Ovarian Clear Cell CystadenocarcinomaPhase 2NCT01196429
Temsirolimus, Carboplatin, and Paclitaxel as First-Line Therapy in Treating Patients With Newly Diagnosed Stage III-IV Clear Cell Ovarian Cancer
A Phase 2 study testing Carboplatin, Docetaxel and Laboratory Biomarker Analysis in people with Ovarian Clear Cell Cystadenocarcinoma and Stage III Ovarian Cancer, run by National Cancer Institute (NCI) at 145 sites in 3 countries.
Trial summary
This phase II trial studies how well temsirolimus, carboplatin, and paclitaxel as first-line therapy works in treating patients with newly diagnosed stage III-IV clear cell ovarian cancer. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Ovarian Clear Cell Cystadenocarcinoma, Stage III Ovarian Cancer, Stage IV Ovarian Cancer
- What is being tested?
- Carboplatin, Docetaxel and Laboratory Biomarker Analysis
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 145 sitesin 3 countries
- Study dates
- Aug 2010to Jan 2015
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients must have stage III or IV clear cell ovarian cancer; primary tumors must be at least 50% clear cell histomorphology in order to be eligible; in addition, the tumors should be negative for expression of Wilms tumor 1 (WT-1) antigen and estrogen receptor (ER) antigen by immunohistochemistry; appropriate tissue sections to confirm stage and histologic classification of cell type must be sent to Gynecologic Oncology Group (GOG) for central pathology review; immunohistochemical stained slides for ER and WT-1 antigen must be also be submitted to GOG for pathology review
- Patients who have met the pre-entry requirements
- Patients must have signed an approved informed consent and authorization permitting release of personal health information
- Patients with a GOG performance status of 0, 1, or 2
- Patients must be entered between 2 and 12 weeks after initial surgery; performed for the combined purpose of diagnosis, staging and cytoreduction
- Patients should be free of active infection requiring antibiotics (with the exception of uncomplicated urinary tract infection [UTI])
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- Absolute neutrophil count >= 1,500/mcl
- Platelets >= 100,000/mcl
- Total bilirubin within normal institutional limits
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) =< 2.5 times institutional upper limit of normal (< 5 times upper limit of normal [ULN] for subjects with liver metastases)
- Alkaline phosphatase =< 2.5 times institutional upper limit of normal (< 5 times ULN for subjects with liver metastases)
- Creatinine =< 1.5 x institutional upper limit of normal, grade 1 per CTCAE v. 4.0
- Cholesterol =< 350 mg/dL (fasting)
- Triglycerides =< 400 mg/dL (fasting)
- Albumin >= 3.0 g/dL
- Prothrombin time (PT) such that international normalized ratio (INR) is =< 1.5 (or an in-range INR, usually between 2 and 3, if a patient is on a stable dose of therapeutic warfarin for management of venous thrombosis including pulmonary thrombo-embolus)
- Partial thromboplastin time (PTT) < 1.2 times the upper limit of normal
- Neurologic function (sensory and motor) =< CTCAE grade 1
Who cannot join
- Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer, are excluded if there is any evidence of other malignancy being present within the last five years; patients are also excluded if their previous cancer treatment contraindicates this protocol therapy
- Patients who have received prior radiotherapy to any portion of the abdominal cavity or pelvis are excluded; prior radiation for localized cancer of the breast, head and neck, or skin is permitted, provided that it was completed more than five years prior to registration, and the patient remains free of recurrent or metastatic disease
- Patients who have received prior chemotherapy for any abdominal or pelvic tumor including neo-adjuvant chemotherapy for their clear cell ovarian cancer
- Patients with primary peritoneal and fallopian tube carcinoma are not eligible
