Stereotactic Body Radiation Therapy in Treating Patients With Recurrent Primary Ovarian or Uterine Cancer

University of Colorado, Denver15 enrolled

Overview

This phase I trial studies the side effects and best dose of stereotactic body radiation therapy in treating patients with ovarian or uterine cancer that has come back. Stereotactic body radiation therapy is a specialized radiation therapy that sends x-rays directly to the tumor using smaller doses over several days and may cause less damage to normal tissue.

This is a phase I study with a primary objective to determine maximum tolerated dose (MTD) of 3 fraction stereotactic body radiation therapy (SBRT) for abdominopelvic recurrences of ovarian cancer (OC) and uterine papillary serous carcinoma (UPSC). This is a dose escalation study that employs a 3+3 design to determine the MTD. Patients are then monitored closely to determine side effects and adverse events, as well as success rates and tumor response to the radiation therapy.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Recurrent Endometrial Serous Adenocarcinoma Recurrent Fallopian Tube Carcinoma Recurrent Ovarian Carcinoma

Eligibility

Sex: FEMALEMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Female patients \> 18 years of age. * ECOG 0 or 1. * Diagnosis of primary ovarian cancer of any histology (patients with diagnoses of fallopian tube and primary peritoneal cancer are also eligible), or primary uterine cancer of papillary serous histology. * Pathologic confirmation of eligible histology. * Three or fewer total sites of active disease (at least one site of active disease to be treated on study must be confined to the abdomen or pelvis excluding liver and must be \< 5 cm in greatest dimension as determined by pre-screening cross-sectional imaging). * Additional site(s) of active disease (such as parenchymal liver and lung metastases, or supraclavicular nodal metastases), should be considered for treatment (off study) with radiation, surgery, or another form of local therapy, at the discretion of the study PI. * Systemic therapy is allowed but SBRT cannot begin until \> or = 7 days after the last cycle of systemic therapy, and systemic therapy cannot be initiated or re-initiated until \> or = 7 days after SBRT. There will be no limit on prior lines of systemic therapy. * Patients with contraindications to intravenous (IV) contrast administration are still eligible for this study if the tumor can be delineated clearly without IV contrast (at the discretion of the treating radiation oncologist) but will not participate in the functional imaging studies. Exclusion Criteria: * Pregnant women. If patients are not status post bilateral salpingo-oopherectomy then pregnancy testing is required. * Patients with active collagen vascular disease (CVD), specifically systemic lupus erythematosus or scleroderma. Patients with a history of CVD without evidence of active disease are eligible for enrollment at the discretion of the study PI. * Patients with inflammatory bowel disease and/or GI ulcers and/or GI fistulas are eligible but only at the discretion of the study PI after personalized review of their medical history and proximity of SBRT targets to gastrointestinal mucosa. * Patients with a separate non-cutaneous cancer diagnosis for which the patient has not been without evidence of disease for at least 5 years.

Outcomes

Primary Outcomes

Maximum Tolerated Dose

This will be accomplished using the standard 3+3 dose escalation design. Dose Limiting Toxicities (DLTs) will be determined through the NCI CTCAE version 4.03.

Time frame: After the completion of SBRT treatment through 3 months of followup.

Secondary Outcomes

One Year Local Control

Local Control will be defined as Stable Disease (SD), Partial Response (PR) or Complete Repsonse (CR) according to RECIST 1.1 criteria. Assessed using Kaplan Meier survival curves.

Time frame: After the completion of SBRT treatment, throughout followup, or death, whichever comes first, up to one year.

Progression Free Survival

The amount of time a patient survives without worsening of disease, according to RECIST 1.1 criteria. Assessed using Kaplan Meier survival curves.

Time frame: After the completion of SBRT treatment, throughout followup, or death, whichever comes first, up to one year.

Overall Survival

The amount of time a patient survives, with or without progression of disease. Assessed using Kaplan Meier survival curves.

Time frame: After the completion of SBRT treatment, throughout followup, or death, whichever comes first, up to one year.

Chemotherapy-Free Interval

The amount of time a patient survives without having to undergo re-initiation of chemotherapy. Assessed using Kaplan Meier survival curves.

Time frame: After the completion of SBRT treatment throughout followup to the re-initiation of chemotherapy, up to one year.

Acute Toxicities

Acute toxicities will be assessed by the NCI CTCAE version 4.03.

Time frame: During SBRT treatment, throughout followup, or death, whichever comes first, up to 6 weeks post treatment.

Late Toxicities

Delayed toxicities will be assessed by the NCI CTCAE version 4.03.

Time frame: After the completion of SBRT treatment, throughout followup, or death, whichever comes first, up to one year.

Quality of Life Assessment through Survey

Quality of life will be assessed through the EORTC QLQ-C30 and OV28 questionnaires.

Time frame: After the completion of SBRT treatment, throughout followup, or death, whichever comes first, up to one year.

Functional Imaging

DCE-CT scans using the Siemens AS open scanner will be assessed according to RECIST 1.1 criteria.

Time frame: Prior to completion of SBRT, immediately after the completion of SBRT, and 6 weeks after the completion of SBRT.

Profile of SBRT-Associated Immune Response

The Human Immune Monitoring Shared Resource will preform cytometry and cytokine arrays, as well as characterizing activation markers.

Time frame: Prior to completion of SBRT, 2 weeks after the completion of SBRT, and 6 weeks after the completion of SBRT.

Stereotactic Body Radiation Therapy in Treating Patients With Recurrent Primary Ovarian or Uterine Cancer

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes