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Fallopian Tube CancerPhase 2NCT00748527

Carboplatin With or Without Decitabine in Treating Patients With Progressive, Advanced Ovarian Epithelial Cancer, Fallopian Tube Cancer, or Primary Peritoneal Cancer

A Phase 2 study testing carboplatin and decitabine in people with Fallopian Tube Cancer and Ovarian Cancer, run by Cancer Research UK at 11 sites in United Kingdom.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

RATIONALE: Drugs used in chemotherapy, such as carboplatin and decitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
carboplatin and decitabine
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
134 participants
Where
11 sitesUnited Kingdom
Study dates
Jul 2007to Nov 2010
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DISEASE CHARACTERISTICS:

  • Histologically or cytologically proven ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer
  • Progressive disease as defined by RECIST criteria and/or CA-125 criteria
  • Advanced disease
  • Previously treated with 1-2 prior platinum-containing regimen(s)
  • Prior hormonal therapy does not count towards the prior treatment
  • Responded to the most recent prior platinum-containing regimen(s) OR no evidence of progression during platinum-containing therapy as documented by RECIST criteria or CA-125 criteria (for patients with no macroscopic residual disease after surgery who are not evaluable by CA-125)
  • Disease relapse 6-12 months after completion of the most recent platinum-containing therapy
  • Patients who received two prior lines of treatment must have had ≥ 6 months between their first and second lines of treatment
  • Patients with disease progression, as defined by CA-125 criteria alone, within 6 months after completion of their last treatment are eligible provided study treatment commences > 6 months after the last prior treatment
  • Patients with disease progression, as defined by GCIG guidelines, within 12 months after completion of their last treatment are eligible provided study treatment commences ≤ 14 months after the last prior treatment
  • Measurable disease by RECIST criteria and/or CA-125 criteria
  • Measurable lesions are defined as those that can be accurately measured in at least one dimension (longest diameter to be recorded) as ≥ 20 mm by conventional techniques (physical examination, CT scan, x-ray, or MRI) or as ≥ 10 mm by spiral CT scan
  • Patients with evaluable disease by CA-125 criteria are eligible provided CA-125 is ≥ 2 times upper limit of normal (ULN) within 2 weeks prior to initiating study treatment
  • Disease is not considered measurable if patient received prior mouse antibodies or if there has been medical and/or surgical interference with the peritoneum or pleura (e.g., paracentesis) within the past 28 days
  • Ascites requiring therapeutic drainage allowed only if there is measurable disease by RECIST criteria
  • Ascites that do not require therapeutic drainage allowed even if disease is evaluable by CA-125 criteria alone

PATIENT CHARACTERISTICS:

  • WHO performance status 0-2
  • Hemoglobin ≥ 10.0 g/dL
  • WBC ≥ 3.0 x 10^9/L
  • Neutrophil count ≥ 1.5 x 10^9/L
  • Platelet count ≥ 100 x 10^9/L
  • Bilirubin ≤ 30 μmol/L
  • ALT and/or AST ≤ 2.5 times ULN (≤ 5 times ULN if due to tumor involvement of liver)
  • EDTA/DTPA clearance ≥ 50 mL/min (uncorrected value)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception for 4 weeks prior to, during, and for 6 months after completion of study treatment
  • No known hepatitis B, hepatitis C, or HIV positivity
  • No non-malignant systemic disease, including active uncontrolled infection, that would make the patient a high medical risk
  • No other current malignancies, except adequately treated cone-biopsied in situ carcinoma of the cervix or basal cell or squamous cell carcinoma of the skin
  • Patients who have undergone potentially curative therapy for a prior malignancy are eligible provided there is no evidence of disease for ≥ 5 years and the patient is deemed to be at low risk for recurrence
  • No intolerance to carboplatin (with a dose of ≥ AUC 5), as defined by any of the following:
  • Neutropenia or thrombocytopenia causing dose delay of > 4 days on more than 2 occasions
  • Grade III or IV hypersensitivity reaction (not controlled by a desensitization regimen)
  • Hospitalization for confirmed febrile neutropenia (fever ≥ 38°C)
  • Requirement for platelet transfusion
  • No other condition that, in the investigator's opinion, would not make the patient a good candidate for this study

