Paclitaxel and Carboplatin With or Without Epirubicin in Treating Patients With Stage IIB, Stage III, or Stage IV Invasive Ovarian Epithelial, Fallopian Tube, or Peritoneal Cancer
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether receiving paclitaxel and carboplatin with epirubicin is more effective than paclitaxel and carboplatin alone for ovarian epithelial, fallopian tube, or peritoneal cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of paclitaxel and carboplatin with or without epirubicin in treating patients who have stage IIB, stage III, or stage IV invasive ovarian epithelial, fallopian tube, or peritoneal cancer.
Fallopian Tube Cancer
Primary Peritoneal Cavity Cancer
Drug: epirubicin hydrochloride
Procedure: conventional surgery
|Study Design:||Allocation: Randomized
Primary Purpose: Treatment
|Official Title:||A Randomized Trial of Paclitaxel/Epirubicin/Carboplatin Combination (TEC) Versus Paclitaxel/Carboplatin (TC) in the Treatment of Women With Advanced Ovarian Cancer|
|Study Start Date:||August 1999|
|Study Completion Date:||May 2003|
- Compare progression free survival and overall survival in patients with stage IIB, III, or IV invasive ovarian epithelial, fallopian tube, or peritoneal cancer treated with paclitaxel and carboplatin with or without epirubicin.
- Compare the toxicity of these 2 regimens in these patients.
- Compare the quality of life of patients treated with these 2 regimens.
OUTLINE: This is a randomized, multicenter study. Patients are stratified by center and type of surgery (delayed surgery: 3 courses of chemotherapy before surgery vs primary surgery: optimally debulked stage IIB or III [residual tumor less than 1 cm] vs primary surgery: suboptimally debulked stage IV [residual tumor 1 cm or greater]).
- Patients are assigned to one of two surgery groups:
- Group A: Patients undergo primary surgery comprised of hysterectomy, bilateral salpingo-oophorectomy (BSO), omentectomy, and resection of all tumor masses, if possible, before beginning chemotherapy. Patients with residual disease greater than 1 cm after completion of primary surgery receive 3 courses of chemotherapy, followed within 6 weeks by interval debulking surgery, followed within 3 weeks by the fourth course of chemotherapy.
- Group B: Patients undergo delayed surgery comprised of hysterectomy, BSO, omentectomy, and resection of all tumor masses, if possible, after completion of 3 courses of chemotherapy.
- Patients are randomized to 1 of 2 chemotherapy arms:
- Arm I: Patients receive epirubicin IV over 15-20 minutes, paclitaxel IV over 3 hours, and carboplatin IV over 1 hour on day 1. Treatment repeats every 3 weeks for 6 courses. Patients with residual tumor after completion of 6 courses may receive 3 additional courses.
- Arm II: Patients receive paclitaxel and carboplatin as above but no epirubicin. Quality of life is assessed before beginning study, after completion of courses 3, 6, and 9 (if applicable), and then at 6 and 12 months after completion of study treatment.
Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 800 patients will be accrued for this study.
|United States, Minnesota|
|St. Mary's/Duluth Clinic Cancer Center|
|Duluth, Minnesota, United States, 55805|
|Leuven, Belgium, B-3000|
|Tom Baker Cancer Center - Calgary|
|Calgary, Alberta, Canada, T2N 4N2|
|Winnipeg, Manitoba, Canada, R3E 0V9|
|Cancer Care Ontario-Hamilton Regional Cancer Centre|
|Hamilton, Ontario, Canada, L8V 5C2|
|Fleurimont, Quebec, Canada, J1H 5N4|
|Centre Hospitalier Universitaire de Quebec|
|Quebec City, Quebec, Canada, G1R 2J6|
|Aalborg, Denmark, 9100|
|Odense University Hospital|
|Odense, Denmark, DK-5000|
|Shaare Zedek Medical Center|
|Jerusalem, Israel, 91031|
|Brescia, Italy, 25123|
|Istituto Nazionale per lo Studio e la Cura dei Tumori|
|Milano (Milan), Italy, 20133|
|Ospedale di Circolo e Fondazione Macchi|
|Varese, Italy, 21100|
|Medisch Spectrum Twente|
|Enschede, Netherlands, 7500 KA|
|Norwegian Radium Hospital|
|Oslo, Norway, N-0310|
|Hospitais da Universidade de Coimbra (HUC)|
|Coimbra, Portugal, 3049|
|Instituto Portugues de Oncologia de Francisco Gentil - Centro de Lisboa|
|Lisbon, Portugal, 1099-023 Codex|
|Institut d'Oncologia Corachan|
|Barcelona, Spain, 08.017|
|Study Chair:||Gunnar B. Kristensen, MD, PhD||Norwegian Radium Hospital|
|Study Chair:||Ignace B. Vergote, MD, PhD||U.Z. Gasthuisberg|
|Study Chair:||Gavin C.E. Stuart, MD||Tom Baker Cancer Centre - Calgary|