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Sponsored by: |
National Institute of Cancerología |
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Information provided by: | National Institute of Cancerología |
ClinicalTrials.gov Identifier: | NCT00533299 |
The current standard for recurrent, persistent or metastatic cisplatin-resistant ovarian cancer is palliative chemotherapy with either topotecan, liposomal doxorubicin or gemcitabine, however, the results need to be improved. Epigenetic aberrations play an important role in cancer progression by silencing growth regulatory genes and there is now evidence that inhibitors of DNA methylation and HDAC inhibition synergize the cytotoxicity of chemotherapy.
Objective. To determine the superiority of epigenetic therapy with hydralazine and valproate plus topotecan over placebo plus topotecan upon progression-free survival.
Hypothesis. Hydralazine and magnesium valproate associated to topotecan will increase progression-free survival from 6 to 9 months as compared with the same regimen of chemotherapy plus placebo.
Condition | Intervention | Phase |
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Ovarian Cancer |
Drug: Hydralazine and magnesium valproate Drug: Placebo |
Phase III |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study |
Official Title: | Randomized, Double-Blind, Phase III Trial of Chemotherapy Plus the Transcriptional Therapy Hydralazine and Magnesium Valproate Versus Chemotherapy Plus Placebo in Cisplatin-Resistant Recurrent Ovarian Cancer. |
Estimated Enrollment: | 211 |
Study Start Date: | August 2007 |
Estimated Study Completion Date: | December 2009 |
Arms | Assigned Interventions |
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1: Experimental
Topotecan hydralazine valproate
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Drug: Hydralazine and magnesium valproate
Hydralazine and valproate will start from seven days before day 1 of chemotherapy until the end of the sixth course. Hydralazine will be administered at 182mg (rapid) or 83mg (slow) according to the acetylator phenotype in a single daily dose and magnesium valproate at an oral dose of 40mg/Kg t.i.d.
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2: Placebo Comparator
Placebo, hydralazine, valproate
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Drug: Placebo
Placebos will start from seven days before day 1 of chemotherapy until the end of the sixth course. Placebo tablets will be administered in an identical form that experimental drugs.
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Randomized, double-blind phase III trial. A total of 211 patients (alpha 0.5, power 0.8)with cisplatin-resistant recurrent or persistent cancer will be randomized to topotecan + placebo or topotecan + hydralazine + valproate for 6 courses every 4 weeks. Patients will receive an oral dose of hydralazine of 182mg (rapid) or 83mg (slow) according to the acetylator phenotype in a single daily dose and magnesium valproate at an oral dose of 40mg/Kg t.i.d. Both drugs in a slow-release formulation. Experimental drugs or placebo will start from seven days before day 1 of chemotherapy until the end of the sixth course.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Other exclusion criteria are uncontrolled systemic disease or infection.
Contact: Alfonso Dueñas-Gonzalez, MD PhD | +5255 56280486 |
Mexico, Tlalpan | |
Instituto Nacional de Cancerologia | Recruiting |
Mexico City, Tlalpan, Mexico, 14080 | |
Principal Investigator: Dolores Gallardo, MD |
Principal Investigator: | Dolores Gallardo, MD | Instituto Nacional de Cancerologia |
Study ID Numbers: | 006/028/DDI |
Study First Received: | September 19, 2007 |
Last Updated: | September 20, 2007 |
ClinicalTrials.gov Identifier: | NCT00533299 History of Changes |
Health Authority: | Mexico: Ethics Committee |
Epigenetics, hydralazine, valproate, ovarian cancer |
Vasodilator Agents Neurotransmitter Agents Tranquilizing Agents Ovarian Neoplasms Gonadal Disorders Hydralazine Psychotropic Drugs Genital Neoplasms, Female Central Nervous System Depressants Endocrine System Diseases Urogenital Neoplasms Cardiovascular Agents |
Ovarian Diseases Antihypertensive Agents Antimanic Agents Valproic Acid Recurrence Genital Diseases, Female Cisplatin Ovarian Cancer Endocrinopathy Anticonvulsants Endocrine Gland Neoplasms |
Vasodilator Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Gonadal Disorders Hydralazine Physiological Effects of Drugs Psychotropic Drugs Urogenital Neoplasms Ovarian Diseases Valproic Acid Genital Diseases, Female Neoplasms by Site Therapeutic Uses Endocrine Gland Neoplasms Ovarian Neoplasms |
Tranquilizing Agents Genital Neoplasms, Female Endocrine System Diseases Central Nervous System Depressants Enzyme Inhibitors Cardiovascular Agents Antihypertensive Agents Antimanic Agents Pharmacologic Actions Adnexal Diseases Neoplasms GABA Agents Central Nervous System Agents Anticonvulsants |