methotrexate plus dipyridamole in treating patients with advanced ovarian cancer

Conditions: Ovarian Cancer

Summary: rationale: drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. dipyridamole may increase the effectiveness of methotrexate and kill more tumor cells. purpose: phase ii trial to study the effectiveness of combining methotrexate and dipyridamole in treating patients with advanced ovarian cancer that is recurrent after or refractory to cisplatin-based chemotherapy.

objectives: i. determine the clinical complete and partial response rate, pathological complete response rate, disease-free survival, and duration of response produced by intraperitoneal dipyridamole/methotrexate (dp/mtx) administered as a 7-day continuous infusion in patients with advanced ovarian carcinoma that is recurrent following or refractory to cisplatin-based chemotherapy. ii. determine the peritoneal and systemic toxicity of dp/mtx. outline: nonrandomized study. single-agent chemotherapy with chemopotentiation. methotrexate, mtx, nsc-740; with dipyridamole, dp, nsc-515776. projected accrual: up to 40 evaluable patients in each category (prior intraperitoneal vs. prior intravenous platinum-based chemotherapy) will be studied. if no responses are seen in the first 20 patients in either category, accrual to that category will cease. an accrual rate of 15 patients/year is anticipated.

Eligibility criteria:
disease characteristics: histologically proven, stage iii/iv ovarian carcinoma that is refractory or recurrent within 1 year of complete response to intraperitoneal or intravenous platinum-based chemotherapy debulking surgery must have been considered at the completion of prior chemotherapy (failure to debulk does not exclude) clinical or radiographic evidence of advanced, predominantly peritoneal disease on physical exam, ct or mri scan, exploratory laparotomy, or peritoneal cytology or by elevated ca-125 (above 35 units in ottawa civic or general hospitals) required disease limited to peritoneal cavity not required, but peritoneal disease should constitute the main life-threatening or symptom-producing component good distribution of contrast medium throughout peritoneal cavity on ct of abdomen and pelvis required measurable, evaluable, or unevaluable disease of any size acceptable patient characteristics: age: 18 and over performance status: not specified life expectancy: more than 2 months hematopoietic: wbc at least 3,000 platelets at least 100,000 hepatic: bilirubin less than 3 x uln sgot less than 3 x uln renal: creatinine less than 1.7 mg/dl (150 micromoles/liter) bun less than 42 mg/dl (15 mmoles/liter) other: no requirement for dp or mtx or any medication known to interact with dp, (i.e., antiplatelet or anticoagulant drugs) or mtx (i.e., chemotherapeutic agents) no second malignancy other than basal cell carcinoma of the skin prior concurrent therapy: recovery from toxicities of prior therapy required biologic therapy: not specified chemotherapy: prior platinum-based chemotherapy required no concurrent chemotherapy endocrine therapy: not specified radiotherapy: no prior abdominopelvic or pelvic radiotherapy no concurrent peritoneal radiotherapy surgery: see disease characteristics other: no concurrent antiplatelet or vasodilatory agents

Keywords: recurrent ovarian epithelial cancer