Radiation Therapy Plus Celecoxib, Fluorouracil, and Cisplatin in Patients With Locally Advanced Cervical Cancer

NCT ID: NCT00023660

Last Updated: 2013-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-08-31

Brief Summary

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RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving radiation therapy in different ways and combining it with chemotherapy may kill more tumor cells. Celecoxib may slow the growth of cervical cancer by stopping blood flow to the tumor.

PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy plus celecoxib, fluorouracil, and cisplatin in treating patients who have locally advanced cervical cancer.

Detailed Description

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OBJECTIVES:

* Determine treatment-related toxicity rates in patients with locally advanced cervical cancer treated with external beam radiotherapy and brachytherapy concurrently with celecoxib, fluorouracil, and cisplatin.
* Determine whether this regimen increases locoregional control rates, distant control, disease-free survival, and overall survival in these patients.
* Determine whether first-failure patterns in patients treated with this regimen are changed compared to historical controls.

OUTLINE: This is a multicenter study.

Patients undergo external beam pelvic radiotherapy once daily five days a weeks for 5 weeks beginning on day 1. Within 8 weeks, patients undergo low-dose or high-dose brachytherapy. Patients also receive concurrent chemotherapy comprising fluorouracil IV continuously over days 2-5, 23-26, and 44-47 and cisplatin IV over 4 hours on days 1, 22, and 43. Oral celecoxib is administered twice daily beginning on day 1 and continuing for 12 months.

Patients are followed every 3 months for 2 years, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 83 patients will be accrued for this study within 1.5 years.

Conditions

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Cervical Cancer

Keywords

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stage III cervical cancer stage IB cervical cancer stage IIB cervical cancer stage IIA cervical cancer stage IVA cervical cancer cervical squamous cell carcinoma cervical adenocarcinoma cervical adenosquamous cell carcinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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celecoxib

Intervention Type DRUG

cisplatin

Intervention Type DRUG

fluorouracil

Intervention Type DRUG

brachytherapy

Intervention Type RADIATION

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed squamous, adenocarcinoma, or adenosquamous carcinoma of the cervix

* Stage IIB-IVA OR
* Stage IB-IIA with pelvic node metastases and/or tumor size at least 5 cm
* No small cell, carcinoid, glassy cell, clear cell, or adenoid cystic disease
* No metastatic disease outside of pelvis
* No para-aortic disease

PATIENT CHARACTERISTICS:

Age:

* 18 to 85

Performance status:

* Zubrod 0-2

Life expectancy:

* At least 6 months

Hematopoietic:

* WBC at least 3,000/mm\^3
* Absolute granulocyte count at least 1,500/mm\^3
* Platelet count at least 100,000/mm\^3

Hepatic:

* Bilirubin no greater than 1.5 mg/dL
* AST or ALT no greater than 2.5 times upper limit of normal (ULN)

Renal:

* Creatinine no greater than 1.5 mg/dL
* Creatinine clearance at least 50 mL/min
* Calcium no greater than 1.3 times ULN

Cardiovascular:

* No severe heart disease

Other:

* Not pregnant or nursing
* Negative pregnancy test
* HIV negative
* No prior allergy to sulfonamides or non-steroidal anti-inflammatory drugs (NSAIDs)
* No prior hypersensitivity to celecoxib or any component of its formulation
* No medical or psychiatric illness that would preclude study
* No active gastrointestinal (GI) ulcer, GI bleeding, or inflammatory bowel disease
* No other prior malignancy within the past 5 years except cutaneous basal cell skin cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* No recent prior celecoxib or other cyclo-oxygenase-2 inhibitor

Chemotherapy:

* No prior systemic chemotherapy

Endocrine therapy:

* Not specified

Radiotherapy:

* No prior radiotherapy to pelvis except transvaginal radiotherapy to control bleeding

Surgery:

* No prior surgery for cervical cancer except biopsy

Other:

* No concurrent phenytoin or lithium
* No other concurrent NSAIDs
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Radiation Therapy Oncology Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David K. Gaffney, MD, PhD

Role: STUDY_CHAIR

University of Utah

Locations

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Mobile Infirmary Medical Center

