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Testen der Kombination von Cediranib und Olaparib im Vergleich zu jedem Medikament allein oder einer anderen Chemotherapie bei rezidivierendem platinresistentem Eierstockkrebs

30. September 2026 aktualisiert von: National Cancer Institute (NCI)

Eine randomisierte Phase-II/III-Studie zur Kombination von Cediranib und Olaparib im Vergleich zu Cediranib oder Olaparib allein oder zur Standard-Chemotherapie bei Frauen mit rezidivierendem platinresistentem oder -refraktärem Ovarial-, Eileiter- oder primärem Peritonealkrebs (COCOS)

This randomized phase II/III trial studies how well cediranib maleate and olaparib work when given together or separately, and compares them to standard chemotherapy in treating patients with ovarian, fallopian tube, or primary peritoneal cancer that has returned (recurrent) after receiving chemotherapy with drugs that contain platinum (platinum-resistant) or continued to grow while being treated with platinum-based chemotherapy drugs (platinum-refractory). Cediranib maleate and olaparib may stop the growth of tumor cells by blocking enzymes needed for cell growth. Chemotherapy drugs work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether giving cediranib maleate and olaparib together may cause more damage to cancer cells when compared to either drug alone or standard chemotherapy.

Studienübersicht

Status

Aktiv, nicht rekrutierend

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

PRIMARY OBJECTIVES:

I. To assess the efficacy and identify (in)active arm(s) of the combination of cediranib maleate (cediranib) and olaparib, cediranib alone, olaparib alone, and physician's choice standard of care chemotherapy, as measured by progression-free survival (PFS) in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase II) II. To assess the efficacy of the combination of cediranib and olaparib, and cediranib monotherapy, as measured by overall survival (OS) and PFS, as compared to physician's choice standard of care chemotherapy in women with recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

SECONDARY OBJECTIVES:

I. To assess the efficacy of the combination of cediranib and olaparib, cediranib alone, olaparib alone, and physician's choice standard of care chemotherapy, as measured by objective response rate (ORR: partial or complete response) by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase II) II. To assess safety endpoints, as measured by frequency and severity of adverse events by Common Terminology Criteria for Adverse Events (CTCAE). (Phase II and Phase III) III. To assess the efficacy of the combination of cediranib and olaparib, and cediranib monotherapy, as measured by ORR as compared to physician's choice standard of care chemotherapy in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

OBJECTIVES WITH INTEGRATED BIOMARKERS:

I. To assess correlation of homologous recombination deficiency (HRD) status, as assessed via BROCA-HR assay with response, as measured by PFS and ORR. (Phase II) II. To evaluate the prognostic and predictive role of circulating endothelial cells (CEC) on comparative effectiveness of targeted therapies and reference chemotherapy. (Phase II) III. To evaluate quality of life data compliance, as measured by the 9-item Disease Related Symptoms (DRS-9) subscale of the National Comprehensive Cancer Network (NCCN)-Functional Assessment of Cancer Therapy (FACT) Ovarian Symptom Index (NFOSI) for utilization and analysis in the Phase III study. (Phase II) IV. To assess correlation of HRD status, as assessed via BROCA-HR assay with response, as measured by OS, PFS and ORR. (Phase III) V. To evaluate the prognostic and predictive role of circulating endothelial cells (CEC) on comparative effectiveness of targeted therapies and reference chemotherapy. (Phase III) VI. To assess the effect on disease-related symptoms (DRS) as measured by the 9-item DRS-P subscale of the NCCN-FACT Ovarian Symptom Index-18 (NFOSI-18), of single agent cediranib and cediranib/olaparib combination, compared to standard chemotherapy, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

EXPLORATORY OBJECTIVES:

I. To assess exploratory biomarkers of potential HRD, including genomic scarring, BRCA1 methylation, BRCA1 protein expression, and mutations in NHEJ, and other genes that might modify HRD. (Phase II and Phase III) II. To evaluate the prognostic and predictive role of angiogenic biomarkers, as assessed by the Duke plasma angiome. (Phase II and Phase III) III. To assess the effect on secondary measures of quality of life, as assessed by the treatment side effects (TSE) and function/well-being (F/WB) subscales of the NFOSI-18, sensory neuropathy as measured by the FACT/GOG-Ntx-4, and health utility as measured by the EQ-5D, of single agent cediranib and cediranib/olaparib combination, compared to standard chemotherapy, in the setting of recurrent platinum-resistant or-refractory ovarian, primary peritoneal or fallopian tube cancer. (Phase III)

OUTLINE:

PHASE II: Patients are randomized to 1 of 4 treatment arms.

ARM I (REFERENCE REGIMEN): Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel intravenously (IV) over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo computed tomography (CT) and magnetic resonance imaging (MRI) throughout the study. (12/05/2016)

ARM II (CEDIRANIB MALEATE AND OLAPARIB): Patients receive cediranib maleate orally (PO) once daily (QD) and olaparib PO twice daily (BID). Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

ARM III (CEDIRANIB): Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

ARM IV (OLAPARIB): Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).

PHASE III: Patients are randomized to 1 of 3 treatment arms.

ARM I (REFERENCE REGIMEN): Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)

ARM II (CEDIRANIB AND OLAPARIB): Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.

ARM III (SINGLE AGENT): Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.

After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months for up to 3 years.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

