Multicenter Trial With PegLiposomal Doxorubicin and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors

This study has been completed.
Sponsor:
Collaborator:
MSD SHARP & DOHME GmbH (formerly Essex Pharma GmbH)
Information provided by (Responsible Party):
AGO Study Group
ClinicalTrials.gov Identifier:
NCT00815945
First received: December 30, 2008
Last updated: March 6, 2014
Last verified: March 2014
  Purpose

Uterine sarcomas account for less than 5% of all carcinomas of the uterine corpus. The prognosis of these patients is extremely limited. Recurrence rates of 50-60% are reported even for early-stage disease (FIGO I/II). Median overall survival is below 12 months in patients with advanced or metastatic disease.

Ovarian carcinosarcoma is extremely rare among ovarian malignancies (< 2%). That is why there is insufficient data as a basis for establishing a gold standard. As a result, these cases tend to be treated in the same way as uterine sarcomas or epithelial ovarian malignancies in clinical practice.

On the basis of data published to date on the treatment of mixed mesenchymal-epithelial tumors, it is clear that the treatments commonly used to date have limited activity while producing clinically relevant toxicity. The regimes verified so far (Cisplatin / Ifosfamide, Ifosfamide/Paclitaxel and Gemcitabine/Docetaxel) exhibit a considerable side effect spectrum and are only rarely feasible on clinical everyday life conditions, so e. g. the rate of withdrawals due to toxicity was in a study collective of selected females treated with the last combination at 40 %. The physician has to check in every individual case if one of the above mentioned combinations is feasible. The search for alternative effective and better tolerated treatment options is essential. The toxicity data on the carboplatin-PLD combination are known, and efficacy has been identified in small cohorts.

The objective of this study is to explore the efficacy of combination PLD-carboplatin treatment in a larger patient population.


Condition Intervention Phase
Mesenchymal Tumor
Carcinosarcoma
Leiomyosarcoma
Drug: PegLiposomal Doxorubicin
Drug: Carboplatin
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase II Study Evaluating PegLiposomal Doxorubicin (PLD) and Carboplatin Combination Chemotherapy in Gynecological Sarcomas and Mixed Epithelial-Mesenchymal Tumors

Resource links provided by NLM:


Further study details as provided by AGO Study Group:

Primary Outcome Measures:
  • Anticancer activity in terms of progression-free survival time (PFS) [ Time Frame: every 3 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Tolerability, i.e. type, frequency, severity and duration of adverse reactions (CTCAE,Version 3.0) [ Time Frame: until recovery of toxicities ] [ Designated as safety issue: Yes ]
  • Anticancer activity in patients with measurable or evaluable disease in terms of response rates (CR, PR, SD, PD) according to RECIST criteria [ Time Frame: six months ] [ Designated as safety issue: No ]
  • Overall survival [ Time Frame: 30 months ] [ Designated as safety issue: No ]
  • Correlation of tumor marker CA-125 with imaging methods [ Time Frame: six months ] [ Designated as safety issue: No ]

Enrollment: 41
Study Start Date: June 2008
Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: PegLiposomal Doxorubicin + Carboplatin
Subjects will receive PegLiposomal Doxorubicin (40mg/m²) and Carboplatin (AUC6) every 28 days. Treatment period up to 6 months (therapy can be continued in case of tumor response and benefit for the patient)
Drug: PegLiposomal Doxorubicin
PegLiposomal Doxorubicin, intravenous, 40mg/m², every 28 days for up to 6 months
Other Name: Caelyx
Drug: Carboplatin
Carboplatin, intravenous, AUC 6, every 28 days for up to 6 months

Detailed Description:

This study in patients with mesenchymal or mixed epithelial mesenchymal tumors of the ovary or uterus is designed as a prospective single-arm, open - label, multicenter phase II study to evaluate the efficacy of PegLiposomal Doxorubicin and Carboplatin combination chemotherapy.

40 patients will be recruited to receive PegLiposomal Doxorubicin (PLD) in a continuous i. v. infusion of at least 60 minutes at a dose of 40 mg/m2 on Day 1, followed by a 30-minute i. v. carboplatin infusion according to AUC 6 (formula devised by Calvert et al).

Patients will get outpatients treatment. At screening the patients' eligibility will be assessed, their baseline and demographic characteristics obtained, and baseline values for the effect variables collected. Patients with measurable lesions, non-measurable lesions or histological documentation will be included into this trial. Measurable lesion and non-measurable lesions will be documented by x-ray, ultrasound, computed tomography or MRI.

The patients' safety will be monitored during therapy until recovery of toxicities.

In patients with measurable lesions at baseline, the (post)-treatment values for effect according to the RECIST criteria will be collected as shown in table 6. CR, PR and SD have to be confirmed by a repeat measurement after an interval of at least four weeks.

Follow-up is scheduled every three months during the first two years after the end of treatment.

