High-Dose Chemotherapy Compared With Standard Chemotherapy in Treating Patients With Stage III or Stage IV Ovarian Epithelial Cancer That Has Been Removed During Surgery
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known which chemotherapy regimen is most effective for ovarian epithelial cancer.
PURPOSE: This randomized phase III trial is studying high-dose chemotherapy to see how well it works compared to standard chemotherapy in treating patients with stage III or stage IV ovarian epithelial cancer that has been removed during surgery.
Procedure: adjuvant therapy
Procedure: bone marrow ablation with stem cell support
Procedure: peripheral blood stem cell transplantation
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||A Randomized Phase III Trial of Sequential High Dose Chemotherapy or Standard Chemotherapy for Optimally Debulked FIGO Stage III and IV Ovarian Cancer|
|Study Start Date:||September 1998|
|Study Completion Date:||September 2007|
- Compare the two-year progression-free survival in patients with optimally debulked stage III or IV ovarian epithelial cancer undergoing high-dose sequential chemotherapy vs standard chemotherapy.
- Compare the overall survival, toxicity, and quality of life in this patient population receiving these two treatment regimens.
OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms.
Arm I: Patients receive 5 courses of sequential high-dose chemotherapy as follows:
- Courses 1 and 2: Patients receive paclitaxel IV over 3 hours and cyclophosphamide IV over 2 hours on day 1 followed by peripheral blood stem cell (PBSC) collection. Patients receive filgrastim (G-CSF) subcutaneously (SC) beginning 24 hours following chemotherapy and continuing until target number of PBSC are reached.
- Courses 3 and 4: Patients receive paclitaxel as in courses 1-2 and carboplatin IV over 4 hours on day 1. At 72 hours following completion of carboplatin, patients receive PBSC infusion. Beginning one day following PBSC infusion, patients receive G-CSF SC until blood counts recover.
- Course 5: Patients receive paclitaxel as in courses 1 and 2 and carboplatin as in courses 3 and 4 and melphalan IV over 15 minutes on day 2 or 3. Patients receive PBSC and G-CSF as in courses 3 and 4.
- Treatment repeats every 3-4 weeks.
- Arm II: Patients receive standard chemotherapy consisting of carboplatin (or cisplatin) and paclitaxel IV over 3 hours every 3 weeks for 6 courses. Patients may receive doxorubicin or epirubicin in addition to the standard chemotherapy every 4 weeks.
Quality of life is assessed prior to therapy, at 4-6 weeks following completion of therapy, and then at 3 months, 9 months, and 15 months.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 208 patients (104 per treatment arm) will be accrued for this study.
|Sozialmedizinisches Zentrum Ost - Donauspital|
|Vienna, Austria, A-1220|
|Centre Hospitalier Notre Dame - Reine Fabiola|
|Charleroi, Belgium, 6000|
|Prague 10, Czech Republic, 10034|
|Thomayer Memorial Teaching Hospital|
|Prague 4, Czech Republic, 14000|
|Staedt Klinikum Karlsruhe GGMBH|
|Karlsruhe, Germany, 76133|
|Klinikum Nuernberg - Klinikum Nord|
|Nuernberg, Germany, D-90419|
|Azienda Ospedaliera Di Bologna Policlinico S. Orsola - Malpighi|
|Bologna, Italy, 40138|
|Ospedale Santa Chiara|
|Pisa, Italy, 56100|
|S. Camillo Hospital|
|Rome, Italy, 00152|
|Ospedale San Bortolo|
|Vicenza, Italy, 36100|
|National Cancer Institute - Bratislava|
|Bratislava, Slovakia, 833 10|
|Hospital Universitario San Carlos|
|Madrid, Spain, 28040|
|Hospital Clinico Universitario de Valencia|
|Valencia, Spain, 46010|
|Centre Hospitalier Universitaire Vaudois|
|Lausanne, Switzerland, CH-1011|
|Leeds Cancer Centre at St. James's University Hospital|
|Leeds, England, United Kingdom, LS9 7TF|
|Cancer Research UK and University College London Cancer Trials Centre|
|London, England, United Kingdom, NW1 2ND|
|Cancer Research Centre at Weston Park Hospital|
|Manchester, England, United Kingdom, M20 9BX|
|Study Chair:||Jonathan A. Ledermann, MD||Cancer Research UK|