- Previous treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus), paclitaxel, or carboplatin
- Patients cannot be receiving enzyme-inducing antiepileptic drugs (enzyme-inducing antiepileptic drugs [EIAEDs]; e.g., phenytoin, carbamazepine, phenobarbital) nor any other cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inducer such as rifampin or St. John's Wort; use of agents that potently inhibit CYP3A4 (and hence may raise temsirolimus levels), such as ketoconazole, is discouraged, but not specifically prohibited; the appropriateness of use of such agents is left to physician discretion; strong CYP3A4 inhibitors are prohibited
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- Patients receiving any investigational agents
- Patients with severely impaired lung function defined as a diffusion lung capacity for carbon monoxide (DLCO) =< 50% of the normal predicted value and/or oxygen (O2) saturation =< 88% at rest on room air
- Patients with symptomatic congestive heart failure of New York Heart Association class III or IV, unstable angina pectoris, symptomatic congestive heart failure, myocardial infarction =< 6 months of start of study drug, serious uncontrolled cardiac arrhythmia or any other clinically significant disease
- Patients with active bleeding or pathologic conditions that carry high risk of bleeding, such as known bleeding disorder, coagulopathy, or tumor involving major vessels
- Patients on maintenance corticosteroids are ineligible with the exception of short term use (fewer than 5 days)
- Patients with baseline requirement for oxygen
- Patients with serious concomitant illness which, in the opinion of the treating physician, will place patient at unreasonable risk from therapy on this protocol
- Patients who are pregnant or nursing; patients of childbearing potential must agree to use contraceptive measures during study therapy and for at least six months after completion of study therapies
- Patients with poorly controlled diabetes
Trial locations and contacts
145 sites in 3 countries.
145 sites in 3 countries
United States121 sites
Abington Memorial Hospital
Abington, Pennsylvania, 19001
Summa Akron City Hospital/Cooper Cancer Center
Akron, Ohio, 44304
Saint Joseph Mercy Hospital
Ann Arbor, Michigan, 48106-0995
Michigan Cancer Research Consortium CCOP
Ann Arbor, Michigan, 48106
University of Colorado Cancer Center - Anschutz Cancer Pavilion
Aurora, Colorado, 80045
PeaceHealth Medical Group PC
Bellingham, Washington, 98226
Saint Alphonsus Cancer Care Center-Boise
Boise, Idaho, 83706
Massachusetts General Hospital Cancer Center
Boston, Massachusetts, 02114
Harrison HealthPartners Hematology and Oncology-Bremerton
Bremerton, Washington, 98310
Harrison Medical Center
Bremerton, Washington, 98310
Providence Saint Joseph Medical Center/Disney Family Cancer Center
Burbank, California, 91505
Lahey Hospital and Medical Center
Burlington, Massachusetts, 01805
Cooper Hospital University Medical Center
Camden, New Jersey, 08103
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599
Carolinas Medical Center/Levine Cancer Institute
Charlotte, North Carolina, 28203
Northwestern University
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
University of Cincinnati
Cincinnati, Ohio, 45267
Case Western Reserve University
Cleveland, Ohio, 44106
MetroHealth Medical Center
Cleveland, Ohio, 44109
Cleveland Clinic Cancer Center/Fairview Hospital
Cleveland, Ohio, 44111
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, 43210
Geisinger Medical Center
Danville, Pennsylvania, 17822
Oakwood Hospital and Medical Center
Dearborn, Michigan, 48124
Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Iowa Oncology Research Association CCOP
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates-Des Moines
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates-Laurel
Des Moines, Iowa, 50314
Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Iowa Lutheran Hospital
Des Moines, Iowa, 50316
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
Saint John Hospital and Medical Center