As from year 3 the follow-up takes place outside the study in the context of general aftercare.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically documented mesenchymal or mixed epithelial-mesenchymal tumor of the ovary or uterus
  • Patients with a primary diagnosis of FIGO I-IV uterine carcinosarcoma and optimum debulking (postoperative residual tumor < 1cm) may be enrolled only if cisplatin-ifosfamide combination therapy is not feasible.
  • Patients with metastatic uterine carcinosarcoma may be enrolled only if Ifosfamide/Paclitaxel combination therapy is not feasible.
  • Patients with metastatic leiomyosarcoma may be enrolled only if gemcitabine-docetaxel combination therapy is not feasible.
  • Measurable (target lesion) tumor, evaluable (non-target lesion) tumor or histological documentation
  • No more than one prior chemotherapy. Any prior platinum or anthracycline- containing chemotherapy must have been completed more than 6 months previously
  • Prior radiotherapy ≤ 25% of the hematopoietic system is allowed provided it took place more than 6 weeks before recruitment
  • Patients are allowed to have received prior anticancer hormone therapy or specific immunotherapy. Patients must have completed these therapies at least three weeks before recruitment to the study
  • All women with a theoretical possibility of pregnancy must produce a negative pregnancy test (serum or urinary) within seven days before starting treatment
  • General health of 0 - 2 on the ECOG score
  • At least 18 years of age
  • Estimated life expectancy above 12 weeks
  • At least 3 weeks since major surgery
  • Appropriate hematologic, renal and hepatic function in accordance with the following definitions:
  • Absolute neutrophil count (ANC) ≥ 1.5 × 109 /l
  • Platelets ≥ 100 × 10 9/l
  • Total bilirubin ≤ 1.25 times upper limit of normal
  • Estimated GFR ≥ 50 ml/min
  • LVEF > 50 %
  • Informed consent must be obtained from all patients.

Exclusion Criteria:

  • More than one prior chemotherapy (or radiochemotherapy)
  • Active infection or other serious medical impairment liable to affect the patient's ability to receive treatment according to protocol.
  • Administration of other chemotherapy drugs or other anticancer hormone treatments during the study.
  • History of clinically manifest atrial or ventricular arrhythmia (> LOWN II) and congestive heart failure, even if controlled by drugs (NYHA class > II). Documented myocardial infarction within 6 months before study enrollment.
  • Pregnant or breastfeeding women, or women not practicing appropriate birth control methods
  • Participation in another study using experimental drugs within the last 30 days
  • Any other conditions or therapies which the physician believes might put the patient at risk or impair the study objective.
  • Known hypersensitivity to carboplatin or pegylated liposomal doxorubicin
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00815945

Locations
Germany
Charité, Campus Virchow Klinikum, Frauenklinik
Berlin, Germany, 13353
Malteser Krankenhaus, Gynäkologie und Geburtshilfe
Bonn, Germany, 53123
Klinikum Bremen-Mitte gGmbH, Frauenklinik
Bremen, Germany, 28177
Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
Dresden, Germany, 01307
Evangelisches Krankenhaus Düsseldorf, Frauenklinik
Duesseldorf, Germany, 40217
Universitätsklinikum Essen, Frauenklinik
Essen, Germany, 45122
Klinikum der J. W. Goethe-Universität, Klinik für Gynäkologie und Geburtshilfe
Frankfurt, Germany, 60590
University Hospital Hamburg-Eppendorf
Hamburg, Germany, 20251
Gynäkologisch-onkologische Praxis
Hannover, Germany, 30177
St. Vincentius Kliniken AG, Frauenklinik
Karlsruhe, Germany, 76135
Universitätsklinikum Giessen und Marburg GmbH, Klinik für Gynäkologie, Gynäkologische Endokrinologie und Onkologie
Marburg, Germany, 35043
Klinikum Großhadern, Frauenklinik
München, Germany, 81377
Universitätsklinikum Tübingen, Frauenklinik
Tübingen, Germany, 72076
Universitätsklinikum Ulm, Universitätsfrauenklinik
Ulm, Germany, 89075
Dr. Horst Schmidt Kliniken GmbH, Klinik für Gynäkologie und gynäkologische Onkologie
Wiesbaden, Germany, 65199
Sponsors and Collaborators
AGO Study Group
MSD SHARP & DOHME GmbH (formerly Essex Pharma GmbH)
Investigators
Principal Investigator: Philipp Harter, MD Klinikum Essen Mitte
  More Information

No publications provided

Responsible Party: AGO Study Group
ClinicalTrials.gov Identifier: NCT00815945     History of Changes
Other Study ID Numbers: AGO-GYN 7
Study First Received: December 30, 2008
Last Updated: March 6, 2014
Health Authority: Germany: Federal Institute for Drugs and Medical Devices
Germany: Ethics Commission

Keywords provided by AGO Study Group:
leiomyosarcoma
carcinosarcoma
mixed epithelial mesenchymal tumor
endometrial stroma sarcomas
Müllerian mixed tumors
carcinosarcoma of the uterus
mesenchymal tumors of the ovary or uterus
mixed epithelial mesenchymal tumors of the ovary or uterus

Additional relevant MeSH terms:
Carcinosarcoma
Mixed Tumor, Mullerian
Leiomyosarcoma
Sarcoma
Neoplasms, Complex and Mixed
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Connective and Soft Tissue
Neoplasms, Muscle Tissue
Doxorubicin
Liposomal doxorubicin
Carboplatin
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Pharmacologic Actions
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 14, 2014