Mobile, Alabama, United States

Site Status

Foundation for Cancer Research and Education

Phoenix, Arizona, United States

Site Status

Mills-Peninsula Health Services

Burlingame, California, United States

Site Status

Sutter Health Western Division Cancer Research Group

Greenbrae, California, United States

Site Status

UCSF Comprehensive Cancer Center

San Francisco, California, United States

Site Status

Memorial Hospital Cancer Center

Colorado Springs, Colorado, United States

Site Status

Baptist Hospital of Miami

Miami, Florida, United States

Site Status

Regional Radiation Oncology Center at Rome

Rome, Georgia, United States

Site Status

Methodist Medical Center of Illinois

Peoria, Illinois, United States

Site Status

Ball Memorial Hospital Cancer Center

Muncie, Indiana, United States

Site Status

West Michigan Cancer Center

Kalamazoo, Michigan, United States

Site Status

CCOP - Kansas City

Kansas City, Missouri, United States

Site Status

Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha

Omaha, Nebraska, United States

Site Status

CCOP - Southern Nevada Cancer Research Foundation

Las Vegas, Nevada, United States

Site Status

Monmouth Medical Center

Long Branch, New Jersey, United States

Site Status

South Jersey Regional Cancer Center

Millville, New Jersey, United States

Site Status

Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital

Mount Holly, New Jersey, United States

Site Status

Newark Beth Israel Medical Center

Newark, New Jersey, United States

Site Status

Community Medical Center

Toms River, New Jersey, United States

Site Status

State University of New York Health Science Center at Brooklyn

Brooklyn, New York, United States

Site Status

New York Methodist Hospital

Brooklyn, New York, United States

Site Status

Comprehensive Cancer Center at Wake Forest University

Winston-Salem, North Carolina, United States

Site Status

Akron General Medical Center

Akron, Ohio, United States

Site Status

Akron City Hospital - Summa Health System

Akron, Ohio, United States

Site Status

Bryn Mawr Hospital

Bryn Mawr, Pennsylvania, United States

Site Status

Mercy Fitzgerald Hospital

Darby, Pennsylvania, United States

Site Status

Delaware County Memorial Hospital

Drexel Hill, Pennsylvania, United States

Site Status

Paoli Memorial Hospital

Paoli, Pennsylvania, United States

Site Status

Kimmel Cancer Center at Thomas Jefferson University - Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Western Pennsylvania Hospital

Pittsburgh, Pennsylvania, United States

Site Status

CCOP - MainLine Health

Wynnewood, Pennsylvania, United States

Site Status

Lankenau Cancer Center at Lankenau Hospital

Wynnewood, Pennsylvania, United States

Site Status

University of Texas - MD Anderson Cancer Center

Houston, Texas, United States

Site Status

LDS Hospital

Salt Lake City, Utah, United States

Site Status

Dixie Regional Medical Center

St. George, Utah, United States

Site Status

CCOP - Marshfield Clinic Research Foundation

Marshfield, Wisconsin, United States

Site Status

Countries

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United States

References

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Viswanathan AN, Moughan J, Small W Jr, Levenback C, Iyer R, Hymes S, Dicker AP, Miller B, Erickson B, Gaffney DK. The quality of cervical cancer brachytherapy implantation and the impact on local recurrence and disease-free survival in radiation therapy oncology group prospective trials 0116 and 0128. Int J Gynecol Cancer. 2012 Jan;22(1):123-31. doi: 10.1097/IGC.0b013e31823ae3c9.

Reference Type BACKGROUND
PMID: 22193645 (View on PubMed)

Weidhaas JB, Li SX, Winter K, Ryu J, Jhingran A, Miller B, Dicker AP, Gaffney D. Changes in gene expression predicting local control in cervical cancer: results from Radiation Therapy Oncology Group 0128. Clin Cancer Res. 2009 Jun 15;15(12):4199-206. doi: 10.1158/1078-0432.CCR-08-2257. Epub 2009 Jun 9.

Reference Type RESULT
PMID: 19509178 (View on PubMed)

Zempolich K, Fuhrman C, Milash B, Flinner R, Greven K, Ryu J, Forbes A, Kerlin K, Nichols RC, Gaffney DK. Changes in gene expression induced by chemoradiation in advanced cervical carcinoma: a microarray study of RTOG C-0128. Gynecol Oncol. 2008 May;109(2):275-9. doi: 10.1016/j.ygyno.2008.01.027. Epub 2008 Mar 4.

Reference Type RESULT
PMID: 18299147 (View on PubMed)

Gaffney DK, Winter K, Dicker AP, Miller B, Eifel PJ, Ryu J, Avizonis V, Fromm M, Greven K. A Phase II study of acute toxicity for Celebrex (celecoxib) and chemoradiation in patients with locally advanced cervical cancer: primary endpoint analysis of RTOG 0128. Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):104-9. doi: 10.1016/j.ijrobp.2006.08.002. Epub 2006 Nov 2.

Reference Type RESULT
PMID: 17084549 (View on PubMed)

Gaffney DK, Winter K, Dicker AP, Miller B, Eifel PJ, Ryu J, Avizonis V, Fromm M, Small W, Greven K. Efficacy and patterns of failure for locally advanced cancer of the cervix treated with celebrex (celecoxib) and chemoradiotherapy in RTOG 0128. Int J Radiat Oncol Biol Phys. 2007 Sep 1;69(1):111-7. doi: 10.1016/j.ijrobp.2007.02.050. Epub 2007 May 4.

Reference Type RESULT
PMID: 17482376 (View on PubMed)

Gaffney DK, Winter K, Fuhrman C, Flinner R, Greven K, Ryu J, Forbes A, Kerlin K, Nichols RC, Zempolich K. Feasibility of RNA collection for micro-array gene expression analysis in the treatment of cervical carcinoma: a scientific correlate of RTOG C-0128. Gynecol Oncol. 2005 May;97(2):607-11. doi: 10.1016/j.ygyno.2005.01.014.

Reference Type RESULT
PMID: 15863167 (View on PubMed)

Other Identifiers

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CDR0000068849

Identifier Type: -

Identifier Source: secondary_id

RTOG-C-0128

Identifier Type: -

Identifier Source: org_study_id