Primary Peritoneal Carcinoma Clinical Trial
Official title:
A Phase III Randomized Trial Of Paclitaxel And Carboplatin Versus Triplet Or Sequential Doublet Combinations In Patients With Epithelial Ovarian Or Primary Peritoneal Carcinoma
Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known which combination chemotherapy regimen is most effective in treating ovarian epithelial cancer and peritoneal cancer. Randomized phase III trial to compare the effectiveness of various combination chemotherapy regimens in treating patients who have stage III or stage IV ovarian cancer or primary peritoneal cancer.
OBJECTIVES:
Compare the efficacy of paclitaxel and carboplatin with or without gemcitabine, doxorubicin
HCl liposome, or topotecan, in terms of overall and progression-free survival, in patients
with stage III or IV ovarian epithelial or serous primary peritoneal carcinoma.
Determine the response rate in patients with measurable disease treated with these regimens.
Compare the toxic effects of these regimens in these patients. Compare the complications in
patients treated with these regimens. Determine the dose-intensity and cumulative dose
delivery for these regimens in these patients.
OUTLINE:
This is a randomized, multicenter study. Patients are stratified into 1 of 3 strata according
to extent of residual disease and plans for interval cytoreductive surgery: Stratum A:
Optimal (microscopic or macroscopic) residual disease without plans for surgery Stratum B:
Suboptimal residual disease without plans for surgery Stratum C: Suboptimal residual disease
with plans for surgeryPatients are randomized to 1 of 5 treatment arms. Arm I: Patients
receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1. Treatment
continues every 3 weeks for 8 courses in the absence of disease progression or unacceptable
toxicity. Arm II: Patients receive chemotherapy as in arm I and gemcitabine IV over 30
minutes on days 1 and 8. Treatment continues as in arm I. Arm III: Patients receive
chemotherapy as in arm I during courses 1-8 and doxorubicin HCl liposome IV over 1 hour on
day 1 during courses 1, 3, 5, and 7. Treatment continues as in arm I. Arm IV: Patients
receive topotecan IV over 30 minutes on days 1-3 and carboplatin IV over 30 minutes on day 3.
Treatment continues every 3 weeks for 4 courses. Patients then receive 4 courses of arm I
chemotherapy. Arm V: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 and
carboplatin IV over 30 minutes on day 8. Treatment continues every 3 weeks for 4 courses.
Patients then receive 4 courses of arm I chemotherapy. Patients with initial unresectable or
suboptimal residual disease (more than 1 cm) may undergo interval cytoreductive surgery
between courses 4 and 5 of chemotherapy. Patients are followed every 3 months for 2 years and
then every 6 months.
PROJECTED ACCRUAL: Approximately 4,000-5,000 patients (800-1,000 per treatment arm) will be
accrued for this study within 3.5-5 years.
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