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Viral Therapy in Treating Patients With Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer That Did Not Respond to Platinum Chemotherapy
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), December 2008
Sponsors and Collaborators: Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00602277
  Purpose

RATIONALE: Viral therapy may be able to kill tumor cells without damaging normal cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of viral therapy in treating patients with ovarian epithelial cancer, primary peritoneal cancer, or fallopian tube cancer that did not respond to platinum chemotherapy.


Condition Intervention Phase
Fallopian Tube Cancer
Ovarian Cancer
Peritoneal Cavity Cancer
Drug: wild-type reovirus
Phase I
Phase II

MedlinePlus related topics: Cancer Ovarian Cancer
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment
Official Title: A Phase ½ Study of Reovirus Serotype 3 - Dearing Strain (REOLYSIN®) (NSC 729968) in Patients With Ovarian, Primary Peritoneal and Fallopian Tube Carcinoma

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Maximum tolerable dose of intraperitoneal (IP) wild-type reovirus when administered with fixed dose IV wild-type reovirus (phase I) [ Designated as safety issue: Yes ]
  • Proportion of patients demonstrating objective antitumor response (partial response and complete response) as measured by RECIST criteria (phase II) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Association of Ras oncogene and molecular markers with objective response [ Designated as safety issue: No ]

Estimated Enrollment: 70
Study Start Date: April 2008
Estimated Primary Completion Date: September 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Phase I: Experimental
Patients receive wild-type reovirus IV over 60 minutes on days 1-5 in course 1, followed by insertion of an IP access port. Beginning in course 2, patients receive wild-type reovirus IV over 60 minutes on days 1-5 and wild-type reovirus IP over 10 minutes on days 1 and 2. Treatment with IV and IP wild-type reovirus repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: wild-type reovirus
Given IV and intraperitoneally
Phase II: Experimental
Patients undergo IP access port insertion before beginning treatment. Patients receive wild-type reovirus IV over 60 minutes on days 1-5 and wild-type reovirus IP (at the maximum tolerated dose determined in phase I) over 10 minutes on days 1 and 2. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.
Drug: wild-type reovirus
Given IV and intraperitoneally

Detailed Description:

OBJECTIVES:

Primary

  • To determine the safety and tolerability of intravenous (IV) and intraperitoneal (IP) administration of wild-type reovirus (REOLYSIN®). (Phase I)
  • To determine the maximum tolerated dose of IP REOLYSIN® when used with a fixed dose of IV REOLYSIN®. (Phase I)
  • To determine the objective response rate (complete response and partial response per RECIST criteria) of treatment with IV and IP REOLYSIN® in patients with recurrent, platinum-refractory ovarian epithelial, peritoneal, or fallopian tube carcinoma. (Phase II)

Secondary

  • To identify viral replication in tumor following IV reovirus.
  • To identify anti-reovirus antibodies in patients being treated with IV and IP REOLYSIN® therapy.
  • To identify viral replication in the abdominal washings of patients undergoing IV and IP REOLYSIN® therapy.
  • To correlate response to therapy with Ras oncogene status.
  • To evaluate double-stranded RNA-activated protein kinase activity in tumors.
  • To correlate molecular predictors of response to REOLYSIN® therapy.

OUTLINE: This is a phase I, dose-escalation study of intraperitoneal (IP) wild-type reovirus when administered with fixed dose IV wild-type reovirus followed by a phase II study.

  • Phase I: Patients receive wild-type reovirus IV over 60 minutes on days 1-5 in course 1, followed by insertion of an IP access port. Beginning in course 2, patients receive wild-type reovirus IV over 60 minutes on days 1-5 and wild-type reovirus IP over 10 minutes on days 1 and 2*. Treatment with IV and IP wild-type reovirus repeats every 28 days in the absence of disease progression or unacceptable toxicity.
  • Phase II: Patients undergo IP access port insertion before beginning treatment. Patients receive wild-type reovirus IV over 60 minutes on days 1-5 and IP (at the maximum tolerated dose determined in phase I) over 10 minutes on days 1 and 2*. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

NOTE: *Patients receive IP wild-type reovirus on days 2 and 3 in course 3.

Prior to each IP wild-type reovirus administration, normal saline is administered through the IP catheter and withdrawn for correlative studies in courses 2 and 3 (phase I) or courses 1 and 2 (phase II). Patients also undergo a CT-guided percutaneous tumor biopsy on day 2 of course 3 (phase I or II). Samples are analyzed by immunohistochemistry, RT-PCR, and electron microscopy for the relevant molecular effects of wild-type reovirus on tumor and normal tissue.

After completion of study treatment, patients are followed for up to 12 weeks.

