Correlation of the Chemoresponse Assay With PFS in Patients With Recurrent Epithelial Ovarian, Peritoneal, or Fallopian Tube Cancer

NCT ID: NCT00288275

Last Updated: 2012-10-05

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

TERMINATED

Total Enrollment

256 participants

Study Classification

OBSERVATIONAL

Study Start Date

2004-07-31

Study Completion Date

2012-10-31

Brief Summary

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Chemoresponse assays (lab test) measure the effect that chemotherapy treatment has on a patient's cancer cells in the lab. This test has shown success in a retrospective study in predicting how an individual patient's tumor will respond to a given chemotherapy and how treatment utilizing an agent that the test said that a patient's cells would be sensitive too corresponds to a longer progression free interval. This study will determine the ability of two tests used to predict the success of chemotherapy in recurrent, persistent, or refractory cancer of the ovaries, fallopian tube(s) or peritoneum by measuring how long patients live without progression.

Detailed Description

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The traditional treatment course for new cases of ovarian, fallopian tube, or peritoneal cancer is cytoreductive surgery followed by chemotherapy with paclitaxel in combination with carboplatin. Unfortunately, despite high initial response rates, the majority of patients recur and subsequent therapy is much less likely to be effective. The use of ineffective chemotherapy can result in unnecessary toxicity and costs, delay of more effective treatment, and the potential for the development of cross-resistance to additional drugs. The ability to individualize therapy by providing the treating physician with ex vivo response information on a panel of drugs should aid in the selection of effective therapy for individual patients, thus resulting in improved outcomes.

Resistance to chemotherapy cannot be predicted by either clinical or histological examination. Historically, the ex vivo sensitivity and resistance of tumor cells has been evaluated as a tool for predicting the clinical response of the patient to therapy. In this study, chemotherapy drugs will be tested using both the Precision Therapeutics' ChemoFx Assay and the Yale Apoptosis Assay. The assay results will be compared to clinical outcomes that will be reported at regular intervals. Blood, tumor pathology slides, and excess tumor cells (if available) will be used to characterize common polymorphisms in drug metabolizing enzymes as well as other molecular markers potentially associated with tumor response.

This is a one-arm validation trial with a goal of approximately 256 evaluable patients recruited from multiple sites. Patients will be drawn from the Yale -New Haven Medical Center and multiple additional sites as needed to meet accrual goals. The patients will be treated with FDA approved drugs and/or drug combinations based on the medical judgment of the treating physician. The study is not randomized and the results of the assay will not be used in the decision process for which agent to select for treatment, but are made available to the treating physician upon further progression.

Conditions

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Ovarian Cancer Fallopian Tube Cancer Peritoneal Neoplasms

Keywords

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Ovarian Cancer Fallopian Tube Cancer Peritoneal Cancer Assay Chemotherapy Recurrent Refractory Persistent Chemoresponse Sensitivity Precision Therapeutics

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Patient has been diagnosed with persistent, refractory, or recurrent epithelial ovarian, peritoneal, or fallopian tube carcinoma.
* Patient must have documented disease defined by physical exam, clinically significant increases in CA-125 (as defined by protocol), CT, MRI scan, PET, x-ray or ultrasound for whom cytoreduction, excisional biopsy, incisional biopsy, or paracentesis is medically indicated, or in the alternative, have agreed to a core biopsy of the primary site, a secondary metastatic site, or a paracentesis or thoracentesis for fluid collection.
* Patient has disease of one of the following histologic epithelial cell types: serous adenocarcinoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, transitional cell carcinoma, clear cell carcinoma, or adenocarcinoma, not otherwise specified (N.O.S.). Cytologic confirmation of diagnosis is acceptable for patients treated with neoadjuvant therapy who have not had a surgical procedure for a histologic confirmation.
* Patient has only received one or two prior chemotherapy regimens for their ovarian, peritoneal, or fallopian tube carcinoma. Multiple previous regimens of Taxol/Carboplatin will be counted as 1 prior chemotherapy regimen (e.g., A patient who receives first line Taxol/Carboplatin, then recurs, then receives Taxol/Carboplatin will be considered to have had only 1 prior regimen.)
* Patient must have completed prior chemotherapy regimens at least 3 weeks prior to tissue extraction.
* Patient must have an estimated life expectancy of greater than six months, as determined by the investigator.
* Patient requires chemotherapy and the investigator plans to administer one of the regimens of interest as deemed by her physician.
* Patient must be a female and at least 18 years of age. Ovarian cancer is a disease that occurs only in women and is exceedingly rare in females under the age of 18.
* Patient must have an ECOG Performance Status of 0, 1, or 2.
* Tumor tissue or ascitic fluid must be available for the assays. Ascites or Pleural alone may be collected and submitted as the sample tissue, but the patient must also have measurable disease as demonstrated by a CA-125 level 2X ULN or measurable lesions on imaging to be eligible.
* Patient must have signed an approved consent form.

