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Phase III Randomized Study of Paclitaxel and Carboplatin With or Without Gemcitabine, Doxorubicin HCl Liposome, or Topotecan in Patients With Stage III or IV Ovarian Epithelial or Serous Primary Peritoneal Carcinoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outline Published Results Related Publications Trial Contact Information Registry Information
Alternate Title
Combination Chemotherapy in Treating Patients With Stage III or Stage IV Ovarian Epithelial Cancer or Primary Peritoneal Cancer
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
---|
Phase III | Treatment | Closed | Any age | GOG-0182 SWOG-G0182, MRC-ICON5, ECOG-G0182, NCT00011986, ISRCTN41636183 |
Objectives - Compare the efficacy of paclitaxel and carboplatin with or without gemcitabine, doxorubicin HCl liposome, or topotecan, in terms of overall and progression-free survival, in patients with stage III or IV ovarian epithelial or serous primary peritoneal carcinoma.
- Determine the response rate in patients with measurable disease treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
- Compare the complications in patients treated with these regimens.
- Determine the dose-intensity and cumulative dose delivery for these regimens in these patients.
Entry Criteria Disease Characteristics:
- Histologically confirmed stage III or IV ovarian epithelial or serous primary
peritoneal carcinoma
- The following are ineligible:
- Germ cell tumors
- Sex cord-stromal tumors
- Carcinosarcomas
- Mixed
Mullerian
tumors or carcinosarcomas
- Metastatic carcinomas from other sites to the
ovary
- Low malignant potential tumors, including micropapillary serous
carcinomas
- Mucinous primary peritoneal carcinoma
- Prior ovarian low malignant potential tumor (borderline carcinoma) that
was
surgically resected with subsequent development of invasive
adenocarcinoma
allowed if no prior chemotherapy
- Optimal (no greater than 1 cm) or suboptimal residual disease after
initial
surgery
- Prior breast cancer allowed provided the following are true:
- Disease-free for more than 5 years
- No prior cytotoxic chemotherapy for breast cancer
- Prior or concurrent primary endometrial cancer allowed if the following
conditions are met:
- Stage no greater than IB
- Less than 3 mm invasion without
vascular or lymphatic
invasion
- No poorly differentiated subtypes, including papillary
serous, clear cell, or other FIGO grade 3 lesions
Prior/Concurrent Therapy:
Biologic therapy: Chemotherapy: - See Disease Characteristics
- Prior chemotherapy for cancer involving the abdominal cavity or pelvis
allowed provided the following are true:
- More than 3 years since prior therapy
- No evidence of recurrent disease
Endocrine therapy: Radiotherapy: - No prior radiotherapy to any portion of the abdominal cavity or pelvis
- Prior radiotherapy for localized breast, head and neck, or
skin cancer allowed provided the following are true:
- More than 3 years since prior therapy
- No evidence of recurrent disease
Surgery: - See Disease Characteristics
- No more than 12 weeks since prior surgical resection
Patient Characteristics:
Age: Performance status: Life expectancy: Hematopoietic: - Absolute neutrophil count at least 1,500/mm3
- Platelet count at least 100,000/mm3
Hepatic: - Bilirubin no greater than 1.5 times upper limit of normal
(ULN)
- AST no greater than 2.5 times ULN
- Alkaline phosphatase no greater than 2.5 times ULN
- No acute hepatitis
Renal: - Creatinine no greater than 1.5 times ULN
Cardiovascular: - No unstable angina
- No myocardial infarction within the past 6 months
- No evidence of abnormal cardiac conduction (e.g., bundle
branch block, heart block) unless stable for the past 6 months
Other: - Not pregnant or nursing
- Fertile patients must use effective contraception
- No greater than grade 1 sensory or motor neuropathy
- No active infection that requires antibiotics
- No other invasive malignancy within the past 5 years except
nonmelanoma skin cancer
- No severe or ongoing gastrointestinal bleeding that requires
blood product support
Expected Enrollment Approximately 4,000-5,000 patients (800-1,000 per treatment arm) will be accrued
for this study within 3.5-5 years. Outline This is a randomized, multicenter study. Patients are stratified into 1
of 3 strata according to extent of residual disease and plans for interval
cytoreductive surgery: - Stratum A: Optimal (microscopic or macroscopic) residual disease without
plans for surgery
- Stratum B: Suboptimal residual disease without plans for surgery
- Stratum C: Suboptimal residual disease with plans for surgery
Patients are randomized to 1 of 5 treatment arms. - Arm I: Patients receive paclitaxel IV over 3 hours and carboplatin IV
over 30 minutes on day 1. Treatment continues every 3 weeks for 8 courses in
the absence of disease progression or unacceptable toxicity.