Detroit, Michigan, 48236
Duke University Medical Center
Durham, North Carolina, 27710
Elkhart Clinic
Elkhart, Indiana, 46514-2098
Michiana Hematology Oncology PC-Elkhart
Elkhart, Indiana, 46514
Elkhart General Hospital
Elkhart, Indiana, 46515
Providence Regional Cancer Partnership
Everett, Washington, 98201
Hurley Medical Center
Flint, Michigan, 48502
Genesys Regional Medical Center
Grand Blanc, Michigan, 48439
Gynecologic Oncology of West Michigan PLLC
Grand Rapids, Michigan, 49546
Hartford Hospital
Hartford, Connecticut, 06102
Saint Francis Hospital and Medical Center
Hartford, Connecticut, 06105
Geisinger Medical Center-Cancer Center Hazleton
Hazleton, Pennsylvania, 18201
Sudarshan K Sharma MD Limted-Gynecologic Oncology
Hinsdale, Illinois, 60521
M D Anderson Cancer Center CCOP Research Base
Houston, Texas, 77030
M D Anderson Cancer Center
Houston, Texas, 77030
Indiana University/Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, 46202
Saint Vincent Oncology Center
Indianapolis, Indiana, 46260
Allegiance Health
Jackson, Michigan, 49201
University of Mississippi Medical Center
Jackson, Mississippi, 39216
Mercy Hospital-Joplin
Joplin, Missouri, 64804
Borgess Medical Center
Kalamazoo, Michigan, 49001
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
University of Kansas Cancer Center
Kansas City, Kansas, 66160
Kettering Medical Center
Kettering, Ohio, 45429
Community Howard Regional Health
Kokomo, Indiana, 46904
IU Health La Porte Hospital
La Porte, Indiana, 46350
Sparrow Hospital
Lansing, Michigan, 48912
Women's Cancer Center of Nevada
Las Vegas, Nevada, 89169
Saint Mary Mercy Hospital
Livonia, Michigan, 48154
Los Angeles County-USC Medical Center
Los Angeles, California, 90033
USC / Norris Comprehensive Cancer Center
Los Angeles, California, 90033
University of Wisconsin Hospital and Clinics
Madison, Wisconsin, 53792
Hillcrest Hospital Cancer Center
Mayfield Heights, Ohio, 44124
Lake University Ireland Cancer Center
Mentor, Ohio, 44060
Froedtert and the Medical College of Wisconsin
Milwaukee, Wisconsin, 53226
Winthrop University Hospital
Mineola, New York, 11501
Michiana Hematology Oncology PC-Mishawaka
Mishawaka, Indiana, 46545
Saint Joseph Regional Medical Center-Mishawaka
Mishawaka, Indiana, 46545
Good Samaritan Regional Health Center
Mount Vernon, Illinois, 62864
Skagit Valley Hospital Regional Cancer Care Center
Mount Vernon, Washington, 98273
Palo Alto Medical Foundation-Gynecologic Oncology
Mountain View, California, 94040
The Hospital of Central Connecticut
New Britain, Connecticut, 06050
Michiana Hematology Oncology PC-Niles
Niles, Michigan, 49120
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Walter Reed Army Medical Center-Olney
Olney, Maryland, 20832
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
Florida Hospital Orlando
Orlando, Florida, 32803
Saint Joseph's Hospital and Medical Center
Phoenix, Arizona, 85013
Michiana Hematology Oncology PC-Plymouth
Plymouth, Indiana, 46563
Saint Joseph Mercy Oakland
Pontiac, Michigan, 48341
Saint Joseph Mercy Port Huron
Port Huron, Michigan, 48060
Harrison HealthPartners Hematology and Oncology-Poulsbo
Poulsbo, Washington, 98370
Women and Infants Hospital
Providence, Rhode Island, 02905
Saint Mary's of Michigan
Saginaw, Michigan, 48601
Lakeland Hospital
Saint Joseph, Michigan, 49085
Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
Memorial University Medical Center
Savannah, Georgia, 31404
Pacific Gynecology Specialists
Seattle, Washington, 98104
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98109
Seattle Cancer Care Alliance
Seattle, Washington, 98109
Group Health Cooperative-Seattle
Seattle, Washington, 98112
Swedish Medical Center-First Hill
Seattle, Washington, 98122-4307
Northwest Hospital
Seattle, Washington, 98133
University of Washington Medical Center
Seattle, Washington, 98195
Olympic Medical Cancer Care Center
Sequim, Washington, 98384
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Michiana Hematology Oncology PC-South Bend
South Bend, Indiana, 46601
South Bend Clinic
