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Phase I Dose Escalation Study of N-acetylcysteine (NAC) Administered Intravenously (IV) in Conjunction With Intraperitoneal (IP) Administered Cisplatin and IV/IP Paclitaxel in Patients With Stage III or IV Ovarian Cancer

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City:   Portland
State:   Oregon
Zip Code:   97239
Conditions:   Ovarian Carcinoma, Stage 3 or 4 - Epithelial Ovarian Carcinoma - Primary Peritoneal Carcinoma
Purpose:   RATIONAL FOR STUDYING IV NAC AS POTENTIAL CHEMOPROTECTANT: Cisplatin has shown efficacy in the treatment of subjects with epithelial ovarian cancer. Systemic toxicities associated with cisplatin include nephro, oto, and nerve toxicities. It may be possible to reduce the toxicities of cisplatin by administering it in conjunction with IV NAC. NAC may reduce cisplatin related nephro, oto, and nerve toxicities without compromising the effectiveness of the chemotherapy against the ovarian cancer cells. It is possible that this combination of drugs may in the future allow ovarian cancer patients to receive the full series of IP cisplatin-paclitaxel chemotherapy, with fewer side effects and improved survival. It is hypothesized that the proposed treatment of stage III or IV epithelial ovarian cancer with IP cisplatin and IV/IP paclitaxel in conjunction with IV NAC will limit the neurotoxicity, nephrotoxicity and ototoxicity that is associated with cisplatin administration.
Study Summary:   OBJECTIVES: PRIMARY: To determine the Maximum Tolerated Dose (MTD) and assess the toxicity of IV NAC in conjunction with IP cisplatin and IV/IP paclitaxel in subjects with stage 3 or 4 epithelial ovarian cancer that has been surgically debulked SECONDARY: - To describe tumor response in subjects receiving treatment for previously debulked stage 3 or 4 epithelial ovarian cancer with IP cisplatin, IV/IP paclitaxel , and IV NAC. - To describe the incidence and severity of nephrotoxicity ( Creatinine Clearance [CrCl]) in subjects undergoing treatment for stage 3 or 4 epithelial ovarian cancer with IP cisplatin, IV paclitaxel and IV NAC and who have had their disease surgically debulked. - To describe the incidence and severity of hearing loss in subjects undergoing treatment for stage 3 or 4 epithelial ovarian cancer with IP cisplatin, IV/IP paclitaxel and IV NAC and who have had their disease surgically debulked. - To describe the incidence and severity of peripheral and autonomic neuropathy in subjects undergoing treatment for stage 3 or 4 epithelial ovarian cancer with IP cisplatin, IV/IP Taxol and IV NAC and who have had their disease surgically debulked. OUTLINE: Subjects will undergo chemotherapy for epithelial ovarian cancer with paclitaxel IV, 135 mg/m2 (Day 1) and IP cisplatin 100 mg/m2 (Day2), followed by Taxol IP, 60 mg/m2 (Day 8) every 3 weeks for 6 courses. Sixty minutes prior to each course of IP cisplatin, IV NAC (starting at 150 mg/kg) will be infused over 30 minutes. A dose escalation schema for NAC will be followed. Toxicity to the therapy will be graded according to the Common Terminology Criteria for Adverse Events.
Criteria:   Inclusion Criteria: - Signed written informed consent in accordance with institutional guidelines - Histologically confirmed diagnosis of stage 3 or 4 epithelial ovarian or primary peritoneal carcinoma - Have had debulking surgery with optimal tumor cytoreduction - Standard treatment offered for ovarian cancer including systemic or intraperitoneal cisplatin with systemic taxane-based chemotherapy - Age ≥ 18 years to ≤ 75 years - Laboratory testing within 14 days of registration: - White blood cell count ≥ 2.5 x 103/mm3 - Absolute granulocyte count ≥ 1.2 x 103/mm3 - Platelets ≥ 100 x 103/mm3 - Creatinine < 1.8 - Bilirubin < 2.0 - SGOT/SGPT < 2.5 x institutional upper limits of normal - Performance status must be ECOG < 2 (Karnofsky ≥ 50) - Life expectancy of ≥ 60 days from the date of registration Exclusion Criteria: - Pregnant, positive beta hCG, or lactating - History of clinically significant reactive airway disease - Active significant cardiac disease as evidenced by New York Heart Association Classification for CHF, Class III or IV - Uncontrolled (over the last 30 days) clinically significant confounding medical conditions - Allergies or other contraindications to IP cisplatin, IV Taxol, or IV NAC.
NCT ID:   NCT01138137
Primary Contact:   Principal Investigator
Edward A Neuwelt, MD
Knight Cancer Institute at Oregon Health & Science University

Edward A Neuwelt, MD
Phone: 503-494-5626
Email: neuwelte@ohsu.edu
Backup Contact:   Email: hedrickn@ohsu.edu
Nancy A Hedrick, BA
Phone: 503-494-5626
Location Contact:   Portland, Oregon 97239
United States

Edward A Neuwelt, MD
Phone: 503-494-5626
Email: neuwelte@ohsu.edu

Site Status: Recruiting

Data Source:   ClinicalTrials.gov
Date Processed:   May 22, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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