Combination Chemotherapy With or Without Whole-Body Hyperthermia in Treating Patients With Recurrent Ovarian Epithelial, Fallopian Tube, or Peritoneal Cancer
A Randomized Phase II/III Trial Comparing Carboplatin-Ifosfamide (IC)-Chemotherapy Vs. IC-Chemotherapy Combined With Extreme Whole Body Hyperthermia In Patients With Recurrence Of Epithelial Ovarian Carcinoma: DOLPHIN-1-STUDY
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Hyperthermia therapy kills tumor cells by heating them to several degrees above body temperature. Combining hyperthermia with chemotherapy may kill more tumor cells. It is not yet known if chemotherapy is more effective with or without whole-body hyperthermia therapy in treating gynecologic cancer.
PURPOSE: Randomized phase II/III trial to compare the effectiveness of chemotherapy with or without whole-body hyperthermia in treating patients who have recurrent ovarian epithelial, fallopian tube, or peritoneal cancer.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Compare the time to progressive disease in patients with recurrent ovarian epithelial, fallopian tube, or extraovarian peritoneal cancer treated with carboplatin and ifosfamide with or without whole body hyperthermia.
- Compare the response rate, duration of response, and survival time of patients treated with these regimens.
- Compare the effect on the presence of disseminated tumor cells in bone marrow in patients treated with these regimens.
- Compare the toxicity of these regimens in these patients.
- Assess quality of life of patients treated with these regimens.
OUTLINE: This is a phase II safety and efficacy study followed by a phase III randomized, open-label, multicenter study.
- Phase II: Patients receive ifosfamide IV over 1 hour and carboplatin IV over 20 minutes on day 1. Patients also undergo whole body hyperthermia for at least 1 hour on day 1. Treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Phase III (after successful treatment of 15 patients in phase II): Patients are stratified according to disease-free interval (6-12 months vs more than 12 months), measurable disease (bidimensionally measurable vs measurable by other clinical means), and disease recurrence (first recurrence vs second or greater recurrence). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive ifosfamide, carboplatin, and whole body hyperthermia as in phase II.
- Arm II: Patients receive ifosfamide and carboplatin as in arm I.
- In both arms, treatment repeats every 28 days for 6 courses in the absence of disease progression or unacceptable toxicity.
Quality of life is assessed before each course, 4 weeks after the last course, and then every 3 months for 2 years.
Patients are followed at 4 weeks and then every 3 months for 2 years.
PROJECTED ACCRUAL: A total of 15 patients will be accrued for phase II of this study. A total of 226 patients (113 per treatment arm) will be accrued for phase III of this study within 2 years.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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-
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Berlin, Germany, D-13353
- Recruiting
- Charite University Hospital - Campus Virchow Klinikum
-
Contact:
- B. Hildebrandt, MD
- Phone Number: 49-30-450-553-636
- Email: bert.hildebrandt@chu-ite.de
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Frankfurt, Germany, D-60488
- Recruiting
- Krankenhaus Nordwest
-
Contact:
- Elke Jaeger, MD
- Phone Number: 49-69-7601-3380
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Hamburg, Germany, D-20246
- Recruiting
- University Medical Center Hamburg - Eppendorf
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Contact:
- S. Hegewisch-Becker, MD
- Phone Number: 49-40-428-033-971
- Email: hegewisch@uke.uni-hamburg.de
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Luebeck, Germany, D-23538
- Recruiting
- Universitaets - Kinderklinik - Luebeck
-
Contact:
- A Bakhshandeh-Bath, MD
- Phone Number: 0049-451-500-2316
- Email: bakhshan@medinf.mu_luebeck.de
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Trostberg, Germany, D-83308
- Recruiting
- Kreiskrankenhaus Trostberg
-
Contact:
- A. Biedermann, MD
- Phone Number: 0862-11-87-5020
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-
-
-
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Budapest, Hungary, 1076
- Recruiting
- Peterfy Korhaz Szulo-Nobeteg Oztaly
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Contact:
- L. Kornya, MD
- Phone Number: 36-1-322-3450
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-
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-
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Amsterdam, Netherlands, 1105 AZ
- Recruiting