Exclusion Criteria

* Patient has ovarian stromal, mixed mullerian, or germ cell tumors
* Patient has borderline carcinoma (uncertain malignant potential)
* Pregnant or lactating patients
* Patients of childbearing potential not employing adequate contraception.
* Patients who are at risk of failure of compliance to the visit schedules and procedures.
* The investigator plans to use an assay to select the chemotherapy drug regimen. The investigator may submit the patient's tissue for testing with other assays, but may not use the results of those assays to select the chemotherapy regimen for the patient for this trial.
* Patients with synchronous primary endometrial cancer or a past history of primary endometrial cancer are excluded unless all of the following conditions are met: Stage not greater than I-B, Less than 3mm invasion without vascular or lymphatic invasion, NO poorly differentiated subtype, including papillary serous, clear cell, or othe FIGO Grade 3 lesion.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Precision Therapeutics

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas J Rutherford, MD

Role: PRINCIPAL_INVESTIGATOR

Yale University

Hong Ma, MD

Role: STUDY_DIRECTOR

Precision Therapeutics, Inc.

Locations

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University of California

Irvine, California, United States

Site Status

Kaiser Permanente

Los Angeles, California, United States

Site Status

Yale University Medical Center

New Haven, Connecticut, United States

Site Status

Florida Gynecologic Oncology

Fort Myers, Florida, United States

Site Status

St. Vincents Medical Center

Jacksonville, Florida, United States

Site Status

The Florida Hospital

Orlando, Florida, United States

Site Status

Women's Cancer Associates

St. Petersburg, Florida, United States

Site Status

Atlanta Medical Center

Atlanta, Georgia, United States

Site Status

Southeastern Gynecologic Oncology Riverdale

Riverdale, Georgia, United States

Site Status

Northwestern University/Prentice Women's Hospital

Chicago, Illinois, United States

Site Status

Rush University

Chicago, Illinois, United States

Site Status

St. Vincent Indianapolis Hospital

Indianapolis, Indiana, United States

Site Status

St. Elizabeth Medical Center

Edgewood, Kentucky, United States

Site Status

University of Minnesota

Minneapolis, Minnesota, United States

Site Status

Washington University

St Louis, Missouri, United States

Site Status

Saint Louis University

St Louis, Missouri, United States

Site Status

The Cooper Health System

Camden, New Jersey, United States

Site Status

Saint Barnabas Medical Center

West Orange, New Jersey, United States

Site Status

Schwartz Gynecologic Oncology, PLLC

Brightwaters, New York, United States

Site Status

University of Cincinnati Medical Center Barrett Cancer Center

Cincinnati, Ohio, United States

Site Status

University Hospital Case Medical Center

Cleveland, Ohio, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

University of Toledo Medical Center

Toledo, Ohio, United States

Site Status

University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, United States

Site Status

Legacy Health System

Portland, Oregon, United States

Site Status

Abington Memorial Hospital

Abington, Pennsylvania, United States

Site Status

UPMC Cancer Center at Magee Womens Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Lankenau Hospital, Mainline Health System

Wynnwood, Pennsylvania, United States

Site Status

Women & Infants Hospital

Providence, Rhode Island, United States

Site Status

Cancer Centers of the Carolinas

Greenville, South Carolina, United States

Site Status

ACORN - The West Clinic

Memphis, Tennessee, United States

Site Status

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

The Methodist Hospital

Houston, Texas, United States

Site Status

University of Virginia Health System

Charlottesville, Virginia, United States

Site Status

University of Wisconsin, Madison

Madison, Wisconsin, United States

Site Status

Countries

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United States

References

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Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, Feuer EJ, Thun MJ; American Cancer Society. Cancer statistics, 2004. CA Cancer J Clin. 2004 Jan-Feb;54(1):8-29. doi: 10.3322/canjclin.54.1.8.

Reference Type BACKGROUND
PMID: 14974761 (View on PubMed)

Ness RB, Wisniewski SR, Eng H, Christopherson W. Cell viability assay for drug testing in ovarian cancer: in vitro kill versus clinical response. Anticancer Res. 2002 Mar-Apr;22(2B):1145-9.

Reference Type BACKGROUND
PMID: 12168915 (View on PubMed)

O'Meara AT, Sevin BU. Predictive value of the ATP chemosensitivity assay in epithelial ovarian cancer. Gynecol Oncol. 2001 Nov;83(2):334-42. doi: 10.1006/gyno.2001.6395.

Reference Type BACKGROUND
PMID: 11606094 (View on PubMed)

McLeod HL, King CR, Marsh S. Application of pharmacogenomics in the individualization of chemotherapy for gastrointestinal malignancies. Clin Colorectal Cancer. 2004 Jun;4 Suppl 1:S43-7. doi: 10.3816/ccc.2004.s.007.

Reference Type BACKGROUND
PMID: 15212705 (View on PubMed)

Kaplan EL, Meier P. Nonparametric estimation of incomplete observations. JASA 1958;43:457-481.

Reference Type BACKGROUND

Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition). Vol 22, No 14S (July 15 Supplement), 2004: 5074.

Reference Type BACKGROUND

Other Identifiers

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PT-301

Identifier Type: -

Identifier Source: org_study_id

NCT00301717

Identifier Type: -

Identifier Source: nct_alias