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • Recovered from prior therapy (alopecia, grade 1 neuropathy, and certain grade 1 toxicities allowed)
  • More than 28 days since prior maintenance therapy (e.g., erlotinib or bevacizumab)
  • More than 4 weeks since prior radiotherapy, endocrine therapy, immunotherapy, chemotherapy, biological therapy, or investigational agents
  • More than 4 weeks since prior major thoracic and/or abdominal surgery and recovered
  • No other concurrent anti-cancer therapy, including radiotherapy or investigational drugs

Trial locations and contacts

11 sites in 1 country.

11 sites in 1 country

United Kingdom11 sites
  • Belfast City Hospital Trust Incorporating Belvoir Park Hospital

    Belfast, Northern Ireland, BT8 8JR

  • Edinburgh Cancer Centre at Western General Hospital

    Edinburgh, Scotland, EH4 2XU

  • Beatson West of Scotland Cancer Centre

    Glasgow, Scotland, G12 0YN

  • Leeds Cancer Centre at St. James's University Hospital

    Leeds, England, LS9 7TF

  • Leicester Royal Infirmary

    Leicester, England, LE1 5WW

  • Saint Bartholomew's Hospital

    London, England, EC1A 7BE

  • Royal Marsden - London

    London, England, SW3 6JJ

  • Hammersmith Hospital

    London, England, W12 OHS

  • Mount Vernon Cancer Centre at Mount Vernon Hospital

    Northwood, England, HA6 2RN

  • Royal Marsden - Surrey

    Sutton, England, SM2 5PT

  • Weston General Hospital

    Weston-super-Mare, England, BS23 4TQ

Other trials in United Kingdom

About this study

Official title: A Cancer Research UK Randomised, Multicentre, Phase II Trial of the DNAhypomethylating Agent, 5-Aza-2'-Deoxycytidine (Decitabine) Given Intravenously in Combination With Carboplatin, Versus Carboplatin Alone Given 4 Weekly in Patients With Progressive, Advanced Ovarian Cancer

RATIONALE: Drugs used in chemotherapy, such as carboplatin and decitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. It is not yet known whether carboplatin is more effective with or without decitabine in treating patients with ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer.

PURPOSE: This randomized phase II trial is studying carboplatin and decitabine to see how well they work compared with carboplatin alone in treating patients with progressive, advanced ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer.

Read the detailed description

OBJECTIVES:

Primary

  • To compare the response rate in patients with progressive, advanced ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer who have methylated hMLH1 DNA in plasma treated with carboplatin with vs without decitabine.

Secondary

  • To compare the response rate in all patients (regardless of methylation status) treated with these regimens.
  • To compare the progression-free survival and overall survival of patients treated with these regimens.
  • To compare the safety and tolerability of these regimens.
  • To determine the feasibility of combining decitabine with carboplatin.
  • To determine the incidence of hypersensitivity reactions to carboplatin.
  • To study the relationship between peak plasma levels of decitabine and global or CpG island specific methylation.
  • To study the relationship between global and gene specific methylation in peripheral blood mononuclear cells and response.

Tertiary

  • To correlate the methylation status of genes associated with drug resistance detected in plasma DNA with response.
  • To determine the sensitivity and specificity of methylation of genes associated with drug resistance detected in plasma DNA as a predictor of methylation status in tumor cells isolated from ascites or tumor biopsy.
  • To study methylation and expression of genes in tumor cells isolated from ascites or tumor biopsy before and after treatment with decitabine and/or carboplatin.
  • To investigate any correlation between methylation and expression of genes in surrogate tissues, body fluids, or tumor cells and response or progression-free survival.
  • To examine markers of cell death in plasma.
  • To compare the methylation in tumor taken at the time of presentation vs at the time of treatment.

OUTLINE: This is a multicenter study. Patients are stratified according to prior first-line treatment (platinum alone vs platinum and taxane vs platinum and other combination), WHO performance status (0 vs 1 vs 2), measurable disease criteria (RECIST criteria vs CA-125 criteria vs both), participating center, and the number of prior platinum-based regimens (1 vs 2). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive carboplatin IV over 30-60 minutes on day 1.
  • Arm II: Patients receive decitabine IV over 6 hours on day 1 and carboplatin IV over 30-60 minutes on day 8.

