Bevacizumab and Low-Dose Cyclophosphamide in Treating Patients With Recurrent Ovarian Epithelial or Primary Peritoneal Cancer

NCT ID: NCT00072566

Last Updated: 2015-05-12

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2003-12-31
• Study Completion Date: 2008-11-30

Brief Summary

This phase II trial is to see if combining bevacizumab with low-dose cyclophosphamide works in treating patients with ovarian epithelial or primary peritoneal cancer that has come back or spread to other parts of the body. Monoclonal antibodies, such as bevacizumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or deliver cancer-killing substances to them. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop tumor cells from dividing so they stop growing or die. Combining bevacizumab with cyclophosphamide may kill more tumor cells.

Detailed Description

OBJECTIVES: Primary I. Determine the time to progression in patients with recurrent ovarian epithelial or primary peritoneal cancer treated with bevacizumab and low-dose cyclophosphamide.

Secondary I. Determine the response rate in patients treated with this regimen. II. Determine the toxicity of this regimen in these patients. III. Determine molecular correlates for response and outcomes in patients treated with this regimen.

OUTLINE: This is a nonrandomized, multicenter study.

Patients receive bevacizumab IV over 30-90 minutes on days 1, 8, and 15 for the first course and on days 1 and 15 for all subsequent courses. Patients also receive low-dose oral cyclophosphamide on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

PROJECTED ACCRUAL: A total of 23-55 patients will be accrued for this study within 1-2 years.

Conditions

Primary Peritoneal Carcinoma; Recurrent Ovarian Carcinoma; Stage IV Ovarian Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Treatment (bevacizumab, cyclophosphamide)

Patients receive bevacizumab IV over 30-90 minutes on days 1, 8, and 15 for the first course and on days 1 and 15 for all subsequent courses. Patients also receive low-dose oral cyclophosphamide on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.

Group Type: EXPERIMENTAL

Bevacizumab

Intervention Type: BIOLOGICAL

Given IV

Cyclophosphamide

Intervention Type: DRUG

Given PO

Laboratory Biomarker Analysis

Intervention Type: OTHER

Correlative studies

Interventions

Bevacizumab

Given IV

Intervention Type: BIOLOGICAL

Cyclophosphamide

Given PO

Intervention Type: DRUG

Laboratory Biomarker Analysis

Correlative studies

Intervention Type: OTHER

Other Intervention Names

Anti-VEGF Humanized Monoclonal Antibody; Anti-VEGF rhuMAb; Avastin; Anti-VEGF; Bevacizumab Biosimilar BEVZ92; Bevacizumab Biosimilar BI 695502; Immunoglobulin G1 (Human-Mouse Monoclonal rhuMab-VEGF Gamma-Chain Anti-Human Vascular Endothelial Growth Factor), Disulfide With Human-Mouse Monoclonal rhuMab-VEGF Light Chain, Dimer; Recombinant Humanized Anti-VEGF Monoclonal Antibody; rhuMab-VEGF; (-)-Cyclophosphamide; 2H-1,3,2-Oxazaphosphorine, 2-[bis(2-chloroethyl)amino]tetrahydro-, 2-oxide, monohydrate; Carloxan; Ciclofosfamida; Ciclofosfamide; Cicloxal; Clafen; Claphene; CP monohydrate; CTX; CYCLO-cell; Cycloblastin; Cycloblastine; Cyclophospham; Cyclophosphamid monohydrate; Cyclophosphamidum; Cyclophosphan; Cyclophosphane; Cyclophosphanum; Cyclostin; Cyclostine; Cytophosphan; Cytophosphane; Cytoxan; Fosfaseron; Genoxal; Genuxal; Ledoxina; Mitoxan; Neosar; Revimmune; Syklofosfamid; WR- 138719

Eligibility Criteria

Inclusion Criteria

• Histologically confirmed recurrent or metastatic ovarian epithelial or primary peritoneal cancer
• Unidimensionally measurable disease

• Previously irradiated indicator lesions must have progressed after radiotherapy
• Received a platinum-containing regimen for primary disease
• No more than 2 prior chemotherapy regimens for recurrent disease

• Must have received prior platinum-based chemotherapy for recurrent disease if it has been > 12 months since treatment for primary disease (except if hypersensitivity to platinum has developed)
• Rechallenge with the same platinum-based regimen is considered 1 prior regimen
• No history or clinical evidence of CNS disease, including primary brain tumor
• No brain metastases
• Performance status - SWOG 0-2
• At least 3 months
• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• No bleeding diathesis
• No coagulopathy
• Bilirubin no greater than 1.5 times normal
• ALT or AST no greater than 3 times upper limit of normal
• INR less than 1.5 (for patients receiving warfarin)
• Creatinine no greater than 1.5 times normal
• No proteinuria (less than 1+)
• Proteinuria less than 500 mg/24-hour urine collection
• No prior deep vein thrombosis
• No prior stroke
• No clinically significant cardiovascular disease
• None of the following within the past year:

• Uncontrolled hypertension
• New York Heart Association class II-IV congestive heart failure
• Serious cardiac arrhythmia requiring medication
• Grade II or greater peripheral vascular disease
• None of the following within the past 6 months:

• Unstable angina
• Myocardial infarction
• Transient ischemic attack
• Cerebrovascular accident
• Other arterial thromboembolic event
• No clinically significant peripheral artery disease
• No active infection requiring parenteral antibiotics
• No known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
• Not pregnant or nursing
• Fertile patients must use effective contraception
• No serious, non-healing wound, ulcer, or bone fracture
• No significant traumatic injury within the past 28 days
• No seizures not controlled with standard medical therapy
• No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix

• All prior invasive malignancies must be in complete remission
• No other concurrent medical, psychological, or social condition that would preclude study participation
• No prior antiangiogenesis agents
• See Disease Characteristics
• Recovered from prior chemotherapy
• See Disease Characteristics
• Recovered from prior radiotherapy
• More than 28 days since prior major surgical procedure or open biopsy and recovered
• At least 3 weeks since prior therapy directed at the malignancy
• No recent or concurrent full-dose anticoagulants or thrombolytic agents

• Anticoagulants to maintain patency of preexisting, permanent indwelling IV catheters allowed
• No concurrent chronic daily aspirin (greater than 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function

• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Agustin Garcia

Role: PRINCIPAL_INVESTIGATOR

City of Hope Comprehensive Cancer Center

Locations

City of Hope Comprehensive Cancer Center

Duarte, California, United States

Countries

United States

Other Identifiers

NCI-2012-02562

Identifier Type: REGISTRY

Identifier Source: secondary_id

NCI-5789

Identifier Type: -

Identifier Source: secondary_id

CHNMC-PHII-45

Identifier Type: -

Identifier Source: secondary_id

CDR0000340522

Identifier Type: -

Identifier Source: secondary_id

CCC-PHII-45

Identifier Type: -

Identifier Source: secondary_id

PHII-45

Identifier Type: OTHER

Identifier Source: secondary_id

5789

Identifier Type: OTHER

Identifier Source: secondary_id

N01CM17101

Identifier Type: NIH

Identifier Source: secondary_id

View Link

P30CA033572

Identifier Type: NIH

Identifier Source: secondary_id

View Link

NCI-2012-02562

Identifier Type: -

Identifier Source: org_study_id