Cisplatin and Radiation Therapy Followed by Paclitaxel and Carboplatin in Treating Patients With Stage I, Stage II, Stage III, or Stage IV Cervical Cancer

This study is currently recruiting participants.
Verified December 2011 by National Cancer Institute (NCI)
Sponsor:
Collaborator:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT01295502
First received: February 11, 2011
Last updated: December 7, 2011
Last verified: December 2011
  Purpose

RATIONALE: Drugs used in chemotherapy, such as cisplatin, paclitaxel, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving paclitaxel and carboplatin (combination chemotherapy) after cisplatin and radiation therapy may kill more tumor cells.

PURPOSE: This phase I trial is studying cisplatin and radiation therapy followed by paclitaxel and carboplatin in treating patients with stage I, stage II, stage III, or stage IV cervical cancer.


Condition Intervention Phase
Cervical Cancer
Drug: carboplatin
Drug: carboplatin-Taxol regimen
Drug: cisplatin
Drug: paclitaxel
Procedure: adjuvant therapy
Radiation: brachytherapy
Radiation: external beam radiation therapy
Phase 1

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Evaluation of Extended Field Radiation Therapy With Concomitant Cisplatin Chemotherapy Followed by Paclitaxel and Carboplatin Chemotherapy in Women With Cervical Carcinoma Metastatic to the Para-Aortic Lymph Nodes

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Maximum-tolerated dose (MTD) of adjuvant carboplatin and paclitaxel [ Designated as safety issue: Yes ]
  • Dose-limiting toxicities (DLT) of adjuvant carboplatin and paclitaxel [ Designated as safety issue: Yes ]
  • Toxicities as assessed by NCI CTCAE v. 4 [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Response rate in patients enrolled with measurable disease [ Designated as safety issue: No ]
  • Progression-free survival at one year and overall survival [ Designated as safety issue: No ]
  • Location of recurrence (loco-regional versus distant) [ Designated as safety issue: No ]
  • Chronic toxicities experienced within one year of study entry [ Designated as safety issue: Yes ]

Estimated Enrollment: 45
Study Start Date: May 2011
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To determine the maximum-tolerated dose (MTD) and dose-limiting toxicities (DLT) of adjuvant carboplatin and paclitaxel chemotherapy following concurrent weekly cisplatin chemotherapy and extended-field radiation in women with newly diagnosed Stage IB-IVA cervical cancer, with positive para-aortic nodes.
  • To determine the feasibility of the treatment regimen over the four courses of adjuvant chemotherapy once the MTD is estimated.
  • To assess the toxicities of the treatment regimen according to the NCI Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0.

Secondary

  • To assess the response rate to this treatment regimen in patients with measurable disease.
  • To examine progression-free survival at one year on this treatment regimen.
  • To examine overall survival.
  • To estimate the frequency of chronic toxicities experienced within one year of study entry.

OUTLINE: This is a multicenter, dose-escalation study of carboplatin and paclitaxel.

Patients receive cisplatin IV on days 1, 8, 15, 22, 29, and 36 and undergo extended-field radiotherapy (including brachytherapy) once daily, 5 days a week, for 6 weeks.

Beginning 4-6 weeks after completion of chemoradiation, patients receive adjuvant chemotherapy comprising paclitaxel IV over 3 hours and carboplatin IV over 30-60 minutes on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.