PROJECTED ACCRUAL: A total of 70 patients (up to 30 for phase I and 40 for phase II) will be accrued for this study.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed ovarian epithelial, primary peritoneal, or fallopian tube cancer
  • Recurrent disease after platinum-based chemotherapy

    • Must have experienced disease persistence during primary platinum-based therapy or recurrence within 12 months after completion of platinum-based chemotherapy ("platinum-refractory" or "platinum-resistant" disease)

      • A patient receiving a second course of platinum-based chemotherapy for platinum-sensitive disease who then develops persistence or recurrence within 12 months is considered eligible for this trial
  • Must have measurable disease by RECIST criteria (phase II)
  • Must have received ≥ 1 prior platinum-based cytotoxic chemotherapy regimen (for primary disease) containing carboplatin, cisplatin, or other organoplatinum compound

    • Initial treatment may have included any of the following:

      • High-dose therapy
      • Consolidation therapy
      • Intraperitoneal (IP) therapy
      • Extended therapy administered after surgical or nonsurgical assessment
    • One additional non-cytotoxic regimen (e.g., monoclonal antibodies, cytokines, or small-molecule inhibitors) for recurrent or persistent disease allowed
  • Patients may have received hormonal therapy for management of disease (e.g., SERMs, aromatase inhibitors, progestins, and GnRH agonists)
  • No loculated ascites for which IP distribution of virus is not expected to be feasible
  • No known brain metastases

PATIENT CHARACTERISTICS:

Inclusion criteria:

  • GOG performance status (PS) 0-2 (Karnofsky PS 60-100%)
  • Life expectancy > 12 weeks
  • Leukocytes ≥ 3,000/mcL
  • Absolute neutrophil count ≥ 1,500/mcL
  • Hemoglobin ≥ 10 g/dL
  • Platelets ≥ 100,000/mcL
  • Total bilirubin normal
  • AST/ALT ≤ 2.5 times upper limit of normal
  • Creatinine normal
  • Ejection fraction > 50% by echocardiogram or MUGA
  • Cardiac enzymes normal
  • Not pregnant or nursing
  • Fertile patients must use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation
  • Must be able to avoid direct contact with pregnant or nursing women, infants, or immunocompromised individuals while on study and for ≥ 3 weeks following the last dose of study agent administration
  • Cardiac conduction abnormalities (e.g., bundle branch block, heart block) are allowed if their cardiac status has been stable for 6 months before study entry

Exclusion criteria:

  • Patients in whom insertion of an IP catheter is not feasible due to surgical contraindications or abdominal and pelvic adhesions
  • Known HIV infection or hepatitis B or C
  • Clinically significant cardiac disease (New York Heart Association class III or IV cardiac disease) including any of the following:

    • Pre-existing arrhythmia
    • Uncontrolled angina pectoris
    • Myocardial infarction 1 year prior to study entry
    • Compromised left ventricular ejection fraction ≥ grade 2 by MUGA or echocardiogram
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirements

PRIOR CONCURRENT THERAPY:

Inclusion criteria:

  • See Disease Characteristics
  • At least 4 weeks since most recent cytotoxic chemotherapy (6 weeks for nitrosoureas or mitomycin C)
  • Recovered from adverse events due to agents administered more than 4 weeks earlier
  • No prior radiotherapy to the abdomen or pelvis
  • No other concurrent investigational agents
  • No investigational or commercial agents or therapies other than those described below may be administered with the intent to treat the patient's malignancy

Exclusion criteria:

  • Chronic oral steroids at an equivalent dose of prednisone 5 mg daily

    • Inhaled steroids allowed
  • Patients on immunosuppressive therapy
  • Concurrent routine prophylactic use of growth factor (filgrastim [G-CSF] or sargramostim [GM-CSF])
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00602277

Locations
United States, Ohio
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Recruiting
Columbus, Ohio, United States, 43210-1240
Contact: Clinical Trials Office - OSU Comprehensive Cancer Center     614-293-4976     osu@emergingmed.com    
Sponsors and Collaborators
Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
Investigators
Study Chair: David E. Cohn, MD Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000584038, OSU-07022, 2007 C0028
Study First Received: January 19, 2008
Last Updated: December 11, 2008
ClinicalTrials.gov Identifier: NCT00602277  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
fallopian tube cancer
recurrent ovarian epithelial cancer
peritoneal cavity cancer

Study placed in the following topic categories:
Ovarian cancer
Digestive System Neoplasms
Ovarian Neoplasms
Gonadal Disorders
Genital Neoplasms, Female
Endocrine System Diseases
Urogenital Neoplasms
Ovarian Diseases
Ovarian epithelial cancer
Abdominal Neoplasms
Fallopian Tube Neoplasms
Dental Caries
Recurrence
Fallopian Tube Diseases
Carcinoma
Genital Diseases, Female
Digestive System Diseases
Peritoneal Diseases
Gastrointestinal Neoplasms
Endocrinopathy
Fallopian tube cancer
Peritoneal Neoplasms
Endocrine Gland Neoplasms

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Adnexal Diseases

ClinicalTrials.gov processed this record on January 14, 2009