Ovarian Cancer Clinical Trial
PV701 in Treating Patients With Advanced or Recurrent Peritoneal Cancer
Summary
RATIONALE: PV701 may be able to kill tumor cells while leaving normal cells undamaged.
PURPOSE: Phase I trial to study the effectiveness of PV701 in treating patients who have advanced or recurrent ovarian epithelial, fallopian tube, primary peritoneal, colorectal, or other cancer found primarily within the peritoneal cavity.
Full Description
OBJECTIVES:
Determine the dose-limiting toxicity and maximum tolerated dose of intraperitoneal PV701 after desensitization in patients with advanced or recurrent malignancy largely confined to the peritoneal cavity these patients.
Determine the optimal desensitization dose of intravenous PV701 in these patients.
Determine the safety of this drug, in terms of cumulative toxicity, in these patients.
Determine, preliminarily, the antitumor activity of this drug in these patients.
Determine the presence and duration of viral shedding, viremia, and immunogenicity of this drug.
OUTLINE: This is an open-label, dose-escalation study comprising 2 different treatment schedules.
Schedule I (optimal desensitization dose): Patients receive PV701 IV over 30 minutes on day 1 followed by intraperitoneal (IP) PV701 on days 4, 7, and 9. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.
Cohorts of 3-6 patients receive escalating doses of PV701 IV and IP until the optimal desensitization dose (ODD) is determined. The ODD is defined as the dose preceding that at which at least 2 of 6 patients experience dose-limiting toxicity (DLT).
Schedule II (maximum tolerated dose):Patients receive the same regimen as in schedule I using PV701 IV at the ODD.
Cohorts of 3-6 patients receive escalating doses of PV701 IP until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 6 patients experience DLT.
PROJECTED ACCRUAL: A total of 3-50 patients will be accrued for this study within 10-17 months.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histological confirmation of 1 of the following:
Ovarian epithelial carcinoma
Fallopian tube cancer
Primary peritoneal cancer
Advanced colorectal carcinoma
Other malignancy confined to the peritoneal cavity or peritoneal surfaces
No lesion greater than 2 cm in greatest diameter based on surgical re-assessment
Low burden of tumor in the abdominal or pelvic cavities and no clinically significant ascites
Received potentially effective therapy when available (e.g., platinum/taxane for ovarian cancer, fluoropyrimidine-based therapy for colorectal cancer)
No concurrent hematological malignancy (e.g., chronic lymphocytic leukemia or non-Hodgkin's lymphoma)
No bilateral adrenal metastases
No adrenal metastases in the remaining adrenal gland after adrenalectomy (including radical nephrectomy)
No lung tumors 5 cm or more
No pleural effusions (at least 25% of hemithorax) by radiography
No CNS metastases by CT scan or MRI
PATIENT CHARACTERISTICS:
Age
18 and over
Performance status
Karnofsky 70-100%
Life expectancy
More than 3 months
Hematopoietic
WBC at least 3,000/mm^3
Absolute neutrophil count at least 1,000/mm^3
Platelet count at least 100,000/mm^3
Hemoglobin greater than 9 g/dL
Hepatic
Bilirubin no greater than 1.5 times upper limit of normal (ULN)
AST and ALT no greater than 1.5 times ULN
Alkaline phosphatase no greater than 1.5 times ULN
No uncontrolled hepatic dysfunction
No active hepatitis B or C
Renal
See Disease Characteristics
Creatinine no greater than 1.6 mg/dL AND/OR
Creatinine clearance at least 50 mL/min
No uncontrolled renal dysfunction
Cardiovascular
No uncontrolled cardiovascular dysfunction
No myocardial infarction within the past 6 months
No life-threatening arrhythmias within the past 6 months
Pulmonary
See Disease Characteristics
No uncontrolled pulmonary dysfunction
No pulmonary atelectasis (lobar)
No pulmonary infiltrates (lobar)
No pulmonary consolidation (lobar or segmental)
No baseline grade II dyspnea
Adrenal
See Disease Characteristics
No uncontrolled adrenal dysfunction
No known adrenal insufficiency
Other
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No uncontrolled gastrointestinal dysfunction
No neurological dysfunction
No serious medical or psychological condition that would preclude study participation or increase the risk of adverse effects of the study treatment
No history of serious immunodeficiency
No active uncontrolled bacterial infection (including asymptomatic urinary tract infection)
No contraindication to intraperitoneal therapy including the following:
Intra-abdominal infection
Dense widespread adhesions
Peritonitis
Periumbilical infection
Bowel obstruction
Ileostomy
No hypersensitivity to eggs
No continued contact with live birds (e.g., poultry farmers, veterinarians, laboratory technicians, pet store owners, breeders)
PRIOR CONCURRENT THERAPY:
Biologic therapy
Not specified
Chemotherapy
See Disease Characteristics
No more than 3 prior cytotoxic chemotherapy regimens
More than 30 days since prior chemotherapy
Endocrine therapy
More than 14 days since prior systemic corticosteroids
Radiotherapy
More than 30 days since prior radiotherapy
Surgery
See Disease Characteristics
No prior complete or partial lobectomy with removal of lung tissue at least segmental size
No prior organ allograft
Other
Recovered from prior therapy
More than 14 days since prior antiviral medication
More than 4 weeks since prior immunosuppressive drugs
No other concurrent investigational drugs
No concurrent chronic immunosuppressive drugs (e.g., cyclosporine)
No vaccination for influenza within 48 hours of study drug administration
No concurrent hypoglycemic agents
No concurrent antiretroviral therapy for HIV-positive patients
No other concurrent anticancer therapy
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There is 1 Location for this study
New York New York, 10021, United States
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