Ovarian Cancer, Fallopian Tube Cancer, Peritoneal Cancer, Ovarian Diseases, Fallopian Tube Diseases, Peritoneal Diseases
Conditions
Keywords
high-grade serous cancer, stage III cancer, stage IV cancer
Brief summary
While significant progress has been made in the treatment and prognosis of ovarian cancer, this progress has mostly shown benefits for younger women. This study aims to understand two things: How body composition (the amount of muscle and water versus fat in in the body) affects the dose and side effects of chemotherapy; and the biological reason for the worse prognosis with aging. To get a good view of these effects, investigators are asking the help of both younger and older women for this project.
Interventions
PROCEDUREBaseline Biopsy
Baseline biopsy (and ascites fluid sampling if applicable). This is done during the normal work-up procedures.
PROCEDURETissue Collection
Tissue collection during debulking surgery.
PROCEDUREBlood Draws
Blood samples for paclitaxel and carboplatin plasma levels will be collected in the study. Paclitaxel will be measured on cycle 1 day 1 at predose and then at the end of the infusion, followed by 1, 2, 4, 8 hours after the end of infusion, then on cycle 1 day 2 at 24 hours after the end of infusion. Carboplatin will be sampled for on cycle 1 day 1 at predose and then at the end of the infusion, followed by 0.5, 1.5, 3.5, 7.5 hours after the end of infusion, then on cycle 1 day 2 at 23.5 hours after the end of infusion.
Sponsors
The V Foundation for Cancer Research
Kay Yow Cancer Fund
H. Lee Moffitt Cancer Center and Research Institute
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Participants must have one of the following: a) Histological or cytological diagnosis of high-grade serous ovarian, fallopian, or peritoneal cancer, stage III or IV; b) In the opinion of investigator, highly suspicious stage III or IV ovarian, fallopian, or peritoneal cancer (histologically confirmed non-serous ovarian, fallopian, and peritoneal cancers will be considered screening failures). * At least one biopsiable lesion by CT/US or laparoscopy. * Have not received previous treatment for ovarian cancer. * Life expectancy of greater than 6 months. * Eastern Cooperative Oncology Group (ECOG) performance status \<3 (Karnofsky \>60%). * Must have adequate organ and marrow function. * Deemed eligible for neo-adjuvant chemotherapy with carboplatin and paclitaxel and surgery by their oncologist. * Women of child-bearing potential must agree to use adequate contraception prior to study entry and for the duration of study participation. * Ability to understand and the willingness to sign a written informed consent document.
Exclusion criteria
* Active second malignancy within last 2 years (except non-melanoma skin cancer or in situ carcinomas. * Prior treatment for ovarian cancer. * Potential participants with known brain metastases will be excluded from this clinical trial. * History of allergic reactions attributed to compounds of similar chemical or biologic composition to carboplatin and paclitaxel. * Known allergy to carboplatin, paclitaxel, or cremophor. * Uncontrolled concomitant illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. * Women who are pregnant. Breastfeeding should be discontinued if the mother is treated with carboplatin and paclitaxel. These potential risks may also apply to other agents used in this study. * HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with carboplatin and paclitaxel or other agents administered during the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation of Skeletal Muscle Index and Fat Index With AUC | 6 months | Assess the correlation of skeletal muscle index and fat index with the AUC of carboplatin and paclitaxel. Pearson's correlation tests will be performed to assess the correlation of skeletal muscle index and fat index with the AUC of carboplatin and paclitaxel. |
| Correlation of Skeletal Muscle Index, Fat Index and AUC with Toxicity | 6 months | Correlate skeletal muscle index, fat index, and AUC with toxicity from preoperative chemotherapy (CTCAE 4.0), nadir neutrophil counts, and relative dose-intensity (RDI). Pearson's correlation tests will be performed to assess skeletal muscle index, fat index, and AUC with toxicity from preoperative chemotherapy, nadir neutrophil counts, and relative dose-intensity (RDI). |
| Association of Age With Changes | 6 months | Assess the association of age with changes in mean values, variance, or strength or correlation under 1A and 1B. Unpaired t-tests, Mann-Whitney tests and ANOVA tests will be performed to assess the differences between young (\<70) and old (\>=70) patients in means, medians and variances of body composition, AUC, toxicity from preoperative chemotherapy, nadir neutrophil counts and RDI. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Impact of Inflammation on Toxicity and Relative Dose-Intensity (RDI) | 6 months | Assess the impact of inflammation on toxicity and RDI. Pearson's correlation tests will be performed to assess the impact of inflammation on toxicity and RDI. |
| Correlation of Age With Gene Expression Changes | 6 months | Assess the correlation with age of gene expression changes in the tumor and its micro-environment before and after neoadjuvant chemotherapy and its correlation with tumor response. Pearson's correlation tests will be performed on age vs. gene expressions, micro-environment and tumor responses before and after neoadjuvant chemotherapy. Paired t-tests will be performed to assess gene expression changes in tumor and its micro-environment before and after neoadjuvant chemotherapy. |
| Impact of Inflammation on Gene Expression and Response | 6 months | Assess the impact of inflammation, as assessed by serum and ascites cytokines on gene expression and response, and its correlation with age. Pearson's correlation tests will be performed to assess the impact of inflammation, as assessed by serum and ascites cytokines on gene expression and response, and its correlation with age. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | 12 months | Correlate the primary and secondary parameters with OS. Multivariate survival tests using Cox Proportional Hazard model and log-rank tests will be performed to assess the above parameters with overall survival. Given the observational nature of this study, no Bonferroni adjustment is planned. |
| Relapse Free Survival (RFS) | 12 months | Correlate the primary and secondary parameters with RFS. Multivariate survival tests using Cox Proportional Hazard model and log-rank tests will be performed to assess the above parameters with relapse-free survival. Given the observational nature of this study, no Bonferroni adjustment is planned. |
Countries
United States
Outcome results
None listed