582

Phase

  • Phase 2
  • Phase 3

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Japan
      • Osaka, Japan, 589 8511
        • Kindai University
      • Saitama, Japan, 350-1298
        • Saitama Medical University International Medical Center
      • Tokyo, Japan, 104 0045
        • National Cancer Center Hospital
    • Ehime
      • Tōon, Ehime, Japan, 791-0295
        • Ehime University Hospital
    • Hokkaido
      • Sapporo, Hokkaido, Japan, 060-8648
        • Hokkaido University Hospital
    • Kagoshima-ken
      • Kagoshima, Kagoshima-ken, Japan, 890-8760
        • Kagoshima City Hospital
    • Tokyo
      • Koto-ku, Tokyo, Japan, 135-8550
        • The Cancer Institute Hospital Of JFCR
  • Kanada
    • Alberta
      • Calgary, Alberta, Kanada, T2N 5G2
        • Arthur J E Child Comprehensive Cancer Centre
      • Edmonton, Alberta, Kanada, T6G 1Z2
        • Cross Cancer Institute
    • Ontario
      • Barrie, Ontario, Kanada, L4M 6M2
        • Royal Victoria Regional Health Centre
      • Hamilton, Ontario, Kanada, L8V 5C2
        • Juravinski Cancer Centre at Hamilton Health Sciences
      • Kingston, Ontario, Kanada, K7L 2V7
        • Kingston Health Sciences Centre
      • London, Ontario, Kanada, N6A 4L6
        • London Regional Cancer Program
      • Sault Ste. Marie, Ontario, Kanada, P6B 0A8
        • Algoma District Cancer Program Sault Area Hospital
      • Toronto, Ontario, Kanada, M5G 2M9
        • University Health Network-Princess Margaret Hospital
      • Toronto, Ontario, Kanada, M4N 3M5
        • Odette Cancer Centre- Sunnybrook Health Sciences Centre
    • Quebec
      • Montreal, Quebec, Kanada, H3T 1E2
        • Jewish General Hospital
      • Montreal, Quebec, Kanada, H2X 3E4
        • CHUM - Centre Hospitalier de l'Universite de Montreal
      • Montreal, Quebec, Kanada, H1T 2M4
        • CIUSSSEMTL-Hopital Maisonneuve-Rosemont
      • Québec, Quebec, Kanada, G1R 2J6
        • CHU de Quebec-L'Hotel-Dieu de Quebec (HDQ)
  • Puerto Rico
      • San Juan, Puerto Rico, 00927
        • Centro Comprensivo de Cancer de UPR
  • Südkorea
      • Incheon, Südkorea, 405-760
        • Gachon University Gil Hospital
      • Seoul, Südkorea, 05505
        • Asan Medical Center
      • Seoul, Südkorea, 06273
        • Gangnam Severance Hospital
      • Seoul, Südkorea, 134-727
        • Kyung Hee University Hospital at Gangdong
      • Seoul, Südkorea, 139-706
        • Korea Cancer Center Hospital
    • Daegu
      • Dalseo-gu, Daegu, Südkorea, 42601
        • Keimyung University-Dongsan Medical Center
    • Kyeonggi-do
      • Seongnam, Kyeonggi-do, Südkorea, 463-707
        • Seoul National University Bundang Hospital
  • Vereinigte Staaten
    • Alabama
      • Birmingham, Alabama, Vereinigte Staaten, 35233
        • University of Alabama at Birmingham Cancer Center
    • Alaska
      • Anchorage, Alaska, Vereinigte Staaten, 99508
        • Alaska Women's Cancer Care
      • Anchorage, Alaska, Vereinigte Staaten, 99508
        • Providence Alaska Medical Center
    • Arkansas
      • Little Rock, Arkansas, Vereinigte Staaten, 72205
        • University of Arkansas for Medical Sciences
    • California
      • Auburn, California, Vereinigte Staaten, 95602
        • Sutter Auburn Faith Hospital
      • Berkeley, California, Vereinigte Staaten, 94704
        • Alta Bates Summit Medical Center-Herrick Campus
      • Carmichael, California, Vereinigte Staaten, 95608
        • Mercy San Juan Medical Center
      • Elk Grove, California, Vereinigte Staaten, 95758
        • Mercy Cancer Center - Elk Grove
      • Greenbrae, California, Vereinigte Staaten, 94904
        • Marin Cancer Care Inc
      • La Jolla, California, Vereinigte Staaten, 92093
        • UC San Diego Moores Cancer Center
      • Mountain View, California, Vereinigte Staaten, 94040
        • Palo Alto Medical Foundation-Camino Division
      • Mountain View, California, Vereinigte Staaten, 94040
        • Palo Alto Medical Foundation-Gynecologic Oncology
      • Oakland, California, Vereinigte Staaten, 94611
        • Kaiser Permanente-Oakland
      • Palo Alto, California, Vereinigte Staaten, 94301
        • Palo Alto Medical Foundation Health Care
      • Rocklin, California, Vereinigte Staaten, 95765
        • Mercy Cancer Center - Rocklin
      • Roseville, California, Vereinigte Staaten, 95661
        • Sutter Roseville Medical Center
      • Sacramento, California, Vereinigte Staaten, 95816
        • Sutter Medical Center Sacramento
      • Sacramento, California, Vereinigte Staaten, 95817
        • University of California Davis Comprehensive Cancer Center
      • Sacramento, California, Vereinigte Staaten, 95814
        • Kaiser Permanente Downtown Commons
      • Sacramento, California, Vereinigte Staaten, 95825
        • Kaiser Permanente Sacramento Medical Center
      • Sacramento, California, Vereinigte Staaten, 95816
        • Mercy Cancer Center - Sacramento
      • San Francisco, California, Vereinigte Staaten, 94115
        • Kaiser Permanente-San Francisco
      • San Francisco, California, Vereinigte Staaten, 94158
        • UCSF Medical Center-Mission Bay
      • San Francisco, California, Vereinigte Staaten, 94115
        • California Pacific Medical Center-Pacific Campus
      • San Luis Obispo, California, Vereinigte Staaten, 93401
        • Pacific Central Coast Health Center-San Luis Obispo
      • Santa Clara, California, Vereinigte Staaten, 95051
        • Kaiser Permanente Medical Center - Santa Clara
      • Santa Cruz, California, Vereinigte Staaten, 95065
        • Palo Alto Medical Foundation-Santa Cruz
      • Santa Rosa, California, Vereinigte Staaten, 95403
        • Sutter Pacific Medical Foundation
      • Sunnyvale, California, Vereinigte Staaten, 94086
        • Palo Alto Medical Foundation-Sunnyvale
      • Vallejo, California, Vereinigte Staaten, 94589
        • Kaiser Permanente-Vallejo
      • Walnut Creek, California, Vereinigte Staaten, 94596
        • Kaiser Permanente-Walnut Creek
      • Woodland, California, Vereinigte Staaten, 95695
        • Woodland Memorial Hospital
    • Colorado
      • Aurora, Colorado, Vereinigte Staaten, 80045
        • UCHealth University of Colorado Hospital
      • Colorado Springs, Colorado, Vereinigte Staaten, 80907
        • Penrose-Saint Francis Healthcare
      • Colorado Springs, Colorado, Vereinigte Staaten, 80909
        • UCHealth Memorial Hospital Central
      • Denver, Colorado, Vereinigte Staaten, 80205
        • Kaiser Permanente-Franklin
      • Denver, Colorado, Vereinigte Staaten, 80220
        • Rocky Mountain Cancer Centers-Rose
      • Fort Collins, Colorado, Vereinigte Staaten, 80524
        • Poudre Valley Hospital
      • Highlands Ranch, Colorado, Vereinigte Staaten, 80129
        • UCHealth Highlands Ranch Hospital
      • Lafayette, Colorado, Vereinigte Staaten, 80026
        • Kaiser Permanente-Rock Creek
      • Lone Tree, Colorado, Vereinigte Staaten, 80124
        • Kaiser Permanente-Lone Tree
    • Connecticut
      • Danbury, Connecticut, Vereinigte Staaten, 06810
        • Danbury Hospital
      • Fairfield, Connecticut, Vereinigte Staaten, 06824
        • Smilow Cancer Hospital Care Center-Fairfield
      • Hartford, Connecticut, Vereinigte Staaten, 06105
        • Smilow Cancer Hospital Care Center at Saint Francis
      • Hartford, Connecticut, Vereinigte Staaten, 06102
        • Hartford Hospital
      • Middletown, Connecticut, Vereinigte Staaten, 06457
        • Middlesex Hospital
      • New Britain, Connecticut, Vereinigte Staaten, 06050
        • The Hospital of Central Connecticut
      • New Haven, Connecticut, Vereinigte Staaten, 06520
        • Yale University
      • Norwalk, Connecticut, Vereinigte Staaten, 06856
        • Norwalk Hospital
      • Trumbull, Connecticut, Vereinigte Staaten, 06611
        • Smilow Cancer Hospital Care Center-Trumbull
    • Delaware
      • Newark, Delaware, Vereinigte Staaten, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Vereinigte Staaten, 19713
        • Medical Oncology Hematology Consultants PA
      • Newark, Delaware, Vereinigte Staaten, 19718
        • Christiana Care Health System-Christiana Hospital
    • District of Columbia
      • Washington D.C., District of Columbia, Vereinigte Staaten, 20016
        • Sibley Memorial Hospital
    • Florida
      • Gainesville, Florida, Vereinigte Staaten, 32610
        • UF Health Cancer Institute - Gainesville
      • Miami Beach, Florida, Vereinigte Staaten, 33140
        • Mount Sinai Medical Center
      • Orlando, Florida, Vereinigte Staaten, 32806
        • Orlando Health Cancer Institute
      • Sarasota, Florida, Vereinigte Staaten, 34239
        • Sarasota Memorial Hospital
    • Georgia
      • Atlanta, Georgia, Vereinigte Staaten, 30308
        • Emory University Hospital Midtown
      • Atlanta, Georgia, Vereinigte Staaten, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Atlanta, Georgia, Vereinigte Staaten, 30309
        • Piedmont Hospital
      • Atlanta, Georgia, Vereinigte Staaten, 30342
        • Northside Hospital
      • Augusta, Georgia, Vereinigte Staaten, 30912
        • Augusta University Medical Center
      • Austell, Georgia, Vereinigte Staaten, 30106
        • WellStar Cobb Hospital
      • Marietta, Georgia, Vereinigte Staaten, 30060
        • Wellstar Kennestone Hospital
      • Marietta, Georgia, Vereinigte Staaten, 30060
        • WellStar Health System Inc
      • Roswell, Georgia, Vereinigte Staaten, 30076
        • WellStar North Fulton Hospital
      • Savannah, Georgia, Vereinigte Staaten, 31405
        • Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
      • Savannah, Georgia, Vereinigte Staaten, 31404
        • Memorial Health University Medical Center
      • Smyrna, Georgia, Vereinigte Staaten, 30080
        • WellStar Vinings Health Park
    • Hawaii
      • Honolulu, Hawaii, Vereinigte Staaten, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Vereinigte Staaten, 96826
        • Kapiolani Medical Center for Women and Children
