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.
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
- Conditions the study is for
- Fallopian Tube Cancer, Ovarian Cancer, Peritoneal Cavity Cancer
- 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
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.
carboplatinDrug
Given IV
decitabineDrug
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Arm I | Active comparator | Patients receive carboplatin IV over 30-60 minutes on day 1. Receives: Drug: carboplatin |
| Arm II | Experimental | Patients 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.
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)
Response rate (PR or CR) in all patients (regardless of methylation status) as measured by RECIST criteria or CA-125 criteria
Progression-free survival and overall survival
Adverse events as measured by NCI CTCAE v3.0
Total dose and dose intensity of carboplatin and decitabine
Incidence of grade 3-4 hypersensitivity reactions
Correlation between peak plasma levels of decitabine and global and CpG island specific DNA methylation in peripheral blood mononuclear cells
Correlation between response (PR or CR) and global and CpG island specific DNA methylation in peripheral blood mononuclear cells
Correlation between response (PR or CR) and CpG island specific DNA methylation in plasma DNA
CpG island specific DNA methylation in plasma and tumor DNA
CpG island specific DNA methylation in tumor DNA and expression of genes as measured by RNA or protein assays
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
Immunoassays of proteins in plasma
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.
- First posted8 Sep 2008 (estimated)
- Study startJul 2007
- Primary completionDec 2009
- Study completionNov 2010
Why it stopped: The study was "withdrawn" due to certain adverse events \[hypersensitivity\].
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Fallopian Tube CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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)
Sponsor and investigators
- Lead sponsor
- Cancer Research UK
- Sponsor type
- University, hospital or other
- Investigators
- Stanley B. Kaye, MD, FRCP, Study chair, Royal Marsden NHS Foundation Trust
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
Study at a glance
From the registry record, last updated by the sponsor on 10 Jul 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- 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
- ClinicalTrials.gov ID
- NCT00748527
- Acronym / sponsor ID
- CRUK-PH2/051
- Keywords
- fallopian tube cancer, stage III ovarian epithelial cancer, stage IV ovarian epithelial cancer, recurrent ovarian epithelial cancer, peritoneal cavity cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The study was "withdrawn" due to certain adverse events \[hypersensitivity\].
- Enrolment
- 134 participants (estimated)
- Lead sponsor
- Cancer Research UKUniversity, hospital or other
- Study start
- Jul 2007
- Primary completion
- Dec 2009 (actual)
- Study completion
- Nov 2010 (actual)
- First posted
- 8 Sep 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm I | Active comparator | Drug: carboplatinPatients receive carboplatin IV over 30-60 minutes on day 1. |
| Arm II | Experimental | Drug: carboplatin, Drug: decitabinePatients receive decitabine IV over 6 hours on day 1 and carboplatin IV over 30-60 minutes on day 8. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| carboplatinGiven IV | Drug | Arm I, Arm II |
| decitabineGiven IV | Drug | Arm II |
Primary outcome
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
13 secondary outcomes
Response rate (PR or CR) in all patients (regardless of methylation status) as measured by RECIST criteria or CA-125 criteria
Progression-free survival and overall survival
Adverse events as measured by NCI CTCAE v3.0
Total dose and dose intensity of carboplatin and decitabine
Incidence of grade 3-4 hypersensitivity reactions
Correlation between peak plasma levels of decitabine and global and CpG island specific DNA methylation in peripheral blood mononuclear cells
Correlation between response (PR or CR) and global and CpG island specific DNA methylation in peripheral blood mononuclear cells
Correlation between response (PR or CR) and CpG island specific DNA methylation in plasma DNA
CpG island specific DNA methylation in plasma and tumor DNA
CpG island specific DNA methylation in tumor DNA and expression of genes as measured by RNA or protein assays
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
Immunoassays of proteins in plasma
CpG island specific DNA methylation in tumor DNA
Results and safety
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.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Jul 2013.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Stanley B. Kaye, MD, FRCP study chair
Royal Marsden NHS Foundation Trust
11 sites in 1 country: see every site and its status.
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.