Please select the eligibility criteria that correspond to the clinical trial below.
Title: Phase 1-2a Dose-Ranging Study of TLK286 in Combination With Doxil in Platinum Refractory or Resistant Ovarian Cancer
Brief Summary: This is a dose-ranging, open-label, Phase 1-2a study of TLK286 in combination with Doxil in patients with platinum refractory or resistant ovarian cancer.


Options:
A: Inclusion Criteria:

* Histologically proven epithelial ovarian cancer, epithelial fallopian tube cancer, or primary peritoneal cancer
* Prior treatment with only 1 platinum based chemotherapy regimen
* Eastern Cooperative Oncology Group status of not more than 2
* Progression more than 6 months after the start of initial chemotherapy treatment

Exclusion Criteria:

* Treatment with more than 1 prior chemotherapy regimen
* Progression within 6 months after starting initial chemotherapy
* Prior exposure to anthracyclines
* Unwilling or unable to have central venous catheter
* Known clinically relevant central nervous system metastasis
B: Inclusion Criteria

* Histologically or cytologically confirmed diagnosis of epithelial cancer of the ovary, fallopian tube cancer or primary peritoneal cancer
* Recurrent epithelial ovarian cancer or persistent disease following primary treatment
* At least one, but no more than four, prior platinum-containing chemotherapy regimens
* At least one prior taxane-containing regimen

Exclusion Criteria

* A history of prior malignancy except for adequately treated carcinoma in situ of the uterine cervix, basal cell or squamous cell skin cancer, or other cancer for which the patient has been disease-free for 2 years
* Known leptomeningeal metastases or carcinomatous meningitis
* Have received prior Doxil or other liposomal doxorubicin
* Having received whole pelvis radiation therapy
C: Inclusion Criteria:

* Are a woman 18 years of age or older
* Have histologically or cytologically confirmed epithelial cancer or primary peritoneal cancer
* Have platinum refractory or resistant cancer
* Measurable disease according to radiographic RECIST criteria progression

Exclusion Criteria:

* Had treatment with first-line chemotherapy other than a platinum-containing regimen
* Have clinically significant cardiac disease
* Have any sign of intestinal obstruction interfering with nutrition
* Are pregnant or lactating
* Had prior treatment with liposomal doxorubicin
* Had prior treatment with Telcyta
D: Inclusion Criteria:

To qualify for randomization and treatment the following criteria must be met:

* Subjects must sign an approved informed consent form
* Subjects must be ≥ 18 years of age
* Subjects must have pathology-confirmed epithelial ovarian, fallopian tube, or primary peritoneal carcinoma
* Subjects must have platinum-resistant ovarian cancer, where platinum-resistant is defined as disease that responded to primary platinum therapy and then progressed within 6 months or disease that progressed during or within 6 months of completing secondary platinum therapy
* Subjects must have at least a single (RECIST-defined) measurable lesion on a radiological evaluation that is conducted no more than four weeks prior to beginning study therapy (EC145 and/or PLD).
* Subjects must have had prior debulking surgery
* Subjects must have received prior platinum-based chemotherapy but must not have received more than 2 prior systemic cytotoxic regimens. Subjects are allowed to receive, but are not required to receive, one additional non-cytotoxic regimen for the management of recurrent or persistent disease. Non-cytotoxic (biologic or cytostatic) agents include, but are not limited to, monoclonal antibodies, cytokines, and small-molecule inhibitors of signal transduction.
* Subjects must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2
* Subjects must have recovered (to baseline/stabilization) from prior cytotoxic therapy-associated acute toxicities. Subjects who have recovered from non-cytotoxic therapy-associated toxicity or who have "controlled" non-cytotoxic therapy toxicity (e.g., vascular endothelial growth factor-related hypertension) can be entered into the trial after a drug wash-out period of 4 half lives
* Subjects must have adequate organ function including:

  1. Bone Marrow Reserve: Absolute neutrophil count(ANC)≥ 1.5x10\^9/L prior to treatment. Subjects on maintenance doses of granulocyte colony stimulating factor (G-CSF) are eligible. Platelets ≥ 100x10\^9/L and hemoglobin ≥ 9 g/dL.
  2. Hepatic: Total bilirubin level \< 1.5 x ULN and alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase(GGT), and alkaline phosphatase levels \< 2.5 x ULN.
  3. Renal: Serum creatinine level ≤ 1.5 x ULN or creatinine clearance ≥ 50 mL/min/1.73m\^2 for subjects with serum creatinine levels above 1.5 x ULN.
  4. Cardiac: Left ventricular ejection fraction (LVEF) equal to or greater than

the institutional lower limit of normal. LVEF must be elevated within 90 days prior to Cycle 1 Day 1

* Subjects of childbearing potential must:

  1. Have a negative serum pregnancy test prior to initiation of the therapeutic regimen
  2. Practice an effective method of birth control (e.g., oral, transdermal or injectable contraceptives, intrauterine device, double-barrier contraception, such as diaphragm and spermicidal jelly) for the duration of their participation in the trial through 3 months following the last dose of study drug.

Exclusion Criteria:

The presence of any of the following will exclude the subject from the study:

* Diagnosis of tumor of low-malignant potential
* Prior exposure to PLD or anthracycline therapy
* Prior exposure to FR-targeted therapy (EC145, EC0225, farletuzumab, etc)
* Prior therapy with mouse antibodies
* Prior therapy with vinorelbine (Navelbine®) or vinca-containing compounds
* Prior abdominal or pelvic radiation therapy, radiation therapy to \> 10% of the bone marrow, or prior radiation therapy within the past 3 years to the breast/sternum, dermal lesions, head or neck
* Recent (i.e., ≤ 6 weeks) history of abdominal surgery or peritonitis
* Serious comorbidities (as determined by the investigator) such as, but not limited to, active congestive heart failure or recent myocardial infarction. Subjects who require antifolate therapy for the management of comorbid conditions (e.g., rheumatoid arthritis) will be excluded from the trial.
* Pregnancy
* Concurrent malignancy or history of other cancer (except noninvasive skin cancer) within the last 5 years
* Symptomatic central nervous system metastasis
* Other concurrent chemotherapy, immunotherapy, radiotherapy, or any ancillary therapy that is considered to be investigational (i.e., used for non-approved indications(s) and in the context of a research investigation). Use of low dose corticosteroid therapy (for nausea prophylaxis, etc) is acceptable; however, concomitant tamoxifen therapy is not. Supportive care measures are allowed.

Answer: B