Intraoperative Hyperthermic Intraperitoneal Chemotherapy With Ovarian Cancer
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Purpose
The current standard treatment for ovarian cancer, tubal cancer, and primary peritoneal cancer is maximal cytoreductive surgery followed by chemotherapy. Recent randomized trials of Gynecologic Oncology Group (GOG) revealed the survival gain in intraperitoneal chemotherapy compared to the intravenous chemotherapy after the optimal cytoreduction in ovarian cancer (GOG#104, GOG#114, GOG#172). Experts attributed such survival gain to the earlier cycles of intraperitoneal chemotherapy when adhesion was minimal from extensive cytoreductive procedures.
Hyperthermia has an anti-cancer activity itself. Especially, hyperthermia promotes chemotherapy to penetrate deeper into the cancer tissue. Therefore, the combination of intraperitoneal chemotherapy with hyperthermia theoretically could lead to higher response rate and better survival outcomes.
*HIPEC: hyperthermic intraperitoneal chemotherapy
There will be an interiom analysis when 50% of patients are enrolled.
At the interim analysis, a statistical test will be performed. The nominal significance levels will be determined later. The exact nominal significance level will be determined based on the exact number of events at the time of the interim analysis. The Stopping boundaries will be calculated using an O'Brien-Fleming error spending function
| Condition | Intervention | Phase |
|---|---|---|
|
Epithelial Ovarian Cancer |
Procedure: Hyperthermic Intraperitoneal Chemotherapy |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | The Phase II Study of Intraoperative Hyperthermic Intraperitoneal Chemotherapy Followed by Intravenous Chemotherapy in Patients With Ovarian Cancer |
- Progression free survival [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]To assess progression free survival rate during 2 years after Intraoperative Hyperthermic Intraperitoneal Chemotherapy followed by Intravenous Chemotherapy in Patients with Ovarian Cancer.
- Overall survival, quality of life [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]
Ovarian cancer patients after HIPEC are observed complication and 3-year survival rate.
Ovarian cancer patients after HIPEC are analyzed quality of life.
| Estimated Enrollment: | 168 |
| Study Start Date: | March 2010 |
| Estimated Study Completion Date: | December 2017 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: HIPEC
Intraoperative Hyperthermic Intraperitoneal Chemotherapy in Patients with Ovarian Cancer
|
Procedure: Hyperthermic Intraperitoneal Chemotherapy
41.5 oC injected into the perfusion cisplatin (75 mg/m2)during 90min
Other Name: Belmont Instrument Corporation
|
Detailed Description:
If a patient is allocated to operation to remove ovarian cancer and metastatic disease in the abdomen, this trial could be considered. Before operation, laboratory test results, image result, patient's medical history, and baseline quality of life will be checked and reviewed.
When optimal cytoreduction (residual tumor<1cm) is attained, this HIPEC (hyperthermic intraperitoneal chemotherapy) could be considered. For the primary advanced epithelial ovarian cancer, HIPEC will be performed at random. For the recurrent ovarian cancer, HIPEC will be performed after completion of cytoreductive procedures. Usually, HIPEC takes one and half hours after cytoreductive surgery.
After cytoreductive surgery followed by HIPEC, adjuvant chemotherapy will be added. The cycle of chemotherapy will be determined according to the patients' clinical outcomes. The laboratory test results, image result, patient's medical history, and baseline quality of life will be checked after the operation, during chemotherapy, and after chemotherapy.
Cytoreduction: an operation to remove ovarian cancer and its metastatic disease
There will be an interiom analysis when 50% of patients are enrolled.
At the interim analysis, a statistical test will be performed. The nominal significance levels will be determined later. The exact nominal significance level will be determined based on the exact number of events at the time of the interim analysis. The Stopping boundaries will be calculated using an O'Brien-Fleming error spending function
Eligibility| Ages Eligible for Study: | up to 75 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Disease status Primary ovarian cancer, tubal cancer, and primary peritoneal cancer (Stage III or more)
- Residual tumor < 1cm after completion of cytoreductive surgery
- Age < 75 year
- Expected survival > 3 months
- Performance status: ECOG 0-1
- Adequate bone marrow function Hb ≥8 g/dl (After correction in case of iron deficient anemia) WBC ≥ 3,000/mm3, Platelet ≥ 100,000/mm3
- Adequate renal function Creatinine ≤ 1.5 mg/dl
- Adequate hepatic function Bilirubin ≤ 1.5 mg/dl and AST and ALT ≤ 80 IU/L
- Optimal cardiopulmonary function for surgery
- Voluntary participation after getting written informed consent.
Exclusion Criteria:
- Unresectable extraperitoneal metastasis (brain, bone, lung parenchyme, and supraclavicular lymph node)
- Suboptimal debulking (residual tumor > 1cm)
- Previous History of other malignancies (except excision of skin cancer)
- Serious heart disease or renal failure
- Serious cardiopulmonary insufficiency
- Uncontrolled infection
- Uncontrolled intercurrent disease
- Psychogenic disorder
- Patients who are suitable candidates by legally
- Pregnant or breast-feeding patients
- Patients who are unsuitable candidates by doctor's decision
- MMMT
Contacts and Locations| Korea, Republic of | |
| National Cancer Center | |
| Goyang, Gyeonggi, Korea, Republic of, 410-769 | |
| Principal Investigator: | Sang-Yoon Park, MD, Ph.D. | National Cancer Center in Korea |
More Information
Publications:
| Responsible Party: | Sang-Yoon Park, Chief , center for Uterine Cancer, National Cancer Center, Korea |
| ClinicalTrials.gov Identifier: | NCT01091636 History of Changes |
| Other Study ID Numbers: | NCCCTS-06-222 |
| Study First Received: | March 23, 2010 |
| Last Updated: | March 14, 2013 |
| Health Authority: | Korea: Institutional Review Board |
Additional relevant MeSH terms:
|
Fever Ovarian Neoplasms Neoplasms, Glandular and Epithelial Body Temperature Changes Signs and Symptoms Endocrine Gland Neoplasms Neoplasms by Site Neoplasms |
Ovarian Diseases Adnexal Diseases Genital Diseases, Female Genital Neoplasms, Female Urogenital Neoplasms Endocrine System Diseases Gonadal Disorders Neoplasms by Histologic Type |
ClinicalTrials.gov processed this record on May 23, 2013