Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer
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Purpose
RATIONALE: Drugs used in chemotherapy, such as carboplatin, paclitaxel, and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays and other types of radiation to kill tumor cells. Giving chemotherapy and radiation therapy after surgery may kill any tumor cells that remain after surgery. It is not yet known whether carboplatin and paclitaxel are more effective with or without cisplatin and radiation therapy in treating patients with endometrial cancer.
PURPOSE: This randomized phase III trial is studying carboplatin and paclitaxel to see how well they work when given with or without cisplatin and radiation therapy in treating patients with stage I, stage II, stage III, or stage IVA endometrial cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Endometrial Cancer |
Drug: carboplatin Drug: cisplatin Drug: paclitaxel |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomized Phase III Trial of Cisplatin and Tumor Volume Directed Irradiation Followed by Carboplatin and Paclitaxel vs. Carboplatin and Paclitaxel for Optimally Debulked, Advanced Endometrial Carcinoma |
- Recurrence-free survival [ Designated as safety issue: No ]
- Overall survival [ Designated as safety issue: No ]
- Cumulative incidence of local recurrence [ Designated as safety issue: No ]
- Cumulative incidence of distant metastases [ Designated as safety issue: No ]
- Acute and late adverse effects as measured by NCI CTCAE v3.0 [ Designated as safety issue: Yes ]
- Patient-reported quality of life [ Designated as safety issue: No ]
| Estimated Enrollment: | 804 |
| Study Start Date: | June 2009 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I
Patients receive cisplatin IV on days 1 and 29. Patients also undergo external-beam radiotherapy once daily, 5 days a week, for 5-6 weeks. Some patients may then undergo brachytherapy over 2-3 weeks. Beginning within 8 weeks after completion of chemoradiotherapy, patients receive paclitaxel IV over 3 hours and carboplatin IV on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
|
Drug: carboplatin
Given IV
Drug: cisplatin
Given IV
Drug: paclitaxel
Given IV
|
|
Experimental: Arm II
Patients receive paclitaxel IV over 3 hours and carboplatin IV on day 1. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.
|
Drug: carboplatin
Given IV
Drug: paclitaxel
Given IV
|
Detailed Description:
OBJECTIVES:
Primary
- Compare the recurrence-free survival of patients with stage I-IVA endometrial carcinoma treated with adjuvant chemoradiotherapy comprising cisplatin and tumor volume-directed radiotherapy followed by carboplatin and paclitaxel vs carboplatin and paclitaxel alone.
Secondary
- Compare the overall survival of patients treated with these regimens.
- Compare the acute and late adverse effects of these regimens in these patients.
- Determine the impact of these regimens on patient-reported quality of life during and for up to 1 year after completion of study treatment.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive cisplatin IV on days 1 and 29. Patients also undergo external-beam radiotherapy once daily, 5 days a week, for 5-6 weeks. Some patients may then undergo brachytherapy over 2-3 weeks. Beginning within 8 weeks after completion of chemoradiotherapy, patients receive paclitaxel IV over 3 hours and carboplatin IV on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive paclitaxel IV over 3 hours and carboplatin IV on day 1. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Patients complete quality-of-life questionnaires at baseline and periodically during study using the FACT-G Physical and Functional Well-Being, FACT-Endometrial, FACT/GOG Neuropathy, and FACT-C (items C3 and C5).
After completion of study therapy, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically confirmed endometrial carcinoma, including the following cell types:
- Clear cell carcinoma
- Serous papillary carcinoma
- Undifferentiated carcinoma
Surgical stage III or IVA disease per FIGO 2009 staging criteria
- Surgical stage III disease includes positive adnexa, tumor invading the serosa, positive pelvic and/or para-aortic nodes, or vaginal involvement
- Surgical stage IVA disease includes bladder or bowel mucosal involvement, but no spread outside the pelvis
- Surgical stage I or II endometrial clear cell or serous papillary carcinoma with positive peritoneal cytology per FIGO 2009 staging criteria
Has undergone optimal surgical debulking that included a hysterectomy and bilateral salpingo-oophorectomy within the past 8 weeks
- Residual tumor after surgery (any single site) ≤ 2 cm in maximum dimension
- No carcinosarcoma
- No parenchymal liver metastases
- No recurrent endometrial cancer or endometrioid stage I or II with positive peritoneal cytology
PATIENT CHARACTERISTICS:
- GOG performance status 0-2
- Life expectancy ≥ 3 months
- WBC ≥ 3,000/mm^3
- ANC ≥ 1,500/mm^3
- Platelet count ≥ 100,000/mm^3
- SGOT and SGPT ≤ 2.5 times upper limit of normal (ULN)
- Alkaline phosphatase ≤ 2.5 times ULN
- Bilirubin ≤ 1.5 times ULN
- Creatinine ≤ ULN
- No myocardial infarction, unstable angina, or uncontrolled arrhythmia within the past 3 months
- No other active invasive malignancy within the past 5 years except for non-melanoma skin cancer
- No history of serious co-morbid or uncontrolled illness that would preclude study therapy
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior pelvic or abdominal radiotherapy
- No prior chemotherapy for endometrial cancer
- No prior cancer treatment that would preclude study therapy
Contacts and Locations
Show 355 Study Locations| Study Chair: | Daniela E. Matei, MD | Indiana University Melvin and Bren Simon Cancer Center |
More Information
Additional Information:
No publications provided
| Responsible Party: | Philip J. DiSaia, Gynecologic Oncology Group |
| ClinicalTrials.gov Identifier: | NCT00942357 History of Changes |
| Other Study ID Numbers: | CDR0000649079, GOG-0258 |
| Study First Received: | July 17, 2009 |
| Last Updated: | August 10, 2012 |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
|
endometrial clear cell carcinoma endometrial papillary serous carcinoma stage IA endometrial carcinoma stage IB endometrial carcinoma stage II endometrial carcinoma |
stage IIIA endometrial carcinoma stage IIIB endometrial carcinoma stage IIIC endometrial carcinoma stage IVA endometrial carcinoma stage IVB endometrial carcinoma |
Additional relevant MeSH terms:
|
Endometrial Neoplasms Sarcoma, Endometrial Stromal Adenoma Endometrial Stromal Tumors Cisplatin Uterine Neoplasms Genital Neoplasms, Female Urogenital Neoplasms Neoplasms by Site Neoplasms Uterine Diseases Genital Diseases, Female Neoplasms, Complex and Mixed Neoplasms by Histologic Type Sarcoma |
Neoplasms, Connective and Soft Tissue Neoplasms, Glandular and Epithelial Carboplatin Paclitaxel Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Radiation-Sensitizing Agents Physiological Effects of Drugs Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Phytogenic |
ClinicalTrials.gov processed this record on May 19, 2013