Heated Chemotherapy for Cancers That Have Spread to the Chest Cavity - Full Text View

Purpose

Cancers that have spread to the inner lining of the chest are classified as Stage IV and bear a poor prognosis. Surgery is rarely an option, with palliative chemotherapy and/or radiation therapy the only treatment options. This study intends to evaluate whether surgical removal of all visible tumor on the chest wall followed by bathing the chest cavity in heated chemotherapy solution will improve outcomes for these advanced cancers.

Condition	Intervention	Phase
Pleural Metastases Breast Cancer Colon Cancer Ovarian Cancer Uterine Cancer Renal Cell Cancer Thymic Cancer	Procedure: Surgical debulking and Intrathoracic Hyperthermic Chemotherapy	Phase 2

Study Type:	Interventional
Study Design:	Allocation: Non-Randomized Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Surgical Cytoreduction Followed by Intraoperative Intrathoracic Hyperthermic Chemotherapy Perfusion for the Management of Disseminated Pleural Malignancies

Resource links provided by NLM:

Genetics Home Reference related topics: breast cancer

MedlinePlus related topics: Breast Cancer Cancer Fever Ovarian Cancer Thymus Cancer Uterine Cancer

U.S. FDA Resources

Further study details as provided by St. Luke's-Roosevelt Hospital Center:

Primary Outcome Measures:

Time to disease progression [ Time Frame: 1 year ] [ Designated as safety issue: No ]
Most cancers that have spread to the chest cavity have limited survival. Response to systemic chemotherapy and radiation therapy is short-lived. This end point will determine the time to disease progression of this experimental treatment modality.
Survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
Most cancers that have spread to the chest cavity have limited survival. Response to systemic chemotherapy and radiation therapy is short-lived. This end point will determine the overall survival period following treatment with this experimental modality.

Secondary Outcome Measures:

Systemic drug absorption [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]
By perfusing the chest cavity with chemotherapy, higher doses can be safely administered as less drug is absorbed systemically and therefore toxicity should be lower. This end point will assess drug toxicity due to intrathoracic perfusion.
Complications [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]
Patients will undergo surgical debulking prior to intrathoracic chemotherapy perfusion. Complications from the surgery as well as inhibited wound healing from chemotherapy will be monitored as a secondary end point.

Estimated Enrollment:	10
Study Start Date:	June 2010
Estimated Study Completion Date:	June 2013
Estimated Primary Completion Date:	June 2012 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Surgical Debulking and Intrathoracic Hyperthermic Chemotherapy Patients in this trial will undergo surgical debulking followed by intrathoracic hyperthermic chemotherapy perfusion.	Procedure: Surgical debulking and Intrathoracic Hyperthermic Chemotherapy Surgical debulking of intrathoracic metastases will be performed, followed by perfusion of the chest with heated Cisplatin for 60 minutes.

Eligibility

Ages Eligible for Study:	18 Years to 75 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Adults aged 18-75 years
Radiographic evidence of pleural dissemination with histologically or cytologically confirmed diagnosis.
Primary source control (breast, ovarian, uterine, colon, renal cell, thymic cancer)
Adequate liver and renal function defined as a bilirubin of < 2.0 mg/dl, albumin > 3.0g/dl, and a creatinine of < 1.5 mg/dl, respectively.
Absolute neutrophil count (ANC) of ≥1,500/mm3 and a platelet count ≥100,000/mm3.
A Karnofsky Performance Status score of ≥60

Exclusion Criteria:

Patients without satisfactory oncological control of their primary cancer.
Radiographic evidence of abdominal, pelvic, or intracranial metastatic disease.
Chemotherapy and/or radiotherapy must have been completed at least one month prior to entry in the study. Patients may not receive concurrent chemotherapy, immunotherapy, radiotherapy, or any investigational drugs while participating in this study.
Significant active medical disease including, but not limited to:
- Cardiac disease, including: congestive heart failure or angina pectoris; recent (within 1 year) history of a myocardial infarction; uncontrolled hypertension; arrhythmias.
- Active infections
- Uncontrolled diabetes mellitus
- Chronic renal insufficiency
- HIV/AIDS - routine HIV testing will not be performed, but patients known to be HIV positive will be excluded.
Pregnant or lactating women.
Allergy to intravenous contrast

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01163552

Contacts

Contact: Cliff P Connery, MD

2125237475

cconnery@chpnet.org

Locations

United States, New York
St. Luke's-Roosevelt Hospital Center	Recruiting
New York, New York, United States, 10019
Principal Investigator: Cliff P Connery, MD

Sponsors and Collaborators

St. Luke's-Roosevelt Hospital Center

Investigators

Principal Investigator:

Cliff P Connery, MD

St. Luke's-Roosevelt Hospital Center, Division of Thoracic Surgery

More Information

Publications:

Matsuzaki Y, Shibata K, Yoshioka M, Inoue M, Sekiya R, Onitsuka T, Iwamoto I, Koga Y. Intrapleural perfusion hyperthermo-chemotherapy for malignant pleural dissemination and effusion. Ann Thorac Surg. 1995 Jan;59(1):127-31.

Ratto GB, Civalleri D, Esposito M, Spessa E, Alloisio A, De Cian F, Vannozzi MO. Pleural space perfusion with cisplatin in the multimodality treatment of malignant mesothelioma: a feasibility and pharmacokinetic study. J Thorac Cardiovasc Surg. 1999 Apr;117(4):759-65.

Yellin A, Simansky DA, Paley M, Refaely Y. Hyperthermic pleural perfusion with cisplatin: early clinical experience. Cancer. 2001 Oct 15;92(8):2197-203.

Iyoda A, Yusa T, Hiroshima K, Fujisawa T. Surgical resection combined with intrathoracic hyperthermic perfusion for thymic carcinoma with an intrathoracic disseminated lesion: a case report. Anticancer Res. 1999 Jan-Feb;19(1B):699-702.

Refaely Y, Simansky DA, Paley M, Gottfried M, Yellin A. Resection and perfusion thermochemotherapy: a new approach for the treatment of thymic malignancies with pleural spread. Ann Thorac Surg. 2001 Aug;72(2):366-70.

Responsible Party:	Gary Schwartz, MD, St. Luke's-Roosevelt Hospital Center
ClinicalTrials.gov Identifier:	NCT01163552 History of Changes
Other Study ID Numbers:	SLR IRB#09-207
Study First Received:	July 14, 2010
Last Updated:	September 2, 2011
Health Authority:	United States: Institutional Review Board

Keywords provided by St. Luke's-Roosevelt Hospital Center:

pleural metastases

Additional relevant MeSH terms:

Breast Neoplasms
Colonic Neoplasms
Carcinoma, Renal Cell
Neoplasm Metastasis
Ovarian Neoplasms
Thymus Neoplasms
Uterine Neoplasms
Pleural Neoplasms
Neoplasms by Site
Neoplasms
Breast Diseases
Skin Diseases
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms

Digestive System Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Kidney Diseases
Urologic Diseases
Neoplastic Processes

ClinicalTrials.gov processed this record on May 16, 2013