E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Epithelial ovarian cancer, Fallopian tube ovarian cancer, Peritoneal ovarian cancer |
Carcinome épithélial ovarien, tubaire ou péritonéal |
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E.1.1.1 | Medical condition in easily understood language |
Ovarian Cancer |
Cancer de l'ovaire |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033131 |
E.1.2 | Term | Ovarian carcinoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10016180 |
E.1.2 | Term | Fallopian tube cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10052171 |
E.1.2 | Term | Peritoneal carcinoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to assess the efficacy, in terms of disease-free survival (DFS), the use of HIPEC treatment combined with standard care (PDS or IDS) or standard care alone (PDS or IDS alone). |
L'objectif principal est d'évaluer l’efficacité, en termes de survie sans maladie (DFS), de la CHIP combinée aux soins standards comparée aux soins standards seuls. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives of the study include:
- Evaluating the efficacy of HIPEC in terms of overall survival (OS) in combination with standard of care
- Evaluating the morbidity associated with HIPEC
- Evaluating the trade-off between efficacy and morbidity using the Q-TWiST approach
- Evaluating the impact of HIPEC in terms of quality of life
Other exploratory objectives include:
- Evaluating the impact of HIPEC on the count of residual viable cells (evaluated by flow cytometry) in abdominal drainage fluids for patients recruited in Centre Oscar Lambret only
- Constituting a biobank (tumoral samples and blood samples) for future translational researches
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Objectifs secondaires :
- Evaluer l’efficacité, en termes de survie globale (OS), de la CHIP combinée aux soins standards
- Evaluer la morbidité associée à la CHIP
- Evaluer le compromis entre l’efficacité et la morbidité, par l’approche du Q-TWiST (Quality-adjusted time without symptoms of disease or toxicity)
- Evaluer l’impact de la CHIP en termes de qualité de vie (QdV)
Objectifs exploratoires :
- Evaluer l’impact de la CHIP sur le nombre de cellules résiduelles (évalué par cytométrie de flux) dans le liquide de drainage abdominal (pour les patientes du Centre Oscar Lambret uniquement)
- Constituer une bio-banque (échantillons tumoraux et échantillons sanguins) pour de futures recherches translationnelles
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Pre-eligibility criteria to be checked before surgery for pre-registration
1. Age ≥18 years and ≤ 76 years
2. Histologically proven primary epithelial ovarian carcinoma or fallopian tube carcinoma or peritoneal carcinoma (including serous papillary adenocarcinoma, clear-cell carcinoma, mucinous adenocarcinoma and endometrioid carcinoma)
3. FIGO stage III
4. Patient eligible for
a. Primary Debulking Surgery (PDS) with planned adjuvant chemotherapy +/- bevacizumab or other targeted therapy
b. Or Interval Debulking Surgery (IDS) after neo-adjuvant chemotherapy +/- bevacizumab or other targeted therapy, with or without planned adjuvant chemotherapy +/- bevacizumab or other targeted therapy. In case of neo-adjuvant chemotherapy, surgery should be performed in a time interval of 3 to 5 weeks in case of chemotherapy without bevacizumab, and in a time interval of 4 to 6 weeks if chemotherapy is combined with bevacizumab. The patient remains eligible for the study if surgery is delayed beyond the recommended time interval.
5. WHO Performance Status ≤ 2
6. Physical status score ASA ≤ 2
7. Adequate bone marrow and renal function, as evidenced by the following tests performed within 7 days prior to surgery:
- Absolute Neutrophil Count (ANC) ≥1,500/mm3
- Platelets ≥100,000/mm3
- Creatinine clearance ≥ 60 mL/ min
8. Signed, IRB-approved written informed consent
9. Patient covered by the French or Belgian “Social Security” regime
Criteria to be checked per-operatively for confirmation of enrolment and randomization
10. Residual disease after surgery CC-0 (no macroscopic residue) or CC-1 (residue < 2.5 mm)
11. Per-operative hemorrhage < 2.5 L
12. Strictly less than 3 digestive resections performed during surgery
13. Diuresis during surgery ≥ 1 mL/ kg/ h
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Critères à vérifier avant la chirurgie
- Age ≥18 ans et ≤ 76 ans
- Carcinome épithélial primitif (ovarien, tubaire ou péritonéal) prouvé histologiquement (incluant adénocarcinome séreux papillaire, à cellules claires, adénocarcinome mucineux et carcinome endométrioïde)
- Stade FIGO III
- Patiente éligible :
o à une chirurgie première (« groupe PDS ») suivie d’une chimiothérapie adjuvante
o ou à une chirurgie intervallaire (« groupe IDS ») après chimiothérapie néoadjuvante suivie ou non d’une chimiothérapie adjuvante
- Performance Status PS-OMS ≤ 2
- Score ASA ≤ 2
- Fonctions hématologiques et rénales adéquates dans les 7 jours précédant la chirurgie
- Consentement éclairé de la patiente
- Patiente couverte par un régime d’assurance maladie (français ou belge).