South Bend, Indiana, 46617
Northern Indiana Cancer Research Consortium CCOP
South Bend, Indiana, 46628
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Rockwood Cancer Treatment Center-DHEC-Downtown
Spokane, Washington, 99204
Baystate Medical Center
Springfield, Massachusetts, 01199
Cancer Research for the Ozarks NCORP
Springfield, Missouri, 65804
Mercy Hospital Springfield
Springfield, Missouri, 65804
CoxHealth South Hospital
Springfield, Missouri, 65807
Geisinger Medical Group
State College, Pennsylvania, 16801
Stony Brook University Medical Center
Stony Brook, New York, 11794
MultiCare Tacoma General Hospital
Tacoma, Washington, 98405
Saint Joseph Medical Center
Tacoma, Washington, 98405
Tulsa Cancer Institute
Tulsa, Oklahoma, 74146
Providence Saint Mary Regional Cancer Center
Walla Walla, Washington, 99362
Saint John Macomb-Oakland Hospital
Warren, Michigan, 48093
Cadence Cancer Center in Warrenville
Warrenville, Illinois, 60555
Wenatchee Valley Hospital and Clinics
Wenatchee, Washington, 98801
Michiana Hematology Oncology PC-Westville
Westville, Indiana, 46391
Geisinger Wyoming Valley/Henry Cancer Center
Wilkes-Barre, Pennsylvania, 18711
Wake Forest University Health Sciences
Winston-Salem, North Carolina, 27157
Japan17 sites
Hyogo Cancer Center
Akashi, Hyōgo, 673-8558
Kagoshima City Hospital
Kagoshima, Kagoshima-ken, 890-8760
Kure National Hospital
Kure, Hiroshima, 737
Shikoku Cancer Center
Matsuyama, 791-0280
National Kyushu Cancer Center
Minamiku, 811 1395
Jikei University School of Medicine
Minato-ku, Tokyo, 105-8461
Iwate Medical University School of Medicine
Morioka, Iwate, 020-8505
University of the Ryukyus Hospital-Col Health Scnc
Nakagami-gun, Okinawa, 903-0215
Niigata University Medical and Dental Hospital
Niigata, Niigata, 951-8520
Kinki University
Osaka, Osaka, 589 8511
Saitama Medical University International Medical Center
Saitama, 350-1298
Hokkaido University Hospital
Sapporo, Hokkaido, 060-8648
Tohoku University School of Medicine
Sendai, Aoba-ku, 980-8574
Keio University
Shinjuku-ku, Tokyo, 160-8582
Shizuoka Cancer Center
Shizuoka, Suntou, 411-8777
National Cancer Center Hospital
Tokyo, 104 0045
Tottori University
Tottori, 680-8550
South Korea7 sites
National Cancer Center-Korea
Goyang-si, Gyeonggi-do, 410-769
Keimyung University-Dongsan Medical Center
Jung-Ku, Daegu, 700-712
Samsung Medical Center
Seoul, Korea, 135-710
Seoul National University Hospital
Seoul, 110-744
Gangnam Severance Hospital
Seoul, 135-720
Asan Medical Center
Seoul, 138-736
Korea Cancer Center Hospital
Seoul, 139-706
About this study
Official title: A Phase II Evaluation of Temsirolimus (CCI-779) (NCI Supplied Agent: NSC# 683864,) in Combination With Carboplatin and Paclitaxel Followed by Temsirolimus Consolidation as First-Line Therapy in the Treatment of Clear Cell Carcinoma of the Ovary
This phase II trial studies how well temsirolimus, carboplatin, and paclitaxel as first-line therapy works in treating patients with newly diagnosed stage III-IV clear cell ovarian cancer. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving temsirolimus with combination chemotherapy may be an effective treatment for ovarian cancer.
Read the detailed description
PRIMARY OBJECTIVES:
- To assess the activity of the study regimen as measured by the proportion of patients who are alive and progression-free for at least 12 months after study entry in patients with newly diagnosed stage III or IV clear cell ovarian cancer in the following populations: patients in the United States (U.S.) and worldwide (outside of Japan) and patients in Japan.
II. To compare progression-free survival in newly diagnosed stage III or IV clear cell ovarian cancer patients in patients in the U.S. and worldwide (outside of Japan) versus patients in Japan.
SECONDARY OBJECTIVES:
- To characterize the duration of overall survival and progression-free survival in each population.
II. To examine the frequency and severity of adverse events as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4 in each population.