    • Idaho
      • Boise, Idaho, Vereinigte Staaten, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Boise, Idaho, Vereinigte Staaten, 83712
        • Saint Luke's Cancer Institute - Boise
      • Fruitland, Idaho, Vereinigte Staaten, 83619
        • Saint Luke's Cancer Institute - Fruitland
      • Meridian, Idaho, Vereinigte Staaten, 83642
        • Saint Luke's Cancer Institute - Meridian
      • Nampa, Idaho, Vereinigte Staaten, 83687
        • Saint Luke's Cancer Institute - Nampa
    • Illinois
      • Aurora, Illinois, Vereinigte Staaten, 60504
        • Rush-Copley Medical Center
      • Bloomington, Illinois, Vereinigte Staaten, 61704
        • Illinois CancerCare-Bloomington
      • Canton, Illinois, Vereinigte Staaten, 61520
        • Illinois CancerCare-Canton
      • Carthage, Illinois, Vereinigte Staaten, 62321
        • Illinois CancerCare-Carthage
      • Centralia, Illinois, Vereinigte Staaten, 62801
        • Centralia Oncology Clinic
      • Chicago, Illinois, Vereinigte Staaten, 60611
        • Northwestern University
      • Chicago, Illinois, Vereinigte Staaten, 60612
        • John H Stroger Jr Hospital of Cook County
      • Chicago, Illinois, Vereinigte Staaten, 60657
        • UChicago Medicine Comprehensive Cancer Center - Saint Joseph Hospital
      • Chicago, Illinois, Vereinigte Staaten, 60612
        • Rush MD Anderson Cancer Center
      • Decatur, Illinois, Vereinigte Staaten, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Vereinigte Staaten, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Effingham, Illinois, Vereinigte Staaten, 62401
        • Crossroads Cancer Center
      • Eureka, Illinois, Vereinigte Staaten, 61530
        • Illinois CancerCare-Eureka
      • Evanston, Illinois, Vereinigte Staaten, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Galesburg, Illinois, Vereinigte Staaten, 61401
        • Illinois CancerCare-Galesburg
      • Geneva, Illinois, Vereinigte Staaten, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview, Illinois, Vereinigte Staaten, 60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Highland Park, Illinois, Vereinigte Staaten, 60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • Hinsdale, Illinois, Vereinigte Staaten, 60521
        • Sudarshan K Sharma MD Limited-Gynecologic Oncology
      • Kewanee, Illinois, Vereinigte Staaten, 61443
        • Illinois CancerCare-Kewanee Clinic
      • Macomb, Illinois, Vereinigte Staaten, 61455
        • Illinois CancerCare-Macomb
      • O'Fallon, Illinois, Vereinigte Staaten, 62269
        • Cancer Care Center of O'Fallon
      • Ottawa, Illinois, Vereinigte Staaten, 61350
        • Illinois CancerCare-Ottawa Clinic
      • Pekin, Illinois, Vereinigte Staaten, 61554
        • Illinois CancerCare-Pekin
      • Peoria, Illinois, Vereinigte Staaten, 61615
        • Illinois CancerCare-Peoria
      • Peru, Illinois, Vereinigte Staaten, 61354
        • Illinois CancerCare-Peru
      • Princeton, Illinois, Vereinigte Staaten, 61356
        • Illinois CancerCare-Princeton
      • Springfield, Illinois, Vereinigte Staaten, 62702
        • Springfield Clinic
      • Springfield, Illinois, Vereinigte Staaten, 62781
        • Springfield Memorial Hospital
      • Warrenville, Illinois, Vereinigte Staaten, 60555
        • Northwestern Medicine Cancer Center Warrenville
      • Zion, Illinois, Vereinigte Staaten, 60099
        • Midwestern Regional Medical Center
    • Indiana
      • Fort Wayne, Indiana, Vereinigte Staaten, 46845
        • Parkview Regional Medical Center
      • Indianapolis, Indiana, Vereinigte Staaten, 46202
        • Indiana University/Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Vereinigte Staaten, 46260
        • Ascension Saint Vincent Indianapolis Hospital
      • Richmond, Indiana, Vereinigte Staaten, 47374
        • Reid Health
      • South Bend, Indiana, Vereinigte Staaten, 46601
        • Memorial Hospital of South Bend
    • Iowa
      • Clive, Iowa, Vereinigte Staaten, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Vereinigte Staaten, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Vereinigte Staaten, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Iowa City, Iowa, Vereinigte Staaten, 52242
        • University of Iowa/Holden Comprehensive Cancer Center
      • Sioux City, Iowa, Vereinigte Staaten, 51101
        • Siouxland Regional Cancer Center
      • West Des Moines, Iowa, Vereinigte Staaten, 50266
        • Mercy Medical Center-West Lakes
    • Kansas
      • Wichita, Kansas, Vereinigte Staaten, 67214
        • Ascension Via Christi Hospitals Wichita
      • Wichita, Kansas, Vereinigte Staaten, 67208
        • Associates In Womens Health
    • Kentucky
      • Edgewood, Kentucky, Vereinigte Staaten, 41017
        • Saint Elizabeth Healthcare Edgewood
      • Lexington, Kentucky, Vereinigte Staaten, 40536
        • University of Kentucky/Markey Cancer Center
    • Louisiana
      • Baton Rouge, Louisiana, Vereinigte Staaten, 70809
        • Mary Bird Perkins Cancer Center
      • Baton Rouge, Louisiana, Vereinigte Staaten, 70809
        • Hematology/Oncology Clinic PLLC
      • Baton Rouge, Louisiana, Vereinigte Staaten, 70817
        • Woman's Hospital
      • Covington, Louisiana, Vereinigte Staaten, 70433
        • Women's Cancer Care-Covington
      • New Orleans, Louisiana, Vereinigte Staaten, 70121
        • Ochsner Medical Center Jefferson
    • Maine
      • Bangor, Maine, Vereinigte Staaten, 04401
        • Eastern Maine Medical Center
      • Brewer, Maine, Vereinigte Staaten, 04412
        • Lafayette Family Cancer Center-EMMC
      • Scarborough, Maine, Vereinigte Staaten, 04074
        • MaineHealth Maine Medical Center- Scarborough
    • Maryland
      • Baltimore, Maryland, Vereinigte Staaten, 21237
        • MedStar Franklin Square Medical Center/Weinberg Cancer Institute
      • Baltimore, Maryland, Vereinigte Staaten, 21287
        • Johns Hopkins University/Sidney Kimmel Cancer Center
      • Baltimore, Maryland, Vereinigte Staaten, 21204
        • Greater Baltimore Medical Center
      • Bel Air, Maryland, Vereinigte Staaten, 21014
        • UM Upper Chesapeake Medical Center
      • Bethesda, Maryland, Vereinigte Staaten, 20892
        • National Institutes of Health Clinical Center
      • Ocean Pines, Maryland, Vereinigte Staaten, 21811
        • TidalHealth Richard A Henson Cancer Institute
      • Salisbury, Maryland, Vereinigte Staaten, 21801
        • TidalHealth Peninsula Regional
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02215
        • Dana-Farber Cancer Institute
      • Boston, Massachusetts, Vereinigte Staaten, 02115
        • Brigham and Women's Hospital
      • Worcester, Massachusetts, Vereinigte Staaten, 01605
        • UMass Memorial Medical Center - Memorial Division
    • Michigan
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109
        • University of Michigan Rogel Cancer Center
      • Ann Arbor, Michigan, Vereinigte Staaten, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brownstown, Michigan, Vereinigte Staaten, 48183
        • Henry Ford Cancer Institute-Downriver
      • Clinton Township, Michigan, Vereinigte Staaten, 48038
        • Henry Ford Macomb Hospital-Clinton Township
      • Detroit, Michigan, Vereinigte Staaten, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Vereinigte Staaten, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Escanaba, Michigan, Vereinigte Staaten, 49829
        • OSF Saint Francis Hospital and Medical Group
      • Farmington Hills, Michigan, Vereinigte Staaten, 48334
        • Weisberg Cancer Treatment Center
      • Grand Rapids, Michigan, Vereinigte Staaten, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Kalamazoo, Michigan, Vereinigte Staaten, 49007
        • West Michigan Cancer Center
      • Lansing, Michigan, Vereinigte Staaten, 48912
        • University of Michigan Health - Sparrow Lansing
      • Pontiac, Michigan, Vereinigte Staaten, 48341
        • Trinity Health Saint Joseph Mercy Oakland Hospital
      • Traverse City, Michigan, Vereinigte Staaten, 49684
        • Munson Medical Center
      • West Bloomfield, Michigan, Vereinigte Staaten, 48322
        • Henry Ford West Bloomfield Hospital
    • Minnesota
      • Bemidji, Minnesota, Vereinigte Staaten, 56601
        • Sanford Joe Lueken Cancer Center
      • Burnsville, Minnesota, Vereinigte Staaten, 55337
        • Fairview Ridges Hospital
      • Coon Rapids, Minnesota, Vereinigte Staaten, 55433
        • Mercy Hospital
      • Edina, Minnesota, Vereinigte Staaten, 55435
        • Fairview Southdale Hospital
      • Mankato, Minnesota, Vereinigte Staaten, 56001
        • Mayo Clinic Health Systems-Mankato
      • Maple Grove, Minnesota, Vereinigte Staaten, 55369
        • Fairview Clinics and Surgery Center Maple Grove
      • Maplewood, Minnesota, Vereinigte Staaten, 55109
        • Saint John's Hospital - Healtheast
      • Minneapolis, Minnesota, Vereinigte Staaten, 55407
        • Abbott-Northwestern Hospital
      • Minneapolis, Minnesota, Vereinigte Staaten, 55455
        • University of Minnesota/Masonic Cancer Center
      • Rochester, Minnesota, Vereinigte Staaten, 55905
        • Mayo Clinic in Rochester
      • Saint Louis Park, Minnesota, Vereinigte Staaten, 55416
        • Park Nicollet Clinic - Saint Louis Park
      • Saint Paul, Minnesota, Vereinigte Staaten, 55101
        • Regions Hospital
      • Saint Paul, Minnesota, Vereinigte Staaten, 55102
        • United Hospital
      • Shakopee, Minnesota, Vereinigte Staaten, 55379
        • Saint Francis Regional Medical Center
      • Woodbury, Minnesota, Vereinigte Staaten, 55125
        • Minnesota Oncology Hematology PA-Woodbury
    • Mississippi
      • Jackson, Mississippi, Vereinigte Staaten, 39216
        • University of Mississippi Medical Center
    • Missouri
      • Cape Girardeau, Missouri, Vereinigte Staaten, 63703
        • Saint Francis Medical Center
      • Columbia, Missouri, Vereinigte Staaten, 65212
