- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03378128
Debulking Surgery in Ovarian Cancer (MIID-SOC)
Minimally Invasive Interval Debulking Surgery in Ovarian Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The objective of this study is to implement, evaluate, and further investigate the role of minimally invasive surgery in patients undergoing interval debulking following neoadjuvant chemotherapy in patients with advanced ovarian cancer.
Primary Objective:
Prospectively evaluate the feasibility and safety of the minimally invasive interval debulking approach
Secondary Objective(s)
- Identify the patient population for which the minimally invasive interval debulking approach will offer comparable, if not improved, outcomes as the laparotomic interval debulking technique
- Validate previously identified preoperative imaging computed tomography (CT) criteria and CA-125 values to predict optimal cytoreduction in laparotomic primary cytoreductive surgery and apply it towards the prediction of optimal cytoreduction (≤ 1 cm residual disease) following minimally invasive interval debulking surgery
- Validate the previously identified laparoscopic scoring system for primary cytoreductive surgery and apply it towards the prediction of optimal cytoreduction (≤ 1 cm residual disease) following minimally invasive interval debulking surgery
- Monitor the number of hospital days in the first 30 days postoperatively (length of stay after interval debulking including any days of readmission)
- Evaluate the oncologic safety as it relates to time to return to chemotherapy in patients who undergo laparoscopic minimally invasive interval debulking surgery
- Evaluate the complications as assessed by incidence of a composite of major complications and a second composite of minor complications
Study Design This will be a prospective pilot study to address feasibility and safety to identify a patient population amenable to this surgical approach. This will allow for the future trial to include randomization
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
North Carolina
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Charlotte, North Carolina, United States, 28203
- Atrium/Charlotte-Mecklenburg Hospital Authority
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Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Taussig Cancer Center, Case Comprehensive Cancer Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subjects must have histologically or cytologically confirmed advanced epithelial ovarian, fallopian tube, or primary peritoneal (≥ International Federation of Gynecology and Obstetrics (FIGO) Stage IIIC)
- Subjects must have received neoadjuvant chemotherapy (any number of cycles) with complete or partial response as assessed by Response Evaluation Criteria in Solid Tumors 1.1 (RECIST) or CA 125 response by Gynecologic Cancer Intergroup (GCIG) criteria
- Performance status Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Subjects must have the ability to understand and the willingness to sign a written informed consent document.
Exclusion Criteria:
- Severe cardiopulmonary disease precluding the use of the minimally invasive technique as deemed by Internal Medicine Preoperative Assessment, Consultant and Treatment (IMPACT)
- Inability to tolerate prolonged Trendelenburg position as deemed by anesthesiology
- Severe hip disease precluding the use of dorsolithotomy position
- Prior pelvic or abdominal radiation
- Clinically large pelvic masses reaching above the umbilicus
- Absence of a documented PR or CR according to RECIST 1.1 or CA 125 response by GCIG criteria to neoadjuvant chemotherapy
- Presence of parenchymal liver metastases on imaging
- Absence of baseline imaging studies (CT abdomen/pelvis and Chest x-ray minimum) both prior to beginning chemotherapy and following chemotherapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: diagnostic laparoscopic assessment after neoadjuvant chemo
All patients will undergo a diagnostic laparoscopic assessment of disease following neoadjuvant chemotherapy
|
The patient will initially undergo a diagnostic laparoscopy by a minimally invasive approach and entry method.
The decision of which approach and entry to perform will be dictated by the primary surgeon of record's preference and their assessment of pre-operative patient factors.
Once the primary surgeon determines the areas of macroscopic disease, he/she will make an assessment as to the need to convert to a laparotomy or continue laparoscopically.
At the completion of the procedure, it will be noted whether an optimal cytoreduction (≤ 1 cm residual disease) or a sub-optimal cytoreduction (>1 cm residual disease) was performed.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients who undergo minimally-invasive interval debulking surgery (MI-IDS) among all patients enrolled in the study
Time Frame: 1 day
|
Feasibility measure
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1 day
|
Percentage of patients experiencing grade 3 or 4 post-operative complications
Time Frame: 30 days post-surgery
|
Accordion Severity Grading system with grade 3-4 scores.
Grade 3 and 4 are severe complications or death.
Severe complications are those requiring endoscopic or interventional radiologic procedures or re-operation as well as complications resulting in failure of 1 or more organ system.
If fewer than 14% of patients have grade 3 or 4 complications, the surgery will be deemed safe.
|
30 days post-surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of patients with optimal cytoreductive surgery (=< 1cm of disease seen at completion of surgery)
Time Frame: 1 day
|
Rate of optimal resection after interval debulking surgery is expected to be between 73%-81%
|
1 day
|
Proportion of patients who have a laparoscopy at the outset and remain laparoscopic throughout their surgery
Time Frame: 1 day
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If greater than 13 of the 50 patients planned to be enrolled on the study complete the laparoscopic surgery, the study will be deemed feasible
|
1 day
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Length of hospital stay
Time Frame: Up to 30 days after surgery
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Time from the end of surgery to when the patient is discharged
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Up to 30 days after surgery
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Time to return to chemotherapy
Time Frame: 30 days after surgery
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From the time of surgery to when the patient returns to chemotherapy treatments.
Shorter times between surgery and chemotherapy are positive outcomes
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30 days after surgery
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Score of the Bristow preoperative predictive index parameters
Time Frame: 1 day
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23 point index where higher scores indicate poorer outcomes
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1 day
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Score of Suidan preoperative predictive index parameters
Time Frame: 1 day
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17 point index where higher scores indicate poorer outcomes
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1 day
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Chad Michener, MD, Cleveland Clinic Taussig Cancer Center, Case Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neoplasms by Histologic Type
- Urogenital Neoplasms
- Neoplasms by Site
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Peritoneal Diseases
- Genital Neoplasms, Female
- Endocrine System Diseases
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- Digestive System Neoplasms
- Endocrine Gland Neoplasms
- Fallopian Tube Diseases
- Abdominal Neoplasms
- Neoplasms
- Ovarian Neoplasms
- Fallopian Tube Neoplasms
- Peritoneal Neoplasms
- Carcinoma, Ovarian Epithelial
Other Study ID Numbers
- CASE9817
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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