After completion of study therapy, patients are followed up every 3 months for 1 year.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Patients with histologically confirmed cervical cancer (squamous, adenocarcinoma, or adenosquamous)

    • FIGO Clinical stages IB, IIA, IIB, IIIA, IIIB, IVA, with positive para-aortic lymph nodes confirmed by PET/CT scan, fine-needle biopsy, extraperitoneal biopsy, laparoscopic biopsy, or lymphadenectomy

      • Scalene node sampling is NOT required

PATIENT CHARACTERISTICS:

  • GOG performance status 0-2
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Creatinine normal OR creatinine clearance > 50 mL/min
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST and ALT ≤ 2.5 times ULN
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Peripheral neuropathy (sensory and motor) ≤ grade 1
  • Patients of child-bearing potential must have a negative serum pregnancy test prior to study entry (within 72 hours prior to initiation of study treatment) and be practicing an effective form of contraception
  • No active infection
  • No circumstances that will not permit completion of this study or the required follow-up
  • No renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplantation, that would require modification of radiation fields
  • Patients with ureteral obstruction must undergo stent or nephrostomy tube placement prior to study entry
  • No history of other invasive malignancies within the past 5 years except non-melanoma skin cancer
  • No significant history of cardiac disease, (i.e., uncontrolled hypertension, unstable angina, congestive heart failure, or uncontrolled arrhythmias) within the past 6 months
  • No known sensitivity reactions to products containing Cremaphor® EL

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior pelvic or abdominal radiotherapy, cytotoxic chemotherapy, or therapy of any kind for this malignancy
  • No prior cancer treatment that contraindicates this protocol therapy
  • No major surgery, excluding diagnostic biopsy, within the past 30 days (to allow for full recovery)
  • No other concurrent investigational agent
  • No concurrent intensity-modulated radiotherapy or helical tomotherapy
  • Patients may NOT receive amifostine or other protective reagents
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01295502

Locations
United States, Iowa
Holden Comprehensive Cancer Center at University of Iowa Recruiting
Iowa City, Iowa, United States, 52242-1002
Contact: Cancer Information Service     800-237-1225        
United States, Ohio
Case Comprehensive Cancer Center Recruiting
Cleveland, Ohio, United States, 44106-5065
Contact: Clinical Trials Office - Case Comprehensive Cancer Center     800-641-2422        
MetroHealth Cancer Care Center at MetroHealth Medical Center Recruiting
Cleveland, Ohio, United States, 44109
Contact: Peter G. Rose, MD     216-444-1712        
Riverside Methodist Hospital Cancer Care Recruiting
Columbus, Ohio, United States, 43214-3998
Contact: Clinical Trials Office - Riverside Methodist Hospital Cancer C     614-566-4475        
United States, Oklahoma
Oklahoma University Cancer Institute Recruiting
Oklahoma City, Oklahoma, United States, 73104
Contact: Robert S. Mannel, MD     405-271-8787        
United States, Rhode Island
Women and Infants Hospital of Rhode Island Recruiting
Providence, Rhode Island, United States, 02905
Contact: Clinical Trials Office - Women and Infants Hospital of Rhode I     401-274-1122        
United States, Virginia
Virginia Commonwealth University Massey Cancer Center Recruiting
Richmond, Virginia, United States, 23298-0037
Contact: Clinical Trials Office -Virginia Commonwealth University Masse     804-628-1939        
Sponsors and Collaborators
Gynecologic Oncology Group
Investigators
Principal Investigator: Cecelia H. Boardman, MD Massey Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: Philip J. DiSaia, Gynecologic Oncology Group
ClinicalTrials.gov Identifier: NCT01295502     History of Changes
Other Study ID Numbers: CDR0000695304, GOG-9926
Study First Received: February 11, 2011
Last Updated: December 7, 2011
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
cervical adenocarcinoma
cervical adenosquamous cell carcinoma
cervical squamous cell carcinoma
stage IB cervical cancer
stage IIA cervical cancer
stage IIB cervical cancer
stage III cervical cancer
stage IVA cervical cancer

Additional relevant MeSH terms:
Uterine Diseases
Uterine Cervical Neoplasms
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Uterine Cervical Diseases
Genital Diseases, Female
Cisplatin
Carboplatin
Paclitaxel
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Radiation-Sensitizing Agents
Physiological Effects of Drugs
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Phytogenic

ClinicalTrials.gov processed this record on May 23, 2013