Chemotherapy Toxicity On Quality of Life in Older Patients With Stage I, Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal Cavity, or Fallopian Tube Cancer

• Tolerance to study treatment, defined as completing four cycles of study treatment, without dose reductions or treatment delays of over seven days [ Designated as safety issue: Yes ]
  

• Quality-of-life, comorbidity index, and nutritional status at baseline, prior to course 3, and at 3-6 weeks after completion of course 4 [ Designated as safety issue: No ]
  
• Clinical response of elderly patients with ovarian, primary peritoneal cavity, or fallopian tube cancer [ Designated as safety issue: No ]
  
• Adverse events as assessed by NCI CTCAE [ Designated as safety issue: Yes ]
  

OBJECTIVES:

Primary

• To determine whether the score on Instrumental Activities of Daily Living (IADL) obtained at time of registration is associated with the ability of patients to complete four courses of chemotherapy without dose reduction or a more than 7-day delay.
• To estimate by regimen the percentage of patients who are able to complete four courses of chemotherapy regardless of dose reductions and delays.
• To compare actual and calculated carboplatin area under the curve (AUC) in this patient population.

Secondary

• To describe the percentage of patients who are entered after primary surgery versus those entered to receive primary or neoadjuvant chemotherapy, the percentage of patients who are treated with each allowed regimen, and the percentage of patients who eventually receive surgery in the primary chemotherapy group.
• To determine whether the need for assistance with IADLs at time of registration is associated with choice of chemotherapy regimen (in both primary chemotherapy and primary surgery patients).
• To explore whether age, baseline scores on the geriatric measures (functional status, nutritional status, or co-morbidity) and quality-of-life (QOL) are correlated with likelihood of completing four courses of chemotherapy without dose reduction or a more than 7-day delay.
• To explore reasons for and timing of dose reductions and delays.
• To describe toxicities, pre-/post-chemotherapy QOL, and pre-/post-chemotherapy scores on geriatric measures in this patient population.

Tertiary

• To explore potential relationships of carboplatin AUC, paclitaxel clearance, and paclitaxel time above a plasma concentration of 0.05 mcM to nadir neutrophil and platelet counts during course 1 of treatment.
• To explore the association between baseline IADL and survival.
• To explore the association between IADL and the functional well-being (FWB) subscale in the Functional Assessment of Cancer Therapy - Ovary (FACT-O).

OUTLINE: Patients receive chemotherapy comprising carboplatin, paclitaxel, and filgrastim (regimen 1) or carboplatin alone (regimen 2) every 21 days for 4 courses according to their physicians and/or patients' choice. Patients may undergo surgery and/or further chemotherapy at the discretion of treating physician.

Patients undergo blood sample collection at baseline and periodically during course 1 for pharmacokinetic studies.

Patients' quality of life is assessed by the Functional Assessment of Cancer Therapy - Ovary (FACT-O), the Functional Assessment of Cancer Treatment - Neurotoxicity (FACT-Ntx subscale), the Instrumental Activities of Daily Living (IADL), and the Ability to Complete Social Activity questionnaires at baseline, prior to courses 1 and 3, and then 3-6 weeks after completion of course 4. Nutritional status, such as body mass index and weight loss, and comorbidity and hearing impairment are also assessed.