III. To estimate the rate of objective tumor response in patients with measurable disease.
TERTIARY OBJECTIVES:
- To explore whether immunohistochemical (IHC) expression of components of the mammalian target of rapamycin (mTOR) signaling pathway (phosphatase and tensin homolog [PTEN], total and phosphorylated protein kinase B [Akt], as well as, ATP-binding cassette, sub-family C [CFTR/MRP], member 3 [ABCC3] [MRP3], ATPase, H+ transporting, lysosomal accessory protein 1 [AB CF2], cyclin E, and vascular endothelial growth factor [VEGF]) are associated with outcome, nationality or clinical characteristics.
II. To explore whether there is any differences in differential gene expression profiles between U.S. and worldwide (outside of Japan) versus Japanese patients.
OUTLINE:
Patients receive paclitaxel* intravenously (IV) over 3 hours and carboplatin IV over 30 minutes on day 1 and temsirolimus IV on days 1 and 8. Treatment repeats every 3 weeks for 6 courses. Patients then receive consolidation therapy comprising temsirolimus IV on days 1, 8, and 15. Treatment repeats every 3 weeks for 11 courses in the absence of disease progression or unacceptable toxicity.
NOTE: * For circumstances in which docetaxel should be substituted for paclitaxel, docetaxel is given IV over 1 hour.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
- Being tested
- Carboplatin, Docetaxel, Laboratory Biomarker Analysis, Paclitaxel, Temsirolimus
- Medical subject headings
- Ovarian Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CarboplatinDrug
Also called Blastocarb, Carboplat, Carboplatin Hexal, Carboplatino
Given IV
DocetaxelDrug
Also called RP56976, Taxotere, Taxotere Injection Concentrate
Given IV
Laboratory Biomarker AnalysisOther
Correlative studies
PaclitaxelDrug
Also called Anzatax, Asotax, Bristaxol, Praxel
Given IV
TemsirolimusDrug
Also called CCI-779, CCI-779 Rapamycin Analog, Cell Cycle Inhibitor 779, Rapamycin Analog
Given IV
| Study group | Role | What they receive |
|---|---|---|
| Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) | Experimental | Patients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1 and temsirolimus IV on days 1 and 8. Treatment repeats every 3 weeks for 6 courses. Patients then receive consolidation therapy comprising temsirolimus IV on days 1, 8, and 15. Treatment repeats every 3 weeks for 11 courses in the absence of disease progression or unacceptable toxicity.
NOTE: * For circumstances in which docetaxel should be substituted for paclitaxel, docetaxel is given IV over 1 hour. Receives: Drug: Carboplatin; Drug: Docetaxel; Other: Laboratory Biomarker Analysis; Drug: Paclitaxel; Drug: Temsirolimus |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of Patients Who Are Alive and Progression-free for at Least 12 Months After Study Entry in Patients With Newly Diagnosed Stage III or IV Clear Cell Ovarian Cancer in the Following Populations: Patients in the U.S./Worldwide and Japan
Progression of target lesions (TL) was a >=20% increase in the sum of the diameters of TL, taking as reference the smallest sum on study (including the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must demonstrate an absolute increase >=5 mm. Progression of non-target lesions (NTL) as defined as appearance of >=1 new lesions or unequivocal progression of existing NTL. Unequivocal progression should not normally trump target lesion status; it must be representative of overall disease status change, not a single lesion increase. Clear progression of only NTL is exceptional, but the opinion of the treating physician should prevail in such circumstances, and the progression status should be later confirmed by a review panel (or Principal Investigator). Progression of TL, unequivocal progression of NTL, or new lesions constitutes progression. This description is abbreviated; see the RECIST 1.1 manuscript for further details.
Measured: Tumor scans were done every other cycle for the first 6 months; then every 3 months x2; then every 6 months thereafter; and at any other time if clinically indicated or signs suggestive of progressive disease or rising levels; for up to 5 years.
Compare Progression-free Survival in Newly Diagnosed Stage III or IV Clear Cell Ovarian Cancer Patients in Patients in the U.S. and Worldwide (Outside of Japan) Versus Patients in Japan.
