Ovarian Cancer Clinical Trial
Official title:
Neoadjuvant Azacitidine With Carboplatin and Paclitaxel for Suboptimal Newly Diagnosed Ovarian Cancer
This is a clinical trial for women with newly diagnosed ovarian cancer. The purpose of this
study is to determine if the addition of a drug called azacitidine (Vidaza®)when added to
carboplatin and paclitaxel will change the genetic material of the tumor so that the
chemotherapy drugs work better.
The study will also determine what the maximum tolerated dose of azacitidine that may be
safely used in combination with carboplatin and paclitaxel.
Ovarian cancer is a highly chemosensitive tumor with good responses to first line
chemotherapy. The problem is the high rate of relapse, especially in advanced disease
Relapses are likely due to the presence of chemoresistant cells that escape from first line
platinum and taxane based regimens. Therefore, outcomes may be improved by adding treatment
to initial standard therapy that makes resistant cells sensitive to chemotherapy. There are
multiple targeted pathways that may achieve this goal. One promising path is epigenetics.
The reasons for this trial are multifold. First, methylation pathways have been proven in
tissue models to be integral to ovarian cancer pathogenesis. Second, cisplatin and
azacitidine are synergistic, and therefore would be promising in combination to improve
ovarian cancer outcomes by combating cisplatin resistance, which is a major cause of ovarian
cancer mortality. It has been proven that azacitidine/decitabine reverses platinum
resistance. Third, azacitidine has shown tolerable toxicity and promise in clinical trials
to date. Ideally, ovarian cancer outcomes are likely to be improved by the addition of
treatment that wipes out chemoresistant cells, thus preventing relapse.
This study is a phase I, non-randomized, dose escalation treatment study using azacitidine
in combination with intravenous chemotherapy with Paclitaxel and carboplatin.
All patients will receive the chemotherapy drugs Carboplatin and Paclitaxel. Patients will
then be randomized to receive one of three different doses of Azacitidine.
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Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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