        • MU Health - University Hospital/Ellis Fischel Cancer Center
      • Joplin, Missouri, Vereinigte Staaten, 64804
        • Mercy Hospital Joplin
      • Springfield, Missouri, Vereinigte Staaten, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Vereinigte Staaten, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Vereinigte Staaten, 63110
        • Barnes-Jewish Hospital
      • St Louis, Missouri, Vereinigte Staaten, 63110
        • Washington University School of Medicine
    • Montana
      • Billings, Montana, Vereinigte Staaten, 59101
        • Billings Clinic Cancer Center
      • Bozeman, Montana, Vereinigte Staaten, 59715
        • Bozeman Health Deaconess Hospital
      • Great Falls, Montana, Vereinigte Staaten, 59405
        • Benefis Sletten Cancer Institute
    • Nebraska
      • Grand Island, Nebraska, Vereinigte Staaten, 68803
        • Nebraska Cancer Specialists/Oncology Hematology West PC
      • Kearney, Nebraska, Vereinigte Staaten, 68847
        • CHI Health Good Samaritan
      • Omaha, Nebraska, Vereinigte Staaten, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Vereinigte Staaten, 68124
        • Alegent Health Bergan Mercy Medical Center
      • Omaha, Nebraska, Vereinigte Staaten, 68130
        • Alegent Health Lakeside Hospital
    • Nevada
      • Las Vegas, Nevada, Vereinigte Staaten, 89106
        • Women's Cancer Center of Nevada
    • New Hampshire
      • Lebanon, New Hampshire, Vereinigte Staaten, 03756
        • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
      • Nashua, New Hampshire, Vereinigte Staaten, 03063
        • Dartmouth Cancer Center - Nashua
    • New Jersey
      • Camden, New Jersey, Vereinigte Staaten, 08103
        • Cooper Hospital University Medical Center
      • Hackensack, New Jersey, Vereinigte Staaten, 07601
        • Hackensack University Medical Center
      • Hamilton, New Jersey, Vereinigte Staaten, 08690
        • The Cancer Institute of New Jersey Hamilton
      • Morristown, New Jersey, Vereinigte Staaten, 07960
        • Morristown Medical Center
      • Neptune City, New Jersey, Vereinigte Staaten, 07753
        • Jersey Shore Medical Center
      • New Brunswick, New Jersey, Vereinigte Staaten, 08903
        • Rutgers Cancer Institute of New Jersey
      • Somerville, New Jersey, Vereinigte Staaten, 08876
        • Robert Wood Johnson University Hospital Somerset
      • Summit, New Jersey, Vereinigte Staaten, 07902
        • Overlook Hospital
      • Voorhees Township, New Jersey, Vereinigte Staaten, 08043
        • MD Anderson Cancer Center at Cooper-Voorhees
    • New Mexico
      • Albuquerque, New Mexico, Vereinigte Staaten, 87106
        • Southwest Gynecologic Oncology Associates Inc
      • Albuquerque, New Mexico, Vereinigte Staaten, 87106
        • University of New Mexico Cancer Center
      • Las Cruces, New Mexico, Vereinigte Staaten, 88011
        • Memorial Medical Center-Las Cruces
    • New York
      • Albany, New York, Vereinigte Staaten, 12208
        • Women's Cancer Care Associates LLC
      • Brooklyn, New York, Vereinigte Staaten, 11203
        • State University of New York Downstate Medical Center
      • Buffalo, New York, Vereinigte Staaten, 14263
        • Roswell Park Cancer Institute
      • New York, New York, Vereinigte Staaten, 10016
        • Laura and Isaac Perlmutter Cancer Center at NYU Langone
      • Rochester, New York, Vereinigte Staaten, 14642
        • University of Rochester
      • Stony Brook, New York, Vereinigte Staaten, 11794
        • Stony Brook University Medical Center
      • Syracuse, New York, Vereinigte Staaten, 13210
        • State University of New York Upstate Medical University
      • The Bronx, New York, Vereinigte Staaten, 10461
        • Montefiore Medical Center-Einstein Campus
      • White Plains, New York, Vereinigte Staaten, 10601
        • Dickstein Cancer Treatment Center
    • North Carolina
      • Asheville, North Carolina, Vereinigte Staaten, 28803
        • AdventHealth Infusion Center Asheville
      • Chapel Hill, North Carolina, Vereinigte Staaten, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Clyde, North Carolina, Vereinigte Staaten, 28721
        • AdventHealth Infusion Center Haywood
      • Durham, North Carolina, Vereinigte Staaten, 27710
        • Duke University Medical Center
      • Goldsboro, North Carolina, Vereinigte Staaten, 27534
        • Southeastern Medical Oncology Center-Goldsboro
      • Hendersonville, North Carolina, Vereinigte Staaten, 28791
        • Margaret R Pardee Memorial Hospital
      • Hendersonville, North Carolina, Vereinigte Staaten, 28792
        • AdventHealth Hendersonville
      • Jacksonville, North Carolina, Vereinigte Staaten, 28546
        • Southeastern Medical Oncology Center-Jacksonville
      • Pinehurst, North Carolina, Vereinigte Staaten, 28374
        • FirstHealth of the Carolinas-Moore Regional Hospital
      • Raleigh, North Carolina, Vereinigte Staaten, 27609
        • Duke Cancer Center Raleigh
      • Wilmington, North Carolina, Vereinigte Staaten, 28401
        • Novant Health New Hanover Regional Medical Center
      • Winston-Salem, North Carolina, Vereinigte Staaten, 27157
        • Wake Forest University Health Sciences
    • North Dakota
      • Bismarck, North Dakota, Vereinigte Staaten, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Vereinigte Staaten, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Vereinigte Staaten, 58122
        • Sanford Broadway Medical Center
    • Ohio
      • Akron, Ohio, Vereinigte Staaten, 44307
        • Cleveland Clinic Akron General
      • Canton, Ohio, Vereinigte Staaten, 44710
        • Aultman Health Foundation
      • Centerville, Ohio, Vereinigte Staaten, 45459
        • Miami Valley Hospital South
      • Cincinnati, Ohio, Vereinigte Staaten, 45219
        • University of Cincinnati Cancer Center-UC Medical Center
      • Cincinnati, Ohio, Vereinigte Staaten, 45220
        • Good Samaritan Hospital - Cincinnati
      • Cincinnati, Ohio, Vereinigte Staaten, 45247
        • TriHealth Cancer Institute-Westside
      • Cleveland, Ohio, Vereinigte Staaten, 44109
        • MetroHealth Medical Center
      • Cleveland, Ohio, Vereinigte Staaten, 44195
        • Cleveland Clinic Foundation
      • Cleveland, Ohio, Vereinigte Staaten, 44111
        • Cleveland Clinic Cancer Center/Fairview Hospital
      • Columbus, Ohio, Vereinigte Staaten, 43214
        • Riverside Methodist Hospital
      • Columbus, Ohio, Vereinigte Staaten, 43210
        • Ohio State University Comprehensive Cancer Center
      • Columbus, Ohio, Vereinigte Staaten, 43219
        • The Mark H Zangmeister Center
      • Dayton, Ohio, Vereinigte Staaten, 45405
        • Grandview Hospital
      • Findlay, Ohio, Vereinigte Staaten, 45840
        • Orion Cancer Care
      • Mayfield Heights, Ohio, Vereinigte Staaten, 44124
        • Hillcrest Hospital Cancer Center
      • Sylvania, Ohio, Vereinigte Staaten, 43560
        • ProMedica Flower Hospital
      • Toledo, Ohio, Vereinigte Staaten, 43606
        • ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
      • West Chester, Ohio, Vereinigte Staaten, 45069
        • University of Cincinnati Cancer Center-West Chester
      • Wright-Patterson Air Force Base, Ohio, Vereinigte Staaten, 45433
        • Wright-Patterson Medical Center
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
        • University of Oklahoma Health Sciences Center
      • Tulsa, Oklahoma, Vereinigte Staaten, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
      • Tulsa, Oklahoma, Vereinigte Staaten, 74133
        • Cancer Treatment Centers of America
    • Oregon
      • Bend, Oregon, Vereinigte Staaten, 97701
        • Saint Charles Health System
      • Gresham, Oregon, Vereinigte Staaten, 97030
        • Legacy Mount Hood Medical Center
      • Portland, Oregon, Vereinigte Staaten, 97210
        • Legacy Good Samaritan Hospital and Medical Center
      • Tualatin, Oregon, Vereinigte Staaten, 97062
        • Legacy Meridian Park Hospital
    • Pennsylvania
      • Abington, Pennsylvania, Vereinigte Staaten, 19001
        • Jefferson Abington Hospital
      • Bethlehem, Pennsylvania, Vereinigte Staaten, 18015
        • Saint Luke's University Hospital-Bethlehem Campus
      • Bryn Mawr, Pennsylvania, Vereinigte Staaten, 19010
        • Bryn Mawr Hospital
      • Danville, Pennsylvania, Vereinigte Staaten, 17822
        • Geisinger Medical Center
      • Ephrata, Pennsylvania, Vereinigte Staaten, 17522
        • Ephrata Cancer Center
      • Ephrata, Pennsylvania, Vereinigte Staaten, 17522
        • Ephrata Community Hospital
      • Gettysburg, Pennsylvania, Vereinigte Staaten, 17325
        • Adams Cancer Center
      • Hanover, Pennsylvania, Vereinigte Staaten, 17331
        • WellSpan Medical Oncology and Hematology
      • Harrisburg, Pennsylvania, Vereinigte Staaten, 17109
        • UPMC Pinnacle Cancer Center/Community Osteopathic Campus
      • Lebanon, Pennsylvania, Vereinigte Staaten, 17042
        • Sechler Family Cancer Center
      • Lewisburg, Pennsylvania, Vereinigte Staaten, 17837
        • Geisinger Medical Oncology-Lewisburg
      • Paoli, Pennsylvania, Vereinigte Staaten, 19301
        • Paoli Memorial Hospital
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
        • University of Pennsylvania/Abramson Cancer Center
      • Pittsburgh, Pennsylvania, Vereinigte Staaten, 15224
        • West Penn Hospital
      • Sayre, Pennsylvania, Vereinigte Staaten, 18840
        • Guthrie Medical Group PC-Robert Packer Hospital
      • West Reading, Pennsylvania, Vereinigte Staaten, 19611
        • Reading Hospital
      • Wexford, Pennsylvania, Vereinigte Staaten, 15090
        • Wexford Health and Wellness Pavilion
      • Williamsport, Pennsylvania, Vereinigte Staaten, 17701
        • UPMC Susquehanna
      • Willow Grove, Pennsylvania, Vereinigte Staaten, 19090
        • Asplundh Cancer Pavilion
      • Wynnewood, Pennsylvania, Vereinigte Staaten, 19096
        • Lankenau Medical Center