Progression-free survival (PFS) was defined s the period from study entry until disease progression, death, or the last date of contact. Progression was based on Response Evaluation Criteria In Solid Tumors (RECIST) 1.1. Outcome measure data not reported because protocol stated "If the combination is declared active (i.e. HO is rejected) in one or both of the populations, the two populations will be compared with respect to PFS using a logrank test stratified by optimal/suboptimal disease status." The combination was not declared active in either population.
Measured: Tumor scans were done every other cycle for the first 6 months;then every 3 mnths x2;then every 6 mnths thereafter; and at any other time if clinically indicated based on symptoms or physical signs suggesting progressive dx or rising serum tumor marker le
Frequency and Severity of Toxicity
Grade 3 or higher adverse events were graded by CTC AE v4
Measured: Each cycle while on treatment
Secondary outcomes (3)
Progression-free Survival
Progression-free survival (PFS) was defined as the period from study entry until disease progression, death, or the last date of contact. Progression was based on RECIST 1.1
Measured: Tumor scans were done every other cycle for the first 6 months; then every 3 months x 2; then every 6 mths thereafter; and at any other time if clinically indicated based on symptoms or physical signs suggestive of progressive disease or rising tumor mark
Overall Survival
Overall survival is defined as the duration of time from study entry to time of death or the date of last contact.
Measured: Every cycle during treatment, then every 3 months for the first 2 years, then every six months for the next three years and then annually for the next 5 years.
Objective Tumor Response
Complete and Partial Tumor Response by RECIST 1.1. RECIST1.1 is a multi-page paper, and response is defined in the protocol across multiple pages, so it is not practical to define response here.
Measured: Every other cycle for first 6 months; then every 3 months for two years; then every six months for the next three years; and at any other time if clinically indicated based on symptoms or physical signs suggestive of progressive disease or rising serum tu
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Sep 2010 (estimated)
- Study startAug 2010
- Primary completionJan 2015
- Study completionJan 2015
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Ovarian Clear Cell CystadenocarcinomaStudies of the same condition, open and under way.
- More trials run by National Cancer Institute (NCI)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 90 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Cancer Institute (NCI)
- Sponsor type
- US National Institutes of Health
- Collaborators
- NRG Oncology
- Responsible party
- Sponsor
- Investigators
- John Farley, Principal investigator, NRG Oncology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01196429
- Sponsor's protocol ID
- NCI-2011-02653
- Other IDs
- NCI-2011-02653, CDR0000684262, GOG-0268, GOG-0268, GOG-0268, U10CA180868, U10CA027469
- Status last verified
- Aug 2019
- First submitted
- 4 Sep 2010
- Last updated
- 8 Aug 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 8 Aug 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II Evaluation of Temsirolimus (CCI-779) (NCI Supplied Agent: NSC# 683864,) in Combination With Carboplatin and Paclitaxel Followed by Temsirolimus Consolidation as First-Line Therapy in the Treatment of Clear Cell Carcinoma of the Ovary
- ClinicalTrials.gov ID
- NCT01196429
- Acronym / sponsor ID
- NCI-2011-02653
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 90 participants (actual)
- Lead sponsor
- National Cancer Institute (NCI)US National Institutes of Health
- Collaborators
- NRG Oncology
- Study start
- Aug 2010
- Primary completion
- Jan 2015 (actual)
- Study completion
- Jan 2015 (actual)
- First posted
- 8 Sep 2010 (estimated)
- Results
- Posted 3 May 2017
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This phase II trial studies how well temsirolimus, carboplatin, and paclitaxel as first-line therapy works in treating patients with newly diagnosed stage III-IV clear cell ovarian cancer. Temsirolimus may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving temsirolimus with combination chemotherapy may be an effective treatment for ovarian cancer.
Detailed description
PRIMARY OBJECTIVES:
- To assess the activity of the study regimen as measured by the proportion of patients who are alive and progression-free for at least 12 months after study entry in patients with newly diagnosed stage III or IV clear cell ovarian cancer in the following populations: patients in the United States (U.S.) and worldwide (outside of Japan) and patients in Japan.
II. To compare progression-free survival in newly diagnosed stage III or IV clear cell ovarian cancer patients in patients in the U.S. and worldwide (outside of Japan) versus patients in Japan.
