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Last Modified: 8/19/2008     First Published: 6/23/2003  
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Phase III Randomized Study of Paclitaxel and Cisplatin Versus Vinorelbine and Cisplatin Versus Gemcitabine and Cisplatin Versus Topotecan and Cisplatin in Patients With Stage IVB, Recurrent, or Persistent Carcinoma of the Cervix

Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Published Results
Trial Contact Information
Registry Information

Alternate Title

Comparison of Four Combination Chemotherapy Regimens Using Cisplatin in Treating Patients With Stage IVB, Recurrent, or Persistent Cancer of the Cervix

Basic Trial Information

Phase
Type
Status
Age
Sponsor
Protocol IDs

Phase III


Treatment


Closed


18 and over


NCI


GOG-0204
NCT00064077

Objectives

  1. Compare the survival and response of patients with stage IVB, recurrent, or persistent carcinoma of the cervix when treated with paclitaxel and cisplatin vs vinorelbine and cisplatin vs gemcitabine and cisplatin vs topotecan and cisplatin.
  2. Compare the toxic effects of these regimens in these patients.
  3. Compare the quality of life of patients treated with these regimens.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma of the cervix
    • Stage IVB, recurrent, or persistent disease


  • Not amenable to curative surgery and/or radiotherapy


  • At least 1 unidimensionally measurable lesion
    • At least 20 mm by palpation, plain x-ray, CT scan, or MRI OR at least 10 mm by spiral CT scan
    • Biopsy confirmation required if lesion is less than 30 mm
    • Target lesion must be outside of a previously irradiated field


  • No craniospinal metastases


Prior/Concurrent Therapy:

Biologic therapy

  • No concurrent cytokines

Chemotherapy

  • At least 6 weeks since prior chemoradiotherapy and recovered
  • No prior chemotherapy (except when concurrently administered with radiotherapy)

Endocrine therapy

  • Not specified

Radiotherapy

  • See Disease Characteristics
  • See Chemotherapy
  • At least 3 weeks since prior radiotherapy and recovered

Surgery

  • Recovered from prior surgery

Patient Characteristics:

Age

  • 18 and over

Performance status

  • GOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Absolute neutrophil count at least 1,500/mm3
  • Platelet count at least 100,000/mm3

Hepatic

  • Bilirubin no greater than 1.5 times normal
  • Alkaline phosphatase no greater than 3 times normal
  • AST no greater than 3 times normal

Renal

  • Creatinine ≤ 1.2 mg/dL

    OR

  • Creatinine > 1.2 mg/dL but < 1.5 mg/dL AND creatinine clearance ≥ 50 mL/min
  • No bilateral hydronephrosis not alleviated by ureteral stents or percutaneous drainage

Other

  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • No prior or concurrent malignancy within the past 5 years except nonmelanoma skin cancer
  • No prior malignancy whose treatment contraindicates the current study therapy
  • No concurrent clinically significant infection

Expected Enrollment

600

A total of 600 patients (150 per treatment arm) will be accrued for this study within 4 years.

Outcomes

Primary Outcome(s)

Quality of life as measured by the FACT-Cervical Trial Outcome of Index and the FACT-Gynecologic Oncology Group/Neurotoxicity subscale at baseline, courses 2 and 5, and 9 months after completion of study treatment

Secondary Outcome(s)

Brief Pain Inventory

Outline

This is a randomized, multicenter study. Patients are randomized to 1 of 4 treatment arms.

  • Arm I: Patients receive paclitaxel IV over 24 hours on day 1 and cisplatin IV over 1-4 hours on day 2.


  • Arm II: Patients receive vinorelbine IV over 6-10 minutes on days 1 and 8 and cisplatin IV over 1-4 hours on day 1.


  • Arm III: Patients receive gemcitabine IV over 30-60 minutes on days 1 and 8 and cisplatin as in arm II.


  • Arm IV: Patients receive topotecan IV over 30 minutes on days 1-3 and cisplatin as in arm II.


In all arms, treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity.

Quality of life is assessed at baseline, before courses 2 and 5, and at 9 months after study entry.

Patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.

Published Results

Monk BJ, Sill M, McMeekin DS, et al.: A randomized phase III trial of four cisplatin (CIS) containing doublet combinations in stage IVB, recurrent or persistent cervical carcinoma: a Gynecologic Oncology Group (GOG) study. [Abstract] J Clin Oncol 26 (Suppl 15): A-LBA5504, 2008.

Wenzel LB, Huang H, Cella D, et al.: Quality-of-life results of a randomized phase III trial of four cisplatin (Cis) containing doublet combinations in stage IVB cervical carcinoma: A gynecologic oncology group (GOG) study. [Abstract] J Clin Oncol 26 (Suppl 15): A-5529, 2008.

Trial Contact Information

Trial Lead Organizations

Gynecologic Oncology Group

Bradley Monk, MD, Protocol chair
Ph: 714-456-7974
Email: bjmonk@uci.edu

Registry Information
Official Title A Randomized Phase III Trial Of Paclitaxel plus Cisplatin versus Vinorelbine plus Cisplatin versus Gemcitabine plus Cisplatin versus Topotecan plus Cisplatin In Stage IVB, Recurrent Or Persistent Carcinoma of the Cervix
Trial Start Date 2003-07-23
Registered in ClinicalTrials.gov NCT00064077
Date Submitted to PDQ 2003-05-19
Information Last Verified 2007-04-30
NCI Grant/Contract Number CA27469

Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol.

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