- Academisch Medisch Centrum at University of Amsterdam
-
Contact:
- Anneke M. Westermann, MD, PhD
- Phone Number: 31-20-566-5955
- Email: a.m.westermann@amc.uva.nl
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed ovarian epithelial, fallopian tube, or extraovarian peritoneal cancer
- Recurrent disease (any FIGO stage)
- Not amenable to curative surgery or radiotherapy alone
- Failed prior primary platinum-based therapy at least 6 months after therapy discontinuation
Measurable lesion by CT scan, MRI, chest x-ray, or sonography
- Physical examination allowed for documenting lymph node and skin metastases
- Physical gynecological examination allowed for well-defined palpable tumor lesions
- Increase in CA 125 without any measurable tumor is not acceptable as indication of recurrence
- No CNS metastases
- No tumor of borderline malignancy
PATIENT CHARACTERISTICS:
Age
- 18 to 65
Performance status
- ECOG 0-2
Life expectancy
- At least 24 weeks
Hematopoietic
- Neutrophil count at least 1,500/mm3
- Platelet count at least 100,000/mm3
Hepatic
- Not specified
Renal
- Creatinine clearance at least 60 mL/min
- No chronic or acute renal failure
Cardiovascular
- Cardiovascular function sufficient for hyperthermia treatment by stress-ECG
- No cardiomyopathy with impaired ventricular function
- No New York Heart Association class III or IV heart disease
- No cardiac arrhythmias influencing LVEF and requiring medication
- No myocardial infarction or angina pectoris within the past 6 months
- No uncontrolled arterial hypertension
Pulmonary
- Pulmonary function sufficient for hyperthermia treatment by pulmonary function tests
Other
- No untreated endocrinological disease (e.g., hyperthyroidism or diabetes mellitus)
- No other primary malignancy except carcinoma in situ of the cervix or adequately treated basal cell skin cancer
- No contraindication against hyperthermia treatment (e.g., photodermatosis, history of malignant hyperthermia, or claustrophobia)
- No hypersensitivity to carboplatin, ifosfamide, or any other study medication
- Not pregnant or nursing
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
- No concurrent cytotoxic or other antineoplastic therapy
Endocrine therapy
- Concurrent hormone replacement therapy allowed
- Concurrent steroid antiemetics allowed
Radiotherapy
- See Disease Characteristics
- At least 1 year since prior radiotherapy (tumoricidal dose) of the pelvis
- Concurrent palliative local radiotherapy for painful (nonprogressive) existing lesion is allowed if other measurable sites are present
- No concurrent radiotherapy to a second existing lesion
Surgery
- See Disease Characteristics
Other
- No prior form of hyperthermic therapy
- At least 3 weeks since other medications as part of another clinical study
- At least 3 weeks since prior investigational agents
- At least 6 weeks since prior betablockers
- No concurrent photosensitizing drugs
- No concurrent betablockers
- No other concurrent anticancer therapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
|---|
|
Toxicity
|
|
Response rate
|
|
Quality of life
|
|
Duration of response
|
|
Survival time
|
|
Time to progressive disease
|
|
Effects on the presence of disseminated tumor cells in bone marrow
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Harald Sommer, MD, Ludwig-Maximilians - University of Munich
Study record dates
Study Major Dates
Study Start
Study Start
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- stage IV ovarian epithelial cancer
- recurrent ovarian epithelial cancer
- recurrent fallopian tube cancer
- recurrent primary peritoneal cavity cancer
- stage IIIA ovarian epithelial cancer
- stage IIIB ovarian epithelial cancer
- stage IIIC ovarian epithelial cancer
- stage IIIA primary peritoneal cavity cancer
- stage IIIB primary peritoneal cavity cancer
- stage IIIC primary peritoneal cavity cancer
- stage IIIA fallopian tube cancer
- stage IIIB fallopian tube cancer
- stage IIIC fallopian tube cancer
- stage IV fallopian tube cancer
- stage IV primary peritoneal cavity cancer
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Peritoneal Diseases
- Genital Neoplasms, Female
- Wounds and Injuries
- Adnexal Diseases
- Digestive System Neoplasms
- Fallopian Tube Diseases
- Abdominal Neoplasms
- Body Temperature Changes
- Heat Stress Disorders
- Fallopian Tube Neoplasms
- Peritoneal Neoplasms
- Hyperthermia
- Molecular Mechanisms of Pharmacological Action
- Antineoplastic Agents
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Carboplatin
- Ifosfamide
Other Study ID Numbers
Other Study ID Numbers
- LMU-DOLPHIN-1
- CDR0000256532 (Registry Identifier: PDQ (Physician Data Query))
- EU-20220
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