SECONDARY OBJECTIVES:
- To characterize the duration of overall survival and progression-free survival in each population.
II. To examine the frequency and severity of adverse events as assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4 in each population.
III. To estimate the rate of objective tumor response in patients with measurable disease.
TERTIARY OBJECTIVES:
- To explore whether immunohistochemical (IHC) expression of components of the mammalian target of rapamycin (mTOR) signaling pathway (phosphatase and tensin homolog [PTEN], total and phosphorylated protein kinase B [Akt], as well as, ATP-binding cassette, sub-family C [CFTR/MRP], member 3 [ABCC3] [MRP3], ATPase, H+ transporting, lysosomal accessory protein 1 [AB CF2], cyclin E, and vascular endothelial growth factor [VEGF]) are associated with outcome, nationality or clinical characteristics.
II. To explore whether there is any differences in differential gene expression profiles between U.S. and worldwide (outside of Japan) versus Japanese patients.
OUTLINE:
Patients receive paclitaxel* intravenously (IV) over 3 hours and carboplatin IV over 30 minutes on day 1 and temsirolimus IV on days 1 and 8. Treatment repeats every 3 weeks for 6 courses. Patients then receive consolidation therapy comprising temsirolimus IV on days 1, 8, and 15. Treatment repeats every 3 weeks for 11 courses in the absence of disease progression or unacceptable toxicity.
NOTE: * For circumstances in which docetaxel should be substituted for paclitaxel, docetaxel is given IV over 1 hour.
After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for 3 years.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) | Experimental | Drug: Carboplatin, Drug: Docetaxel, Other: Laboratory Biomarker Analysis, Drug: Paclitaxel, Drug: TemsirolimusPatients receive paclitaxel IV over 3 hours and carboplatin IV over 30 minutes on day 1 and temsirolimus IV on days 1 and 8. Treatment repeats every 3 weeks for 6 courses. Patients then receive consolidation therapy comprising temsirolimus IV on days 1, 8, and 15. Treatment repeats every 3 weeks for 11 courses in the absence of disease progression or unacceptable toxicity. NOTE: * For circumstances in which docetaxel should be substituted for paclitaxel, docetaxel is given IV over 1 hour. |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (18 listed)
- Patients must have stage III or IV clear cell ovarian cancer; primary tumors must be at least 50% clear cell histomorphology in order to be eligible; in addition, the tumors should be negative for expression of Wilms tumor 1 (WT-1) antigen and estrogen receptor (ER) antigen by immunohistochemistry; appropriate tissue sections to confirm stage and histologic classification of cell type must be sent to Gynecologic Oncology Group (GOG) for central pathology review; immunohistochemical stained slides for ER and WT-1 antigen must be also be submitted to GOG for pathology review
- Patients who have met the pre-entry requirements
- Patients must have signed an approved informed consent and authorization permitting release of personal health information
- Patients with a GOG performance status of 0, 1, or 2
- Patients must be entered between 2 and 12 weeks after initial surgery; performed for the combined purpose of diagnosis, staging and cytoreduction
Key exclusion criteria (15 listed)
- Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer, are excluded if there is any evidence of other malignancy being present within the last five years; patients are also excluded if their previous cancer treatment contraindicates this protocol therapy
- Patients who have received prior radiotherapy to any portion of the abdominal cavity or pelvis are excluded; prior radiation for localized cancer of the breast, head and neck, or skin is permitted, provided that it was completed more than five years prior to registration, and the patient remains free of recurrent or metastatic disease
- Patients who have received prior chemotherapy for any abdominal or pelvic tumor including neo-adjuvant chemotherapy for their clear cell ovarian cancer
- Patients with primary peritoneal and fallopian tube carcinoma are not eligible
- Previous treatment with an mTOR inhibitor (sirolimus, temsirolimus, everolimus), paclitaxel, or carboplatin
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CarboplatinAlso: Blastocarb, Carboplat, Carboplatin Hexal, CarboplatinoGiven IV | Drug | Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) |
| DocetaxelAlso: RP56976, Taxotere, Taxotere Injection ConcentrateGiven IV | Drug | Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) |
| Laboratory Biomarker AnalysisCorrelative studies | Other | Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) |
| PaclitaxelAlso: Anzatax, Asotax, Bristaxol, PraxelGiven IV | Drug | Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) |
| TemsirolimusAlso: CCI-779, CCI-779 Rapamycin Analog, Cell Cycle Inhibitor 779, Rapamycin AnalogGiven IV | Drug | Treatment (paclitaxel, carboplatin, temsirolimus, docetaxel) |
Primary outcome
Proportion of Patients Who Are Alive and Progression-free for at Least 12 Months After Study Entry in Patients With Newly Diagnosed Stage III or IV Clear Cell Ovarian Cancer in the Following Populations: Patients in the U.S./Worldwide and Japan
Time frame: Tumor scans were done every other cycle for the first 6 months; then every 3 months x2; then every 6 months thereafter; and at any other time if clinically indicated or signs suggestive of progressive disease or rising levels; for up to 5 years.