      • York, Pennsylvania, Vereinigte Staaten, 17403
        • WellSpan Health-York Hospital
    • Rhode Island
      • Providence, Rhode Island, Vereinigte Staaten, 02905
        • Women and Infants Hospital
    • South Carolina
      • Anderson, South Carolina, Vereinigte Staaten, 29621
        • AnMed Health Cancer Center
      • Gaffney, South Carolina, Vereinigte Staaten, 29341
        • Gibbs Cancer Center-Gaffney
      • Greenville, South Carolina, Vereinigte Staaten, 29607
        • Saint Francis Cancer Center
      • Greenville, South Carolina, Vereinigte Staaten, 29601
        • Saint Francis Hospital
      • Greer, South Carolina, Vereinigte Staaten, 29651
        • Gibbs Cancer Center-Pelham
      • Hilton Head Island, South Carolina, Vereinigte Staaten, 29926-3827
        • South Carolina Cancer Specialists PC
      • Spartanburg, South Carolina, Vereinigte Staaten, 29303
        • Spartanburg Medical Center
      • Union, South Carolina, Vereinigte Staaten, 29379
        • SMC Center for Hematology Oncology Union
    • South Dakota
      • Rapid City, South Dakota, Vereinigte Staaten, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, Vereinigte Staaten, 57105
        • Avera Cancer Institute
      • Sioux Falls, South Dakota, Vereinigte Staaten, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Vereinigte Staaten, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Kingsport, Tennessee, Vereinigte Staaten, 37660
        • Ballad Health Cancer Care - Kingsport
      • Kingsport, Tennessee, Vereinigte Staaten, 37660
        • Wellmont Holston Valley Hospital and Medical Center
      • Knoxville, Tennessee, Vereinigte Staaten, 37916
        • Covenant Health Cancer Centers
      • Knoxville, Tennessee, Vereinigte Staaten, 37932
        • Covenant Health Cancer Centers - West
      • Nashville, Tennessee, Vereinigte Staaten, 37232
        • Vanderbilt University/Ingram Cancer Center
    • Texas
      • Dallas, Texas, Vereinigte Staaten, 75235
        • Parkland Memorial Hospital
      • Dallas, Texas, Vereinigte Staaten, 75390
        • UT Southwestern/Simmons Cancer Center-Dallas
      • Houston, Texas, Vereinigte Staaten, 77030
        • Houston Methodist Hospital
      • Houston, Texas, Vereinigte Staaten, 77070
        • Methodist Willowbrook Hospital
      • Sugar Land, Texas, Vereinigte Staaten, 77479
        • Houston Methodist Sugar Land Hospital
    • Utah
      • Murray, Utah, Vereinigte Staaten, 84107
        • Intermountain Medical Center
      • Salt Lake City, Utah, Vereinigte Staaten, 84112
        • Huntsman Cancer Institute/University of Utah
      • Salt Lake City, Utah, Vereinigte Staaten, 84106
        • Utah Cancer Specialists-Salt Lake City
      • South Jordan, Utah, Vereinigte Staaten, 84009
        • South Jordan Health Center
      • St. George, Utah, Vereinigte Staaten, 84770
        • Saint George Regional Medical Center
    • Vermont
      • Berlin Corners, Vermont, Vereinigte Staaten, 05602
        • Central Vermont Medical Center/National Life Cancer Treatment
      • Burlington, Vermont, Vereinigte Staaten, 05401
        • University of Vermont Medical Center
      • Burlington, Vermont, Vereinigte Staaten, 05405
        • University of Vermont and State Agricultural College
    • Virginia
      • Charlottesville, Virginia, Vereinigte Staaten, 22908
        • University of Virginia Cancer Center
      • Richmond, Virginia, Vereinigte Staaten, 23235
        • VCU Massey Cancer Center at Stony Point
      • Richmond, Virginia, Vereinigte Staaten, 23298
        • VCU Massey Comprehensive Cancer Center
    • Washington
      • Bellingham, Washington, Vereinigte Staaten, 98225
        • PeaceHealth Saint Joseph Medical Center
      • Edmonds, Washington, Vereinigte Staaten, 98026
        • Swedish Cancer Institute-Edmonds
      • Kennewick, Washington, Vereinigte Staaten, 99336
        • Kadlec Clinic Hematology and Oncology
      • Mount Vernon, Washington, Vereinigte Staaten, 98274
        • Skagit Valley Hospital
      • Mount Vernon, Washington, Vereinigte Staaten, 98274
        • Skagit Regional Health Cancer Care Center
      • Seattle, Washington, Vereinigte Staaten, 98122
        • Swedish Medical Center-First Hill
      • Seattle, Washington, Vereinigte Staaten, 98195
        • University of Washington Medical Center - Montlake
      • Seattle, Washington, Vereinigte Staaten, 98104
        • Pacific Gynecology Specialists
      • Seattle, Washington, Vereinigte Staaten, 98109
        • Fred Hutchinson Cancer Center
      • Seattle, Washington, Vereinigte Staaten, 98133
        • University of Washington Medical Center - Northwest
      • Seattle, Washington, Vereinigte Staaten, 98133
        • Women's Cancer Center of Seattle
      • Vancouver, Washington, Vereinigte Staaten, 98686
        • Legacy Salmon Creek Hospital
      • Wenatchee, Washington, Vereinigte Staaten, 98801
        • Wenatchee Valley Hospital and Clinics
    • West Virginia
      • Charleston, West Virginia, Vereinigte Staaten, 25304
        • Vandalia Health/CAMC Institute for Academic Medicine
      • Huntington, West Virginia, Vereinigte Staaten, 25701
        • Edwards Comprehensive Cancer Center
      • Morgantown, West Virginia, Vereinigte Staaten, 26506
        • West Virginia University Healthcare
      • Morgantown, West Virginia, Vereinigte Staaten, 26505
        • Monongalia Hospital
    • Wisconsin
      • Appleton, Wisconsin, Vereinigte Staaten, 54915
        • Ascension Northeast Wisconsin-Saint Elizabeth Cancer Center-Appleton
      • Burlington, Wisconsin, Vereinigte Staaten, 53105
        • Aurora Cancer Care-Southern Lakes VLCC
      • Chippewa Falls, Wisconsin, Vereinigte Staaten, 54729
        • Marshfield Clinic-Chippewa Center
      • Eau Claire, Wisconsin, Vereinigte Staaten, 54701
        • Marshfield Clinic Cancer Center at Sacred Heart
      • Fond du Lac, Wisconsin, Vereinigte Staaten, 54937
        • Aurora Health Center-Fond du Lac
      • Germantown, Wisconsin, Vereinigte Staaten, 53022
        • Aurora Health Care Germantown Health Center
      • Grafton, Wisconsin, Vereinigte Staaten, 53024
        • Aurora Cancer Care-Grafton
      • Green Bay, Wisconsin, Vereinigte Staaten, 54311
        • Aurora BayCare Medical Center
      • Green Bay, Wisconsin, Vereinigte Staaten, 54301
        • Saint Vincent Hospital Cancer Center Green Bay
      • Green Bay, Wisconsin, Vereinigte Staaten, 54303
        • Saint Vincent Hospital Cancer Center at Saint Mary's
      • Kenosha, Wisconsin, Vereinigte Staaten, 53142
        • Aurora Cancer Care-Kenosha South
      • La Crosse, Wisconsin, Vereinigte Staaten, 54601
        • Gundersen Lutheran Medical Center
      • Ladysmith, Wisconsin, Vereinigte Staaten, 54848
        • Marshfield Medical Center - Ladysmith
      • Madison, Wisconsin, Vereinigte Staaten, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Marinette, Wisconsin, Vereinigte Staaten, 54143
        • Aurora Bay Area Medical Group-Marinette
      • Marinette, Wisconsin, Vereinigte Staaten, 54143
        • Saint Vincent Hospital Cancer Center at Marinette
      • Marshfield, Wisconsin, Vereinigte Staaten, 54449
        • Marshfield Medical Center-Marshfield
      • Mequon, Wisconsin, Vereinigte Staaten, 53097
        • Ascension Columbia Saint Mary's Hospital-Ozaukee Campus-Mequon
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53226
        • Medical College of Wisconsin
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53209
        • Aurora Cancer Care-Milwaukee
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53215
        • Aurora Saint Luke's Medical Center
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53233
        • Aurora Sinai Medical Center
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53211
        • Ascension Columbia Saint Mary's Hospital-Milwaukee Campus
      • Minocqua, Wisconsin, Vereinigte Staaten, 54548
        • Marshfield Medical Center - Minocqua
      • Mukwonago, Wisconsin, Vereinigte Staaten, 53149
        • ProHealth D N Greenwald Center
      • Oconomowoc, Wisconsin, Vereinigte Staaten, 53066
        • ProHealth Oconomowoc Memorial Hospital
      • Oconto Falls, Wisconsin, Vereinigte Staaten, 54154
        • Saint Vincent Hospital Cancer Center at Oconto Falls
      • Oshkosh, Wisconsin, Vereinigte Staaten, 54904
        • Vince Lombardi Cancer Clinic - Oshkosh
      • Oshkosh, Wisconsin, Vereinigte Staaten, 54904
        • Ascension Northeast Wisconsin-Mercy Hospital-Oshkosh
      • Racine, Wisconsin, Vereinigte Staaten, 53406
        • Aurora Cancer Care-Racine
      • Rice Lake, Wisconsin, Vereinigte Staaten, 54868
        • Marshfield Medical Center-Rice Lake
      • Sheboygan, Wisconsin, Vereinigte Staaten, 53081
        • Vince Lombardi Cancer Clinic-Sheboygan
      • Stevens Point, Wisconsin, Vereinigte Staaten, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Stevens Point, Wisconsin, Vereinigte Staaten, 54481
        • Aspirus Cancer Care - Stevens Point
      • Sturgeon Bay, Wisconsin, Vereinigte Staaten, 54235-1495
        • Saint Vincent Hospital Cancer Center at Sturgeon Bay
      • Summit, Wisconsin, Vereinigte Staaten, 53066
        • Aurora Medical Center in Summit
      • Two Rivers, Wisconsin, Vereinigte Staaten, 54241
        • Vince Lombardi Cancer Clinic-Two Rivers
      • Waukesha, Wisconsin, Vereinigte Staaten, 53188
        • UW Cancer Center at ProHealth Care
      • Waukesha, Wisconsin, Vereinigte Staaten, 53188
        • ProHealth Waukesha Memorial Hospital
      • Wausau, Wisconsin, Vereinigte Staaten, 54401
        • Marshfield Clinic-Wausau Center
      • Wauwatosa, Wisconsin, Vereinigte Staaten, 53226
        • Aurora Cancer Care-Milwaukee West
      • West Allis, Wisconsin, Vereinigte Staaten, 53227
        • Aurora West Allis Medical Center
      • Weston, Wisconsin, Vereinigte Staaten, 54476
        • Marshfield Medical Center - Weston
      • Wisconsin Rapids, Wisconsin, Vereinigte Staaten, 54494
        • Marshfield Clinic - Wisconsin Rapids Center

