NCT01414608

Cisplatin and Radiation Therapy With or Without Carboplatin and Paclitaxel in Patients With Locally Advanced Cervical Cancer

Official Title:

A Phase III Trial of Adjuvant Chemotherapy Following Chemoradiation as Primary Treatment for Locally Advanced Cervical Cancer Compared to Chemoradiation Alone: The OUTBACK Trial

Summary

This randomized phase III trial studies how well giving cisplatin and radiation therapy together with or without carboplatin and paclitaxel works in treating patients with cervical cancer has spread from where it started to nearby tissue or lymph nodes. Drugs used in chemotherapy, such as cisplatin, carboplatin, and paclitaxel, work in different ways to stop the growth of \[cancer/tumor\] cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. External radiation therapy uses high-energy x rays to kill tumor cells. Internal radiation uses radioactive material placed directly into or near a tumor to kill tumor cells. It is not yet known whether giving cisplatin and external and internal radiation therapy together with carboplatin and paclitaxel kills more tumor cells.

Eligibility

Inclusion Criteria:

* Eligible patients will have locally advanced cervical cancer suitable for primary treatment with chemoradiation with curative intent, in addition to:

* Federation of Gynecology and Obstetrics (FIGO) 2008 stage IB1 \& node positive, IB2, IIA, IIB, IIIB, or IVA disease
* Eastern Cooperative Oncology Group (ECOG) performance status 0-2
* Histological diagnosis of squamous cell carcinoma, adenocarcinoma or adenosquamous cell carcinoma of the cervix
* White blood cells (WBC) >= 3.0 x 10\^9/L
* Absolute neutrophil count (ANC) >= 1.5 x 10\^9/L
* Platelet count >= 100 x 10\^9/L
* Bilirubin =< 1.5 times upper limit of normal (ULN)
* Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) =< 2.5 x ULN (if both tests are done, both results need to be =< 2.5 x ULN)
* Creatinine =< ULN (Common Toxicity Criteria \[CTC\] grade 0) OR calculated creatinine clearance (Cockcroft-Gault formula) >= 60 mL/min OR >= 50 mL/min by ethylenediaminetetraacetic acid (EDTA) creatinine clearance
* Written informed consent

Exclusion Criteria:

* Any previous pelvic radiotherapy
* Para-aortic nodal involvement above the level of the common iliac nodes or L3/L4 (if biopsy proven, PET positive, or >= 15 mm short-axis diameter on computed tomography \[CT\])
* FIGO 2008 stage IIIA disease
* Patients assessed at presentation as requiring interstitial brachytherapy treatment
* Patients with bilateral hydronephrosis unless at least one side has been stented and renal function fulfills the required inclusion criteria
* Previous chemotherapy for this tumor
* Evidence of distant metastases
* Prior diagnosis of Crohn's disease or ulcerative colitis
* Peripheral neuropathy >= grade 2 (per Common Terminology Criteria for Adverse Events \[CTCAE\] version \[v\]4)
* Patients who have undergone a previous hysterectomy or will have a hysterectomy as part of their initial cervical cancer therapy; this includes patients with a prior history of supracervical hysterectomy
* Patients with other invasive malignancies, with the exception of non-melanoma skin cancer and in situ melanoma, who had (or have) any evidence of the other cancer present within the last 5 years
* Patients who are pregnant or lactating
* Any contraindication to the use of cisplatin, carboplatin, or paclitaxel chemotherapy
* Serious illness or medical condition that precludes the safe administration of the trial treatment 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
* Patients who are known to be human immunodeficiency virus (HIV) positive

Disease(s) and\or Condition(s)

Cervical Adenocarcinoma

Cervical Adenosquamous Carcinoma

Cervical Squamous Cell Carcinoma, Not Otherwise Specified

Stage IB Cervical Cancer AJCC v6 and v7

Stage IIA Cervical Cancer AJCC v7

Stage IIB Cervical Cancer AJCC v6 and v7

Stage IIIB Cervical Cancer AJCC v6 and v7

Stage IVA Cervical Cancer AJCC v6 and v7

Primary Purpose
  • TREATMENT
Intervention/Treatment
    • Type: RADIATION
    • Name: Brachytherapy
    • Description: Undergo brachytherapy
    • Arm Group Labels: Arm I (cisplatin, radiation therapy, brachytherapy), Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
    • Type: DRUG
    • Name: Carboplatin
    • Description: Given IV
    • Arm Group Labels: Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
    • Type: DRUG
    • Name: Cisplatin
    • Description: Given IV
    • Arm Group Labels: Arm I (cisplatin, radiation therapy, brachytherapy), Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
    • Type: RADIATION
    • Name: External Beam Radiation Therapy
    • Description: Undergo external beam radiation therapy
    • Arm Group Labels: Arm I (cisplatin, radiation therapy, brachytherapy), Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
    • Type: DRUG
    • Name: Paclitaxel
    • Description: Given IV
    • Arm Group Labels: Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
    • Type: OTHER
    • Name: Quality-of-Life Assessment
    • Description: Ancillary studies
    • Arm Group Labels: Arm I (cisplatin, radiation therapy, brachytherapy), Arm II (cisplatin, radiation therapy, brachytherapy, chemo)
Sponsor
  • GOG Foundation