Progression of target lesions (TL) was a >=20% increase in the sum of the diameters of TL, taking as reference the smallest sum on study (including the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must demonstrate an absolute increase >=5 mm. Progression of non-target lesions (NTL) as defined as appearance of >=1 new lesions or unequivocal progression of existing NTL. Unequivocal progression should not normally trump target lesion status; it must be representative of overall disease status change, not a single lesion increase. Clear progression of only NTL is exceptional, but the opinion of the treating physician should prevail in such circumstances, and the progression status should be later confirmed by a review panel (or Principal Investigator). Progression of TL, unequivocal progression of NTL, or new lesions constitutes progression. This description is abbreviated; see the RECIST 1.1 manuscript for further details.
Compare Progression-free Survival in Newly Diagnosed Stage III or IV Clear Cell Ovarian Cancer Patients in Patients in the U.S. and Worldwide (Outside of Japan) Versus Patients in Japan.
Time frame: Tumor scans were done every other cycle for the first 6 months;then every 3 mnths x2;then every 6 mnths thereafter; and at any other time if clinically indicated based on symptoms or physical signs suggesting progressive dx or rising serum tumor marker le
Progression-free survival (PFS) was defined s the period from study entry until disease progression, death, or the last date of contact. Progression was based on Response Evaluation Criteria In Solid Tumors (RECIST) 1.1. Outcome measure data not reported because protocol stated "If the combination is declared active (i.e. HO is rejected) in one or both of the populations, the two populations will be compared with respect to PFS using a logrank test stratified by optimal/suboptimal disease status." The combination was not declared active in either population.
Frequency and Severity of Toxicity
Time frame: Each cycle while on treatment
Grade 3 or higher adverse events were graded by CTC AE v4
3 secondary outcomes
Progression-free Survival
Time frame: Tumor scans were done every other cycle for the first 6 months; then every 3 months x 2; then every 6 mths thereafter; and at any other time if clinically indicated based on symptoms or physical signs suggestive of progressive disease or rising tumor mark
Overall Survival
Time frame: Every cycle during treatment, then every 3 months for the first 2 years, then every six months for the next three years and then annually for the next 5 years.
Objective Tumor Response
Time frame: Every other cycle for first 6 months; then every 3 months for two years; then every six months for the next three years; and at any other time if clinically indicated based on symptoms or physical signs suggestive of progressive disease or rising serum tu
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Aug 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
John Farley principal investigator
NRG Oncology
145 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Carboplatin, Docetaxel and Laboratory Biomarker Analysis in people with Ovarian Clear Cell Cystadenocarcinoma and Stage III Ovarian Cancer, run by National Cancer Institute (NCI) at 145 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 18 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 145 sites in United States, Japan, South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 3 May 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of Patients Who Are Alive and Progression-free for at Least 12 Months After Study Entry in Patients With Newly Diagnosed Stage III or IV Clear Cell Ovarian Cancer in the Following Populations: Patients in the U.S./Worldwide and Japan (time frame: Tumor scans were done every other cycle for the first 6 months; then every 3 months x2; then every 6 months thereafter; and at any other time if clinically indicated or signs suggestive of progressive disease or rising levels; for up to 5 years.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Aug 2019.