In both arms, treatment repeats every 28 days for up to 8 courses in the absence of disease progression or unacceptable toxicity.

Patients undergo blood sample collection periodically for pharmacodynamic studies. Samples are assessed for methylation of hMLH1 by methylation-specific PCR; global DNA methylation by high performance liquid chromatography (HPLC) ; methylation of the MAGE-1A gene promoter by methylation-specific PCR or bisulfite pyrosequencing; and markers of apoptosis by ELISA. Pharmacokinetic studies of decitabine are also performed using blood samples from patients randomized to arm II. Ascitic fluid and/or tumor tissue samples may also be collected for pharmacodynamic studies.

After completion of study treatment, patients are followed at 28 days and then every 2 months thereafter.

Peer Reviewed and Funded or Endorsed by Cancer Research UK.

Being tested
carboplatin, decitabine
Keywords
fallopian tube cancer, stage III ovarian epithelial cancer, stage IV ovarian epithelial cancer, recurrent ovarian epithelial cancer, peritoneal cavity cancer
Medical subject headings
Fallopian Tube Neoplasms, Ovarian Neoplasms, Carcinoma, Ovarian Epithelial

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT00748527
Study groupRoleWhat they receive
Arm IActive comparatorPatients receive carboplatin IV over 30-60 minutes on day 1.
Receives: Drug: carboplatin
Arm IIExperimentalPatients receive decitabine IV over 6 hours on day 1 and carboplatin IV over 30-60 minutes on day 8.
Receives: Drug: carboplatin; Drug: decitabine

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Response rate (partial response [PR] or complete response [CR]) in patients with methylated hMLH1 DNA in plasma as measured by RECIST criteria or CA-125 criteria

Secondary outcomes (13)
  1. Response rate (PR or CR) in all patients (regardless of methylation status) as measured by RECIST criteria or CA-125 criteria

  2. Progression-free survival and overall survival

  3. Adverse events as measured by NCI CTCAE v3.0

  4. Total dose and dose intensity of carboplatin and decitabine

  5. Incidence of grade 3-4 hypersensitivity reactions

  6. Correlation between peak plasma levels of decitabine and global and CpG island specific DNA methylation in peripheral blood mononuclear cells

  7. Correlation between response (PR or CR) and global and CpG island specific DNA methylation in peripheral blood mononuclear cells

  8. Correlation between response (PR or CR) and CpG island specific DNA methylation in plasma DNA

  9. CpG island specific DNA methylation in plasma and tumor DNA

  10. CpG island specific DNA methylation in tumor DNA and expression of genes as measured by RNA or protein assays

  11. Correlation between response (PR, CR, or stable disease) and CpG island specific DNA methylation in tumor DNA and expression of genes by RNA or protein assays

  12. Immunoassays of proteins in plasma

  13. CpG island specific DNA methylation in tumor DNA

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Sep 2008 (estimated)
  2. Study startJul 2007
  3. Primary completionDec 2009
  4. Study completionNov 2010

Why it stopped: The study was "withdrawn" due to certain adverse events \[hypersensitivity\].

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Masking
None (open label)
Enrolment
134 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00748527
Sponsor's protocol ID
CRUK-PH2/051
Other IDs
CDR0000613805, EUDRACT-2006-002324-41, MGI-CRUK-PH2/051, CTA-21106/0219/001
Status last verified
Sep 2008
First submitted
5 Sep 2008
Last updated
10 Jul 2013
Results posted
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing carboplatin and decitabine in people with Fallopian Tube Cancer and Ovarian Cancer, run by Cancer Research UK at 11 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 10 Jul 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: The study was "withdrawn" due to certain adverse events \[hypersensitivity\].). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Response rate (partial response [PR] or complete response [CR]) in patients with methylated hMLH1 DNA in plasma as measured by RECIST criteria or CA-125 criteria. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Jul 2013.

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