Clinical trial NCT00771810: Study of Drug to Reduce Thrombocytopenia in Patients Receiving Chemo for Ovarian, Fallopian Tube or Peritoneal Cancer
Official title: Ph IIb Study Evaluating the Safety & Efficacy of TXA127 in the Reduction of Incidence and Severity of Thrombocytopenia in Patients Receiving Combination Gemcitabine and Platinum Therapy for Ovarian, Fallopian Tube, or Peritoneal Carcinoma
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Thrombocytopenia
Neutropenia
Lymphopenia
Anemia
Keywords: Ovarian Cancer
Thrombocytopenia
Cytopenia
Chemotherapy
Lead sponsor: Tarix Pharmaceuticals
Sponsor class: INDUSTRY
First posted: 2008-10-13
Enrollment: 34
Sex: FEMALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: This research study will investigate the safety and effectiveness of two different dose levels of a new, unapproved drug to be given along with the chemotherapy regimens gemcitabine and carboplatin or gemcitabine and cisplatin prescribed to women for the treatment of ovarian cancer. This experimental drug is called TXA127 and is being tested for effectiveness to see if it will help reduce some of the side effects of the chemotherapy, primarily low blood platelet levels that lead to excess bleeding. This study also intends to test the safety of TXA127 when given as an injection under the skin on a daily basis concurrently with up to 6 cycles of the prescribed chemotherapy.

Detailed description: This is a Phase IIb, multicenter, randomized, double-blind, placebo-controlled study comparing safety and efficacy of two dose levels of TXA127 when administered during 6 cycles of combination gemcitabine and platinum-based chemotherapy. This study intends to investigate the effectiveness of TXA127 for the mitigation of severity and/or incidence of thrombocytopenia, as well as safety when administered as a self-injected, subcutaneous solution.

Females 18 years of age or older with a confirmed diagnosis of ovarian carcinoma who are scheduled to undergo combination chemotherapy with gemcitabine and carboplatin or gemcitabine and cisplatin will be considered for this study. Subjects may be chemotherapy naïve, newly diagnosed, or post a single course of chemotherapy followed by a progression- and treatment-free interval of at least 3 months, or post 2 or more previous courses of chemotherapy after a progression- and treatment-free interval of at least 6 months.

Subjects will be randomized in a 1:1:1 ratio to one of the following three blinded treatment groups: placebo, 100 ug/kg/day TXA127 and 300 ug/kg/day TXA127.

Treatment will be concurrent with up to six consecutive 21-day cycles of one of the following gemcitabine and platin regimens:

Regimen A

* Intravenous cisplatin therapy at a dose of 30-50 mg/m2 given on Day 1 of the cycle
* Intravenous gemcitabine at a dose of 800 mg/m2 given on Day 1 after cisplatin and on Day 8 of the cycle.

Regimen B

* Intravenous gemcitabine at a dose of 1000 mg/m2 given on Days 1 and 8 of the cycle
* Intravenous carboplatin AUC 4 given after gemcitabine on Day 1 of the cycle

TXA127 will be self-administered as a subcutaneous injection by the subject once daily on Days 2-6 and 9-15 during each cycle of chemotherapy. Blood specimens will be drawn for hematologic analysis on Days 1, 8 and 15 of each treatment cycle.

Eligibility criteria: Inclusion Criteria:

* Females at least 18 years of age with ovarian carcinoma who are one of the following:

  * Newly diagnosed with ovarian cancer and chemotherapy naïve, or
  * Post a single previous course of chemotherapy, with a 3-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit, or
  * Post two or more previous courses of chemotherapy with a 6-month disease-progression and treatment-free interval, with the exception of antibody therapy, prior to the study screening visit.
* Must be scheduled for a course of combination chemotherapy consisting of gemcitabine and cisplatin or gemcitabine and carboplatin to be administered in 21-day cycles
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
* Adequate bone marrow, renal, and hepatic functions as measured by standard chemistry and hematology blood tests
* Adequate blood coagulation parameters as measured by standard blood tests for coagulation

Exclusion Criteria:

* Any clinical or laboratory abnormality greater than Grade 2 toxicity (NCI criteria), with the exception of laboratory parameters specified in the inclusion criteria
* Significant unstable cardiovascular disease
* Uncontrolled high blood pressure
* Current use of an angiotensin converting enzyme (ACE) inhibitor or angiotensin II antagonists
* Evidence of metastatic disease to the bone
* Metastatic disease to the CNS requiring treatment or radiation therapy
* Uncontrolled infection(s)
* Radiation therapy or chemotherapy (except as specified in the inclusion criteria) within the previous 5 years
* Concurrent use of hematopoietic or erythropoietic agents

Primary outcomes:
measure: Chemotherapy Cycles During Which the Platelet Count Measures Below 50,000/mm3
timeFrame: During a maximum of six 3-week chemotherapy cycles
Secondary outcomes:
measure: Subjects With Platelet Counts Below 50,000/mm3
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Treatment Cycles With Platelets Counts Below 25,000/mm3
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Chemotherapy Dose Intensity and Dose Density
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Lymphopenia as Determined by Lymphocyte Count
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Neutropenia
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Anemia
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Mucositis
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Alopecia
timeFrame: During a maximum of six 3-week chemotherapy cycles
measure: Rescue Treatment for Hematopoiesis and Mucositis
timeFrame: During a maximum of six 3-week chemotherapy cycles
Other outcomes:
Locations:
city: Mobile
country: United States
facility: University of Southern Alabama Mitchell Cancer Institute
state: Alabama
city: Los Angeles
country: United States
facility: USC - LAC Medical Center
state: California
city: Orange
country: United States
facility: University of California - Irvine, Chao Family Comprehensive Cancer Center
state: California
city: Chicago
country: United States
facility: Rush University Medical Center
state: Illinois
city: Wichita
country: United States
facility: Associates in Women's Health
state: Kansas
city: Brightwaters
country: United States
facility: Schwartz Gynecologic Oncology, PLLC
state: New York
Study officials:
affiliation: US Biotest, Inc.
name: Gere S diZerega, MD
role: STUDY_DIRECTOR
References:
citation: Rodgers KE, Oliver J, diZerega GS. Phase I/II dose escalation study of angiotensin 1-7 [A(1-7)] administered before and after chemotherapy in patients with newly diagnosed breast cancer. Cancer Chemother Pharmacol. 2006 May;57(5):559-68. doi: 10.1007/s00280-005-0078-4. Epub 2005 Aug 12.
citation: Ellefson DD, diZerega GS, Espinoza T, Roda N, Maldonado S, Rodgers KE. Synergistic effects of co-administration of angiotensin 1-7 and Neupogen on hematopoietic recovery in mice. Cancer Chemother Pharmacol. 2004 Jan;53(1):15-24. doi: 10.1007/s00280-003-0710-0. Epub 2003 Oct 16.