-line chemotherapy in women with epithelial ovarian, Fallopian tube or primary peritoneal cancer.

Full description

This is a randomized, multicenter international study. Patient are stratified according to Residual tumor diameter([0cm(No residual)] vs. [0cm<residual<1cm] vs. [1cm<residual<2cm] vs. [>2 cm]), FIGO stage(StageII vs. III vs. IV) and institution. Patient randomized to one of the treatment arms described below.

RegimenI(Standard treatment: dd-TCiv therapy): Paclitaxel administered by IV infusion weekly plus concurrent carboplatin administered by IV infusion once every 3 weeks

RegimenII(Study treatment: dd-TCip therapy): Paclitaxel administered by IV infusion weekly plus concurrent carboplatin administered by IP injection once every 3 weeks

The 3-week period (21 days) is 1 cycle. Protocol treatment basically comprises 6 cycles. IDS is allowed to be performed after 3, 4 or 5 cycles of the protocol treatment. In such cases, the protocol treatment must be restarted within 8 weeks after IDS. If IDS is performed, patients can receive up to 3 additional cycles of the protocol treatment after IDS. If interval debulking surgery (IDS) is performed after 3, 4 or 5 cycles, the patients can receive up to 3 additional cycles of the protocol treatment. A total of 6 to 8 cycles will be repeated.

The analysis of efficacy will be performed on all randomized subjects in accordance with the intention-to-treat (ITT) principle. In order to assess the robustness of the results, the same analyses will be done using all randomized subjects who satisfy the eligibility criteria. The analysis of safety will be performed on all subjects who have received at least one dose of study treatment.

Enrollment

655 patients

Sex

Female

Ages

20+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients assumed to have a stageII-IV epithelial ovarian, fallopian tube, or primary peritoneal cancer as a pre-surgery diagnosis
Patients scheduled to undergo laparotomy

*Both optimal and suboptimal patients will be eligible for the study (Suboptimal patients, as well as those who undergo only exploratory laparotomy, are eligible.)
ECOG Performance Status: 0-2
Patients who provide consent for placement of the IP port system, if randomized to Regimen II (Study treatment: dd-TCip therapy)
Patients expected to receive the first protocol treatment within 8 weeks after the comprehensive staging surgery
Lab data and clinical examination: Data within 28 days before the scheduled date of surgery
- Neutrophil count ≧ 1,500 /mm3
- Platelet count ≧ 100,000 /mm3
- AST (GOT) ≦ 100 IU/L
- ALT (GPT) ≦ 100 IU/L
- Total bilirubin < 1.5 mg/dL
- Serum Creatinine < 1.5 mg/dL
- Electrocardiogram (ECG): Patients with normal ECG, Asymptomatic patients with abnormal ECGs not requiring medical intervention
- Neuropathy(Both motor and sensory) ≦ Grade1 (CTCAE Version 4.0)
Patients expected to survive longer than 3 months from the start date of the protocol treatment
Patients aged 20 years and older at the time of tentative registration (with no upper age limit)
Patients who provide written informed consent for participation in this trial

Exclusion criteria

Patients assumed to have a borderline malignancy of the ovary, fallopian tube, or primary peritoneal cancer
Patients who have received previous chemotherapy or radiation therapy to treat the current disease
Patients who have a synchronous malignancy or who have been progression-free less than 5 years for a metachronous malignancy (Patients with basal and squamous cell carcinoma of the skin, as well as carcinoma in situ, and intramucosal carcinoma cured by local treatment, are eligible for the study)
Patients with serious medical complications, such as serious heart disease, cerebrovascular accidents, uncontrolled diabetes mellitus, uncontrolled hypertension, pulmonary fibrosis, interstitial pneumonitis, active bleeding, an active gastrointestinal ulcer, or a serious neurological disorder
Patients who have had a hypersensitivity reaction to polyoxyethylated or hydrogenated castor oil
Patients with a pleural effusion requiring continuous drainage
Patients with an active infection requiring antibiotics
Patients who are pregnant, nursing or of child-bearing potential
Patients with evidence upon physical examination of brain tumor and any brain metastases
Patients for whom completion of this study and/or follow-up is deemed inappropriate for any reason
Patients with any signs/symptoms of interstitial pneumonia