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Weiblich

Beschreibung

Inclusion Criteria:

  • Patients must have histologically or cytologically confirmed ovarian cancer, peritoneal cancer or fallopian tube cancer and must have a histological diagnosis of either serous or endometrioid cancer based on local histopathological findings; both endometrioid and serous histology should be high-grade for eligibility of non-mutation carriers; patients with clear cell, mixed epithelial, undifferentiated carcinoma, or transitional cell carcinoma histologies are also eligible, provided that the patient has a known deleterious germline BRCA1 or BRCA2 mutation identified through testing at a clinical laboratory

    • Note: Due to the long acceptance of BRCA testing through Myriad, Myriad testing will be accepted; if testing for BRCA is done by other organizations, documentation from a qualified medical professional (e.g., ovarian cancer specialty physician involved in the field, high risk genetics physician, genetics counselor) listing the mutation and confirming that the laboratory results showed a recognized germ line deleterious BRCA 1 or BRCA 2 mutation or BRCA rearrangement is required (12/05/2016); a copy of Myriad or other BRCA mutational analysis (positive or variants of unknown significance [VUS] or negative) reports will be requested but not required for study enrollment

  • Patients should have recurrent platinum-resistant or- refractory disease - defined as disease that has progressed by imaging while receiving platinum or had recurrence within 6 months of the last receipt of platinum-based chemotherapy; rising CA125 only is not considered as platinum-resistant or refractory disease (12/05/2016)

  • Phase II study: measurable disease by RECIST 1.1 criteria; if archival tumor sample is not available tumor sample from fresh biopsy is acceptable (12/05/2016)

  • Phase III study: evaluable disease - defined as RECIST 1.1 measurable disease OR non-measurable disease (defined as solid and/or cystic abnormalities on radiographic imaging that do not meet RECIST 1.1 definitions for target lesions OR ascites and/or pleural effusion that has been pathologically demonstrated to be disease-related in the setting of a cancer antigen [CA]125 >= 2 x upper limit of normal [ULN])

  • No more than 3 prior treatment regimens (including primary therapy; no more than 1 prior non-platinum based therapy in the platinum-resistant/-refractory setting); hormonal therapies used as single agents (i.e. tamoxifen, aromatase inhibitors) will not count towards this line limit (12/05/2016)

  • Patients may not have had a prior anti-angiogenic agent in the recurrent setting; prior use of bevacizumab in the upfront or upfront maintenance setting is allowed

  • Patients may not have previously received a PARP-inhibitor

  • Patient must have provided study specific informed consent prior to study entry

  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 or 2

  • Absolute neutrophil count >= 1,500/mcL (12/05/2016)

  • Platelets >= 100,000/mcL (12/05/2016)

  • Hemoglobin >= 10 g/dL (12/05/2016)

  • Total bilirubin within =< 1.5 times the upper limit of normal (ULN) institutional limits (12/05/2016)

  • Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3 x institutional ULN; if intrahepatic liver metastases are present, AST and ALT must be =< 5 times institutional ULN (12/05/2016)

  • Creatinine =< 1.5 x the institutional ULN (12/05/2016)

  • Urine protein: creatinine ratio urine protein creatinine (UPC) of =< 1 OR less than or equal to 2+ proteinuria on two consecutive dipsticks taken no less than 1 week apart; UPC is the preferred test; patients with 2+ proteinuria on dipstick must also have a 24-hour urine collection demonstrating protein of =< 500 mg over 24 hours (12/05/2016)

  • Toxicities of prior therapy (excepting alopecia) should be resolved to less than or equal to grade 1 as per CTCAE; patients with long-standing stable grade 2 neuropathy may be considered after discussion with the study chair.

  • Adequately controlled blood pressure (systolic blood pressure [SBP] =< 140; diastolic blood pressure [DBP] =< 90 mmHg) on maximum of three antihypertensive medications; patients must have a BP of =< 140/90 mmHg taken in the clinic setting by a medical professional within 2 weeks prior to starting study; it is strongly recommended that patients who are on three antihypertensive medications be followed by a cardiologist or a primary care physician for management of BP while on protocol; patients must be willing and able to check and record daily blood pressure readings; blood pressure cuffs will be provided to patients randomized to cediranib alone and the combination of olaparib and cediranib arms (12/05/2016)

  • Adequately controlled thyroid function, with no symptoms of thyroid dysfunction and thyroid-stimulating hormone (TSH) within normal limits (12/05/2016)

  • Able to swallow and retain oral medications and without gastrointestinal (GI) illnesses that would preclude absorption of cediranib or olaparib

  • Age >= 18 years

  • Cediranib has been shown to terminate fetal development in the rat, as expected for a process dependent on VEGF signaling; for this reason, women of child-bearing potential must have a negative pregnancy test prior to study entry; women of child-bearing potential must agree to use two reliable forms of contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 6 weeks after cediranib discontinuation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately

  • Olaparib adversely affects embryofetal survival and development in the rat; for this reason, women of child-bearing potential must have a negative pregnancy test prior to study entry; women of child-bearing potential must agree to use must agree to use two reliable forms of contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 3 months after the last dose of olaparib; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately

Exclusion Criteria:

  • Patients who have had chemotherapy or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) of starting treatment or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier; patients may not have had hormonal therapy within 2 weeks prior to entering the study; patients receiving raloxifene for bone health as per Food and Drug Administration (FDA) indication may remain on raloxifene absent other drug interactions (12/05/2016)

