Recurrent Ovarian Cancer Clinical Trial
Official title:
Slowed Carboplatin Infusion for Ovarian Cancer Patients Receiving Carboplatin Re-Treatment
This is a research study to determine if administering carboplatin at a slower rate when re-treating recurrent ovarian cancer patients prior to the development of a hypersensitivity reaction will decrease the frequency and severity of future hypersensitivity reactions.
For women with recurrent ovarian cancer, re-treatment with carboplatin is frequently
recommended. However, carboplatin re-treatment can result in an allergic or allergic-like
reaction called a hypersensitivity reaction. Symptoms of a hypersensitivity reaction can
include, but are not limited to itching, rash, swelling of the lips, tongue, or throat,
chest pain, chest tightness, shortness of breath, wheezing, abdominal pain, nausea,
vomiting, diarrhea, palpitations, dizziness, confusion, and low pressure. Hypersensitivity
reactions occur in 20-40% of women with recurrent ovarian cancer who are re-treated with
carboplatin. At least half of the hypersensitivity reactions are described as moderately
severe with symptoms of generalized rash, wheezing, facial swelling, difficulty
breathing/shortness of breath, and hypotension (low blood pressure).
Patients who suffer from a hypersensitivity reaction while receiving carboplatin and require
additional therapy may receive future carboplatin infusions utilizing a "desensitization"
technique. A desensitization is when carboplatin is administered in slowly increasing
amounts as an inpatient under the direction of the department of Allergy Immunology at
Massachusetts General Hospital. A desensitization allows patient to safely receive
carboplatin, but requires an inpatient hospitalization, which may be of significant
inconvenience to some patients.
As part of this study, the participant will continue to receive carboplatin as part of their
standard therapy. The change would be instead of carboplatin being administered over a 30
minute period, the carboplatin be administered intravenously according to the following
schedule:
- First hour - Administer 1 percent of total dose
- Second hour - Administer 9 percent
- Third hour - Administer 90 percent
Standard pre-medications will be administered immediately prior to the carboplatin infusion
which will include of 20 mg of dexamethasone, 50mg of diphenhydramine, and famotidine 20 mg.
The participant's medical record will also be reviewed to evaluate whether age, cancer
stage/grade, number of previous carboplatin cycles, accompanying agents, and/or medical
conditions have an effect on hypersensitivity reactions. The participant will also be asked
to fill out a short optional form regarding race and ethnicity to evaluate whether or not
these factors contribute to hypersensitivity reactions.
If the participant experiences a hypersensitivity reaction, the study protocol will be
discontinued. A standard blood draw for a tryptase (a blood test for an allergic reaction)
will be obtained at the time of the reaction along with other discretionary laboratories
recommended by your oncologist. The participant will then be referred to the Allergy
Immunology Department if carboplatin is determined to be necessary for future treatment.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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