a controlled study of the effectiveness of oregovomab (antibody) plus chemotherapy in advanced ovarian cancer

Conditions: Ovarian Neoplasms

Summary: this is a phase 2 randomized study with two treatment arms to compare the effectiveness of oregovomab (a murine monoclonal antibody directed against cancer antigen 125 (ca125)) when combined with first-line chemotherapy (carboplatin and paclitaxel) to first-line chemotherapy (carboplatin and paclitaxel alone) in female patients with advanced ovarian cancer.

oregovomab is an investigational drug previously used in clinical trials as an immunotherapeutic treatment of ovarian cancer patients whose tumor cells express the tumor associated antigen, ca125. the active component of oregovomab is the activated murine monoclonal antibody b43.13, an immunoglobulin g1k (igg1k) subclass immunoglobulin that binds with high affinity (1.16e10/m) to ca125. ca125 is a surface glycoprotein antigen that is expressed on more than 80% of all non-mucinous epithelial ovarian carcinomas where it occurs at elevated levels in the serum of patients with ovarian cancer. little is known about its biological function. ca125 is associated with a large molecular weight mucin-like glycoprotein complex of 200-250 kilodaltons (kda) and its genetic structure has recently been elucidated. there is good evidence to suggest that ca125 is a relevant target antigen for antigen-mediated immunotherapy of ovarian cancer. the study will compare the effectiveness of oregovomab (a murine monoclonal antibody directed against cancer antigen 125 (ca125)) when combined with first-line chemotherapy (carboplatin and paclitaxel) to first-line chemotherapy (carboplatin and paclitaxel alone) in female patients with advanced ovarian cancer.

Eligibility criteria:
inclusion criteria: * have newly diagnosed epithelial adenocarcinoma of ovarian, tubal or peritoneal origin and french fédération internationale de gynécologie et d'obstétrique (figo) stage iii/iv disease. * have preoperative ca125 levels \> 50 u/ml * have optimal cytoreduction (rt\<1) * be anticipated to have first-line chemotherapy infusion within 6 weeks after surgery * be available to complete the protocol for the duration of the study * have adequate bone marrow function: absolute neutrophil count (anc) greater than or equal to 1,500/µl, equivalent to common terminology criteria (ctcae v3.0) grade 1. platelets greater than or equal to 100,000/µl; hemoglobin greater than or equal to 8.0 g/dl * have adequate renal function: creatinine less than or equal to 1.5 x institutional upper limit normal (uln), ctcae v3.0 grade 1 * have adequate hepatic function: bilirubin less than or equal to 1.5 x uln (ctcae v3.0 grade 1). sgot and alkaline phosphatase less than or equal to 2.5 x uln (ctcae v3.0 grade 1) * able to sign informed consent and provide authorization permitting release of personal health information * have an eastern cooperative oncology group (ecog) performance status of 0 or 1 exclusion criteria: * have an active autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus (sle), ulcerative colitis, crohn's disease, multiple sclerosis (ms), ankylosing spondylitis) * have a known allergy to murine proteins or have had a documented anaphylactic reaction to any drug, or cannot tolerate cyclophosphamide * are being chronically treated with immunosuppressive drugs such as cyclosporin, adrenocorticotropic hormone (acth), or systemic corticosteroids. * have a recognized immunodeficiency disease including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia * have an acquired, hereditary, or congenital immunodeficiency * have uncontrolled diseases other than cancer * have contraindications to the use of pressor agents * have undergone more than one surgical debulking * have hepatic dysfunction, eg, bilirubin more than 1.5 times higher than normal levels, lactate dehydrogenase (ldh), serum glutamic oxaloacetic transaminase (sgot) and serum glutamic pyruvic transaminase (sgpt) doubled compared to normal or albumin \<3.5 g/dl * have severe renal insufficiency with serum creatinine \>1.6 mg/dl * have concomitant diseases or treatments that may confound the results of the study, which may preclude the completion of the protocol or may mask adverse reactions * are to be tested with other medications during treatment * are unable to read or understand or unable to sign the necessary written consent before starting treatment

Keywords: ovarian cancer neoplasm adenocarcinoma ca125