  • Any other investigational agents within the past 4 weeks

  • Prior treatment affecting the VEGF/VEGFR pathway or the angiopoietin pathway in the recurrent setting, including but not limited to thalidomide, bevacizumab, sunitinib, sorafenib, pazopanib, cediranib, nintedanib, and trebananib; bevacizumab used in the upfront setting in conjunction with chemotherapy and/or as maintenance to treat newly diagnosed disease will be allowed

  • Prior use of PARP-inhibitors

  • CA-125 only disease without Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 measurable or otherwise evaluable disease

  • Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to starting cediranib

  • Current signs and/or symptoms of bowel obstruction or signs and/or symptoms of bowel obstruction within 3 months prior to starting study drugs

  • History of intra-abdominal abscess within the past 3 months

  • History of gastrointestinal perforation; patients with a history of abdominal fistula will be considered eligible if the fistula was surgically repaired or has healed, there has been no evidence of fistula for at least 6 months, and patient is deemed to be at low risk of recurrent fistula (12/05/2016)

  • Dependency on IV hydration or total parenteral nutrition (TPN)

  • Any concomitant or prior invasive malignancies with the following curatively treated exceptions:

    • Treated limited stage basal cell or squamous cell carcinoma of the skin
    • Carcinoma in situ of the breast or cervix
    • Primary endometrial cancer meeting the following conditions: stage not greater than IA, grade 1 or 2, no more than superficial myometrial invasion, without vascular or lymphatic invasion; no poorly differentiated subtypes, including papillary serous/serous, clear cell, or other Federation of Gynecology and Obstetrics (FIGO) grade 3 lesions (12/05/2016)
    • Prior cancer treated with a curative intent with no evidence of recurrent disease 5 years following diagnosis and judged by the investigator to be at low risk of recurrence

  • Patients with untreated brain metastases, spinal cord compression, or evidence of symptomatic brain metastases or leptomeningeal disease as noted on computed tomography (CT) or magnetic resonance imaging (MRI) scans should not be included on this study, since neurologic dysfunction may confound the evaluation of neurologic and other adverse events; patients with treated brain metastases and resolution of any associated symptoms must demonstrate stable post-therapeutic imaging for at least 6 months following therapy prior to starting study drug

  • Patients with any of the following:

    • History of myocardial infarction within six months
    • Unstable angina
    • Resting electrocardiogram (ECG) with clinically significant abnormal findings
    • New York Heart Association functional classification of III or IV

  • If cardiac function assessment is clinically indicated or performed: left ventricular ejection fraction (LVEF) less than normal per institutional guidelines, or < 55%, if threshold for normal not otherwise specified by institutional guidelines

    • Patients with the following risk factors should have a baseline cardiac function assessment:

      • Prior treatment with anthracyclines
      • Prior treatment with trastuzumab
      • Prior central thoracic radiation therapy (RT), including RT to the heart
      • History of myocardial infarction within 6 to 12 months (Patients with history of myocardial infarction within 6 months are excluded from the study)
      • Prior history of impaired cardiac function

  • History of stroke or transient ischemic attack within six months

  • Clinical significant peripheral vascular disease or vascular disease (aortic aneurysm or aortic dissection)

  • Evidence of coagulopathy or bleeding diathesis; therapeutic anticoagulation for prior thromboembolic events is permitted

  • Evidence suggestive of myelodysplastic syndrome (MDS) or acute myelogenous leukemia (AML) on peripheral blood smear or bone marrow biopsy, if clinically indicated

    • No prior allogeneic bone marrow transplant or double umbilical cord blood transplantation (dUBCT)

  • Patients may not use any complementary or alternative medicines including natural herbal products or folk remedies as they may interfere with the effectiveness of the study treatments

  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia (other than atrial fibrillation with controlled ventricular rate), or psychiatric illness/social situations that would limit compliance with study requirements (12/05/2016)

  • Known human immunodeficiency virus (HIV)-positive individuals are ineligible because of the potential for pharmacokinetic interactions with cediranib or olaparib; in addition, these individuals are at increased risk of lethal infections when treated with marrow-suppressive therapy

  • Participants receiving any medications or substances that are strong inhibitors or inducers of CYP3A4 are ineligible

    • Strong inhibitors and inducers of UGT/PgP should be used with caution (12/05/2016)

  • Pregnant women are excluded from this study because cediranib and olaparib are agents with the potential for teratogenic or abortifacient effects; because there is an unknown but potential risk of adverse events in nursing infants secondary to treatment of the mother with cediranib and olaparib, breastfeeding should be discontinued if the mother is treated with cediranib or olaparib; these potential risks may also apply to other agents used in this study

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Phase II Arm I (reference regimen)

Patients undergo physician's choice of standard of care chemotherapy, comprising either paclitaxel IV over 60 minutes on days 1, 8, 15, and 22 every 28 days (Regimen I); pegylated liposomal doxorubicin hydrochloride IV over 60 minutes on day 1 every 28 days (Regimen II); or topotecan hydrochloride IV over 30 minutes on days 1, 8, and 15 every 28 days or days 1-5 every 21 days (Regimen III). Treatment continues in the absence of disease progression or unacceptable toxicity. No modification of the assigned regimens, such as additional drugs (gemcitabine, or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Arzneimittel: Paclitaxel

Given IV

Andere Namen:
  • Taxol
  • Anzatax
  • Asotax
  • Bristolxol
  • Praxel
  • Taxol Konzentrat
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Pegylated Liposomal Doxorubicin Hydrochloride

Given IV

Andere Namen:
  • ATI-0918
  • Caelyx
  • Doxil
  • Doxilen
  • Doxorubicin-HCl-Liposom
  • Duomeisu
  • Evakuierung
  • LipoDox
  • Liposomales Adriamycin
  • Liposomal eingekapseltes Doxorubicin
  • Pegyliertes Doxorubicin-HCl-Liposom
  • S-Liposomales Doxorubicin
  • Stealth Liposomales Doxorubicin
  • TLC D-99
  • Dox-SL
  • Doxorubicin-HCl Liposomal
  • Doxorubicin-Hydrochlorid-Liposom
  • Lipodox 50
  • Liposomales Doxorubicin-Hydrochlorid
  • Pegyliertes liposomales Doxorubicin
  • Liposomales Doxorubicin
Arzneimittel: Topotecan

Given IV

Andere Namen:
  • Hycamptamin
  • Topotecan-Lacton
Arzneimittel: Topotecan Hydrochloride

Given IV

Andere Namen:
  • Hycamtin
  • Hycamptamin
  • SKF S-104864-A
  • Topotecan HCl
  • Topotecanhydrochlorid (oral)
  • Potactasol
  • Evotopin
  • Topotec
  • Nogitecanhydrochlorid
  • SKF S 104864 A
  • SKF S104864A
Experimental: Phase II Arm II (cediranib maleate, olaparib)

Patients receive cediranib maleate PO QD and olaparib PO BID. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Cediranib Maleate

Given PO

Andere Namen:
  • AZD2171
  • AZD2171 Maleat
  • Kürzlich
Arzneimittel: Olaparib

Given PO

Andere Namen:
  • Lynparza
  • AZD2281
  • AZD-2281
  • KU-0059436
  • PARP-Inhibitor AZD2281
  • KU0059436
  • Olanib
  • Olaparix
  • KU 0059436
Arzneimittel: Cediranib

Given PO

Andere Namen:
  • AZD2171
  • AZ-D2171
  • AZD 2171
Experimental: Phase II Arm III (cediranib maleate)

Patients receive cediranib maleate PO daily continuously. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Cediranib Maleate

Given PO

Andere Namen:
  • AZD2171
  • AZD2171 Maleat
  • Kürzlich
Arzneimittel: Cediranib

Given PO

Andere Namen:
  • AZD2171
  • AZ-D2171
  • AZD 2171
Experimental: Phase II Arm IV (olaparib)

Patients receive olaparib PO BID on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study. (In July 2018, the Data Monitoring Committee voted to exclude the olaparib alone regimen).
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Olaparib

Given PO

Andere Namen:
  • Lynparza
  • AZD2281
  • AZD-2281
  • KU-0059436
  • PARP-Inhibitor AZD2281
  • KU0059436
  • Olanib
  • Olaparix
  • KU 0059436
Aktiver Komparator: Phase III Arm I (reference regimen)

Patients undergo physician's choice standard of care chemotherapy as in Phase II Arm I. No modification of the assigned regimens, such as additional drugs (gemcitabine or bevacizumab) is allowed. Patients also undergo CT and MRI throughout the study. (12/05/2016)
Arzneimittel: Paclitaxel

Given IV

Andere Namen:
  • Taxol
  • Anzatax
  • Asotax
  • Bristolxol
  • Praxel
  • Taxol Konzentrat
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Pegylated Liposomal Doxorubicin Hydrochloride

Given IV

Andere Namen:
  • ATI-0918
  • Caelyx
  • Doxil
  • Doxilen
  • Doxorubicin-HCl-Liposom
  • Duomeisu
  • Evakuierung
  • LipoDox
  • Liposomales Adriamycin
  • Liposomal eingekapseltes Doxorubicin
  • Pegyliertes Doxorubicin-HCl-Liposom
  • S-Liposomales Doxorubicin
  • Stealth Liposomales Doxorubicin
  • TLC D-99
  • Dox-SL
  • Doxorubicin-HCl Liposomal
  • Doxorubicin-Hydrochlorid-Liposom
  • Lipodox 50
  • Liposomales Doxorubicin-Hydrochlorid
  • Pegyliertes liposomales Doxorubicin
  • Liposomales Doxorubicin
Arzneimittel: Topotecan

Given IV

Andere Namen:
  • Hycamptamin
  • Topotecan-Lacton
Arzneimittel: Topotecan Hydrochloride

Given IV

Andere Namen:
  • Hycamtin
  • Hycamptamin
  • SKF S-104864-A
  • Topotecan HCl
  • Topotecanhydrochlorid (oral)
  • Potactasol
  • Evotopin
  • Topotec
  • Nogitecanhydrochlorid
  • SKF S 104864 A
  • SKF S104864A
Experimental: Phase III Arm II (cediranib maleate, olaparib)

Patients receive cediranib maleate PO and olaparib PO as in Phase II Arm II. Patients also undergo CT and MRI throughout the study.
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Cediranib Maleate

Given PO

Andere Namen:
  • AZD2171
  • AZD2171 Maleat
  • Kürzlich
Arzneimittel: Olaparib

Given PO

Andere Namen:
  • Lynparza
  • AZD2281
  • AZD-2281
  • KU-0059436
  • PARP-Inhibitor AZD2281
  • KU0059436
  • Olanib
  • Olaparix
  • KU 0059436
Arzneimittel: Cediranib

Given PO

Andere Namen:
  • AZD2171
  • AZ-D2171
  • AZD 2171
Experimental: Phase III Arm III (single-agent cediranib maleate)

Patients receive cediranib maleate PO as determined by the Phase II study. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT and MRI throughout the study.
Verfahren: Computed Tomography

Undergo CT

Andere Namen:
  • CT
  • KATZE
  • Computertomographie
  • Computergestützte axiale Tomographie
  • CT-Scan
  • Tomographie
  • Computerisierte Axialtomographie (Verfahren)
  • Computertomographie (CT)-Scan
  • Diagnosekatze Scan
  • Diagnose -Katzen -Scan -Service -Typ
Verfahren: Magnetic Resonance Imaging

Undergo MRI

Andere Namen:
  • MRT
  • Magnetresonanz
  • Magnetresonanztomographie-Scan
  • Medizinische Bildgebung, Magnetresonanz / Kernspinresonanz
  • HERR
  • MR-Bildgebung
  • MRT-Untersuchung
  • NMR-Bildgebung
  • NMRI
  • Kernspinresonanztomographie
  • Magnetresonanztomographie (MRT)
  • sMRT
  • Magnetresonanztomographie (Verfahren)
  • MRTs
  • Strukturelle MRT
Sonstiges: Questionnaire Administration

Ancillary studies

Arzneimittel: Cediranib Maleate

Given PO

Andere Namen:
  • AZD2171
  • AZD2171 Maleat
  • Kürzlich
Arzneimittel: Cediranib

Given PO

Andere Namen:
  • AZD2171
  • AZ-D2171
  • AZD 2171

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Progression-free Survival (PFS) (Phase II Only)
Zeitfenster: The protocol required lesion assessments every 9 weeks from cycle 1, day 1 for the first year, then every 12 weeks thereafter until disease progression. Approximately 42 months.

Progression free survival (PFS) was defined as the number of months between study enrollment and documentation of disease progression (RECIST 1.1) or death from any cause. Patients still alive and disease free at the last follow-up were censored on the date of last CT Scan, or the CT Scan date prior to two missed assessments.

Disease progression is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).
The protocol required lesion assessments every 9 weeks from cycle 1, day 1 for the first year, then every 12 weeks thereafter until disease progression. Approximately 42 months.
Progression-free Survival (PFS) (Phase III Only)
Zeitfenster: The protocol required lesion assessments every 9 weeks from cycle 1, day 1 for the first year, then every 12 weeks thereafter until disease progression. Approximately 42 months.

Progression free survival (PFS) was defined as the number of months between study enrollment and documentation of disease progression (RECIST 1.1) or death from any cause. Patients still alive and disease free at the last follow-up were censored on the date of last CT Scan, or the CT Scan date prior to two missed assessments.

Disease progression is defined as at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study). In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. (Note: the appearance of one or more new lesions is also considered progression).
The protocol required lesion assessments every 9 weeks from cycle 1, day 1 for the first year, then every 12 weeks thereafter until disease progression. Approximately 42 months.
Overall Survival (OS) (Phase III Only)
Zeitfenster: Time from study enrollment to death due to any cause, assessed up to 5 years

Overall survival will be evaluated. To allow for better understanding of time to subsequent therapy and OS, patients on experimental study drug(s) or standard chemotherapy arm will be followed after progression, with data capture to include the date of initiation of the subsequent therapy, detailed information on the type of subsequent therapy received, and time to progression on the subsequent therapy.
Time from study enrollment to death due to any cause, assessed up to 5 years

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Objective Response Rate (Complete Response and Partial Response) (Phase II Only)
Zeitfenster: Up to 5 years

The Response Rates were estimated as the binomial proportion of patients with Best Overall Response of Complete or Partial response according to RECIST 1.1 criteria.

A Complete response (CR) is defined as the complete disappearance of all target lesions, while a Partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameters of target lesions compared to the baseline measurement; essentially, the tumor shrinks significantly but does not completely disappear. Overall response (OR) = CR + PR.
Up to 5 years
Objective Response Rate (Complete Response and Partial Response for Phase III Only)
Zeitfenster: Up to 5 years

The Response Rates were estimated as the binomial proportion of patients with Best Overall Response of Complete or Partial response according to RECIST 1.1 criteria.

A Complete response (CR) is defined as the complete disappearance of all target lesions, while a Partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameters of target lesions compared to the baseline measurement; essentially, the tumor shrinks significantly but does not completely disappear. Overall response (OR) = CR + PR.
Up to 5 years
Incidence of Grade 3 (or Higher) Adverse Events
Zeitfenster: Up to 5 years

Adverse events will be categorized by CTCAE V4.0. This outcome will report the count of participants who experienced a grade 3 (or higher) adverse event.
Up to 5 years

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Patient-reported Scores of Disease-related Symptoms
Zeitfenster: Up to 5 years

Measured by the 9-item Disease Related Symptoms (DRS-9) subscale of the National Comprehensive Cancer Network (NCCN)-Functional Assessment of Cancer Therapy (FACT) Ovarian Symptom Index (NFOSI-18).
Up to 5 years
Gene Mutations Assessed BROCA-HR
Zeitfenster: Up to 5 years

A single proportional hazards model will be used to estimate the treatment hazard ratios (and variances) for each of the experimental treatments selected for phase III evaluation relative to the reference treatment (chemotherapy) group. The model will include adjustments for prior platinum-free interval, prior bevacizumab treatment, age at study enrollment, randomly assigned study treatment and BROCA-HR status. The estimated hazard ratio(s) for BROCA-HR and the corresponding confidence intervals will be depicted with a forest plot, and assessed for qualitative interaction(s).
Up to 5 years
Change in Circulating Endothelial Cell Levels
Zeitfenster: Baseline up to 5 years

A proportional hazards model will be used to assess a linear association between the change in circulating endothelial cell values and the log relative hazard of death within each treatment group. Sensitivity analyses will include known prognostic factors in the model. A plot of the martingale residuals or estimated relative hazards by change in circulating endothelial cell quintiles will be used to qualitatively assess the assumption of a linear relationship between the change in circulating endothelial cell values and the log relative hazard.
Baseline up to 5 years
Biomarkers in Plasma Angiome
Zeitfenster: Up to 5 years

A proportional hazards model will be used to assess whether the pretreatment values of any of these analytes have a prognostic association with overall survival. The model will include clinical covariates: age, performance status, and the randomly assigned study treatment. Proportional hazards models will be used to assess the relationship between patients' analyte values and log hazard. A proportional hazards model will be used to assess the potential predictive associations between analytes, treatment and survival.
Up to 5 years

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

National Cancer Institute (NCI)

Mitarbeiter

NRG Oncology
Canadian Cancer Trials Group

Ermittler

  • Hauptermittler: Jung-min Lee, NRG Oncology

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Allgemeine Veröffentlichungen

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

3. Mai 2016

Primärer Abschluss (Tatsächlich)

12. Juni 2023

Studienabschluss (Geschätzt)

4. März 2027

Studienanmeldedaten

Zuerst eingereicht

17. Juli 2015

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

17. Juli 2015

Zuerst gepostet (Geschätzt)

20. Juli 2015

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

1. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

30. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • NCI-2015-00651
  • U10CA180868 (US NIH Stipendium/Vertrag)
  • NCI-2015-00651 (Registrierungskennung: CTRP (Clinical Trial Reporting Program))
  • NRG-GY005 (Andere Kennung: CTEP)
  • s16-01681
  • NRG-GY005
  • NRG-GY005 (Andere Kennung: NRG Oncology)

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