- Arm II: Patients receive chemotherapy as in arm I and gemcitabine IV
over 30 minutes on days 1 and 8. Treatment continues as in arm I.
- Arm III: Patients receive chemotherapy as in arm I during courses 1-8
and doxorubicin HCl liposome IV over 1 hour on day 1 during courses 1, 3, 5,
and 7. Treatment continues as in arm I.
- Arm IV: Patients receive topotecan IV over 30 minutes on days 1-3 and
carboplatin IV over 30 minutes on day 3. Treatment continues every 3 weeks for
4 courses. Patients then receive 4 courses of arm I chemotherapy.
- Arm V: Patients receive gemcitabine IV over 30 minutes on days 1 and 8
and carboplatin IV over 30 minutes on day 8. Treatment continues every 3 weeks
for 4 courses. Patients then receive 4 courses of arm I chemotherapy.
Patients with initial unresectable or suboptimal residual disease (more
than 1 cm) may undergo interval cytoreductive surgery between courses 4 and 5
of chemotherapy. Patients are followed every 3 months for 2 years and then every 6 months. Published ResultsBookman MA: GOG0182-ICON5: 5-arm phase III randomized trial of paclitaxel (P) and carboplatin (C) vs combinations with gemcitabine (G), PEG-lipososomal doxorubicin (D), or topotecan (T) in patients (pts) with advanced-stage epithelial ovarian (EOC) or primary peritoneal (PPC) carcinoma. [Abstract] J Clin Oncol 24 (Suppl 18): A-5002, 256s, 2006. Bookman MA, Brady MF, McGuire WP, et al.: Evaluation of new platinum-based treatment regimens in advanced-stage ovarian cancer: a Phase III Trial of the Gynecologic Cancer Intergroup. J Clin Oncol 27 (9): 1419-25, 2009.[PUBMED Abstract] Bookman MA, Greer BE, Ozols RF: Optimal therapy of advanced ovarian cancer: carboplatin and paclitaxel vs. cisplatin and paclitaxel (GOG 158) and an update on GOG0 182-ICON5. Int J Gynecol Cancer 13 (6): 735-40, 2003 Nov-Dec.[PUBMED Abstract] Copeland LJ, Bookman M, Trimble E, et al.: Clinical trials of newer regimens for treating ovarian cancer: the rationale for Gynecologic Oncology Group Protocol GOG 182-ICON5. Gynecol Oncol 90 (2 Pt 2): S1-7, 2003.[PUBMED Abstract] Krivak TC, Darcy KM, Tian C, et al.: Relationship between ERCC1 polymorphisms, disease progression, and survivalin GOG0182, a Gynecologic Oncology Group phase III trial of platinum-based chemotherapy in women with advanced stage epithelial ovarian or primary peritoneal cancer. [Abstract] J Clin Oncol 26 (Suppl 15): A-5540, 2008. Related PublicationsBaysal BE, DeLoia JA, Willett-Brozick JE, et al.: Analysis of CHEK2 gene for ovarian cancer susceptibility. Gynecol Oncol 95 (1): 62-9, 2004.[PUBMED Abstract]
Trial Contact Information
Trial Lead Organizations Gynecologic Oncology Group ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Michael Bookman, MD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | William McGuire, MD, Protocol co-chair | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Ph: 443-777-7826; 877-715-4673 |
| ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) |
Southwest Oncology Group ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Amy Tiersten, MD, Protocol chair(Contact information may not be current) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) |
Medical Research Council Clinical Trials Unit ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Helen Pearce, PhD, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) |
Registry Information | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Official Title | | A Phase III Randomized Trial Of Paclitaxel And Carboplatin Versus Triplet Or Sequential Doublet Combinations In Patients With Epithelial Ovarian Or Primary Peritoneal Carcinoma | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Trial Start Date | | 2001-01-29 | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Registered in ClinicalTrials.gov | | NCT00011986 | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Date Submitted to PDQ | | 2001-01-03 | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | Information Last Verified | | 2004-09-09 | ![](https://webarchive.library.unt.edu/eot2008/20090514202424im_/http://www.cancer.gov/images/spacer.gif) | NCI Grant/Contract Number | | CA27469 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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