Critères à vérifier en per-opératoire
- Maladie résiduelle CC-0 ou CC-1(résidu < 2.5 mm)
- Hémorragie per-opératoire < 2.5 L
- < 3 résections digestives
- Diurèse per-opératoire ≥ 1mL/ kg/ h
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E.4 | Principal exclusion criteria |
- Carcinosarcoma
- Cirrhosis
- Known hypersensitivity to any of the study drugs, study drug classes, or excipients in the formulation
- Pregnant or breastfeeding woman
- Inability to comply with medical follow-up of the trial (geographical, social or psychic reasons)
- Person under guardianship or curatorship
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- Carcinosarcome
- Cirrhose
- Hypersensibilité connue à la molécule expérimentale ou apparentée, ou à l’un des excipients contenu dans la spécialité
- Femme enceinte ou allaitante
- Incapacité à être suivi dans le cadre de l'essai (raisons géographiques, sociales ou psychiques)
- Patients sous tutelle ou curatelle
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E.5 End points |
E.5.1 | Primary end point(s) |
Disease-free survival (DFS) |
Survie sans maladie (DFS) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
DFS will be computed as the time interval between randomization and progression, relapse or death from any cause. Progression and relapses will be confirmed by the local tumor board, based on GCIC criteria. For patients alive without progression or relapse, data will be censored at the date of last follow-up visit. |
La DFS sera calculée comme le délai entre la randomisation et la première progression, rechute ou décès de toute cause. Les progressions et rechutes seront confirmées par la RCP du centre en se basant sur le critère GCIC. Les patientes vivantes sans progression ni rechute seront censurées à la date des dernières nouvelles. |
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E.5.2 | Secondary end point(s) |
Secondary endpoints:
1) Overall survival
OS will be computed as the time interval between randomization and death from any cause. For patients alive, data will be censored at the date of last follow-up.
2) Adverse events
Adverse events will be evaluated according to NCI-CTCAE V5.0 over the whole treatment duration plus 60 days, excluding AE unequivocally related to the disease under study or its progression. Adverse events of grade 3 or more (grade 3+) will be counted as severe adverse events.
3) Quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) computed from survival times (overall survival and progression-free survival) and adverse events data (date of occurrence of grade 3+ adverse event classified as drug-related) as detailed in the statistical considerations.
4) Quality of life will be evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire–Score 30 (QLQ-C30), and Quality of Life Questionnaire–Ovarian Cancer Module (QLQ-OV28)
Exploratory endpoints:
1) Count of residual viable cells (evaluated by flow cytometry) in abdominal drainage fluids
2) Further researches on the constituted biobank (tumoral samples and blood samples) could be performed if additional and specific funding is obtained.
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Critères d'évaluation secondaires:
- L’OS sera calculée comme le délai entre la randomisation et le décès de toute cause. Les patientes vivantes seront censurées à la date des dernières nouvelles
- Les Evénements Indésirables (EI) seront évalués selon l’échelle NCI-CTCAE V5.0 sur la durée globale du traitement plus 30 jours, en excluant les EI non clairement reliés à la maladie dans le cadre de l’étude ou de sa progression. Les EI de grade ≥3 seront considérés comme des EI sévères.
- Le Q-TWiST sera calculé à partir des temps de survie (OS et DFS) et des données d’EI (date de survenue des grades ≥3 considérés comme reliés au traitement)
- La QdV sera évaluée par le questionnaire QLQ-C30 et le module spécifique au cancer de l’ovaire QLQ-OV28 de l’EORTC (European Organisation for Research and Treatment of Cancer)
Critères d'évaluations exploratoires:
- nombre de cellules résiduelles (évalué par cytométrie de flux) dans le liquide de drainage abdominal (pour les patientes du Centre Oscar Lambret uniquement)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Between randomisation and the eventual progression, relapse of the disease or death. |
Entre la randomisation et la première progression, rechute ou décès de toute cause. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Soins standards (chirurgie et chimiothérapie) |
Standard care (surgery and chemotherapy) |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 13 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 14 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The end of the study is defined as LPI (last patient in) + 14 months to have relevant data in terms of DFS |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 6 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 6 |