Ovarian Cancer Clinical Trial

Viral Therapy in Treating Patients With Ovarian Epithelial Cancer, Primary Peritoneal Cancer, or Fallopian Tube Cancer That Did Not Respond to Platinum Chemotherapy

Summary

This phase I/II trial is studying the side effects and best dose of viral therapy in treating patients with ovarian epithelial cancer, primary peritoneal cancer, or fallopian tube cancer that did not respond to platinum chemotherapy (phase II closed as of 1/7/2011). Viral therapy may be able to kill tumor cells without damaging normal cells.

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Full Description

PRIMARY OBJECTIVES:

I. Determine the safety and tolerability of intravenous (IV) and intraperitoneal (IP) administration of wild-type reovirus (REOLYSIN®).

II. Determine the maximum tolerated dose of IP REOLYSIN® when used with a fixed dose of IV REOLYSIN®.

III. Determine the objective response rate (complete response and partial response per Response Evaluation Criteria in Solid Tumors [RECIST] criteria) of treatment with IV and IP REOLYSIN® in patients with recurrent, platinum-refractory ovarian epithelial, peritoneal, or fallopian tube carcinoma. (Phase II) (phase II closed as of 1/7/2011).

SECONDARY OBJECTIVES:

I. To identify viral replication in tumor following IV reovirus. II. To identify anti-reovirus antibodies in patients being treated with IV and IP REOLYSIN® therapy.

III. To identify viral replication in the abdominal washings of patients undergoing IV and IP REOLYSIN® therapy.

IV. To correlate response to therapy with Ras oncogene status. V. To evaluate double-stranded RNA-activated protein kinase activity in tumors. VI. To correlate molecular predictors of response to REOLYSIN® therapy.

OUTLINE: This is a phase I, dose-escalation study of intraperitoneal (IP) wild-type reovirus when administered with fixed dose IV wild-type reovirus.

PHASE I: Patients receive wild-type reovirus IV over 60 minutes on days 1-5 in course 1, followed by insertion of an IP access port. Beginning in course 2, patients receive wild-type reovirus IV over 60 minutes on days 1-5 and wild-type reovirus IP over 10 minutes on days 1 and 2*. Treatment with IV and IP wild-type reovirus repeats every 28 days in the absence of disease progression or unacceptable toxicity.

PHASE II: Patients undergo IP access port insertion before beginning treatment. Patients receive wild-type reovirus IV over 60 minutes on days 1-5 and IP (at the maximum tolerated dose determined in phase I) over 10 minutes on days 1 and 2*. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity (phase II closed as of 1/7/2011). NOTE: *Patients receive IP wild-type reovirus on days 2 and 3 in course 3.

Prior to each IP wild-type reovirus administration, normal saline is administered through the IP catheter and withdrawn for correlative studies in courses 2 and 3 (phase I) or courses 1 and 2 (phase II). Patients also undergo a CT-guided percutaneous tumor biopsy on day 2 of course 3 (phase I or II). Samples are analyzed by immunohistochemistry, RT-PCR, and electron microscopy for the relevant molecular effects of wild-type reovirus on tumor and normal tissue.

After completion of study treatment, patients are followed for up to 12 weeks.

View Eligibility Criteria

Eligibility Criteria

Inclusion Criteria:

Histologically confirmed ovarian epithelial, primary peritoneal, or fallopian tube cancer

Recurrent disease after platinum-based chemotherapy

Must have experienced disease persistence during primary platinum-based therapy or recurrence within 12 months after completion of platinum-based chemotherapy ("platinum-refractory" or "platinum-resistant" disease)

A patient receiving a second course of platinum-based chemotherapy for platinum-sensitive disease who then develops persistence or recurrence within 12 months is considered eligible for this trial
Must have measurable disease by RECIST criteria (phase II) (phase II closed as of 1/7/2011)

Must have received ≥ 1 prior platinum-based cytotoxic chemotherapy regimen (for primary disease) containing carboplatin, cisplatin, or other organoplatinum compound

Initial treatment may have included any of the following:

High-dose therapy
Consolidation therapy
Intraperitoneal (IP) therapy
Extended therapy administered after surgical or nonsurgical assessment
One additional non-cytotoxic regimen (e.g., monoclonal antibodies, cytokines, or small-molecule inhibitors) for recurrent or persistent disease allowed
Patients may have received hormonal therapy for management of disease (e.g., SERMs, aromatase inhibitors, progestins, and GnRH agonists)
No loculated ascites for which IP distribution of virus is not expected to be feasible
No known brain metastases
GOG performance status (PS) 0-2 (Karnofsky PS 60-100%)
Life expectancy > 12 weeks
Leukocytes ≥ 3,000/mcL
Absolute neutrophil count ≥ 1,500/mcL
Hemoglobin ≥ 10 g/dL
Platelets ≥ 100,000/mcL
Total bilirubin normal
AST/ALT ≤ 2.5 times upper limit of normal
Creatinine normal
Ejection fraction > 50% by echocardiogram or MUGA
Cardiac enzymes normal
Not pregnant or nursing
Fertile patients must use adequate contraception (hormonal or barrier method of birth control or abstinence) prior to study entry and for the duration of study participation
Must be able to avoid direct contact with pregnant or nursing women, infants, or immunocompromised individuals while on study and for ≥ 3 weeks following the last dose of study agent administration
Cardiac conduction abnormalities (e.g., bundle branch block, heart block) are allowed if their cardiac status has been stable for 6 months before study entry
At least 4 weeks since most recent cytotoxic chemotherapy (6 weeks for nitrosoureas or mitomycin C)
Recovered from adverse events due to agents administered more than 4 weeks earlier
No prior radiotherapy to the abdomen or pelvis
No other concurrent investigational agents
No investigational or commercial agents or therapies other than those described below may be administered with the intent to treat the patient's malignancy

Exclusion Criteria:

Patients in whom insertion of an IP catheter is not feasible due to surgical contraindications or abdominal and pelvic adhesions
Known HIV infection or hepatitis B or C

Clinically significant cardiac disease (New York Heart Association class III or IV cardiac disease) including any of the following:

Pre-existing arrhythmia
Uncontrolled angina pectoris
Myocardial infarction 1 year prior to study entry
Compromised left ventricular ejection fraction ≥ grade 2 by MUGA or echocardiogram
Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, or psychiatric illness/social situations that would limit compliance with study requirements

Chronic oral steroids at an equivalent dose of prednisone 5 mg daily

Inhaled steroids allowed
Patients on immunosuppressive therapy
Concurrent routine prophylactic use of growth factor (filgrastim [G-CSF] or sargramostim [GM-CSF])

Study is for people with:

Ovarian Cancer

Phase:

Phase 1

Estimated Enrollment:

70

Study ID:

NCT00602277

Recruitment Status:

Completed

Sponsor:

National Cancer Institute (NCI)

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There is 1 Location for this study

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Ohio State University Comprehensive Cancer Center
Columbus Ohio, 43210, United States

How clear is this clinincal trial information?

Study is for people with:

Ovarian Cancer

Phase:

Phase 1

Estimated Enrollment:

70

Study ID:

NCT00602277

Recruitment Status:

Completed

Sponsor:


National Cancer Institute (NCI)

How clear is this clinincal trial information?

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