Sunitinib in Recurrent and Refractory Ovarian, Fallopian Tube and Peritoneal Carcinoma

A Phase II Trial of Sunitinib in Recurrent and Refractory Ovarian, Fallopian Tube and Peritoneal Carcinoma

The purpose of this study is to determine the effectiveness of sunitinib on participants with ovarian, fallopian tube or peritoneal cancer. Sunitinib is a newly discovered drug that may stop cancer cells from growing by blocking the blood supply to the tumor.

This study used a two-stage design to evaluate efficacy of sunitinib based on overall response (OR) defined as complete response (CR) or partial response (PR). The null and alternative OR rate were 5% and 20%. If one or more patients enrolled in the stage one cohort (n=17 patients) achieved PR or better than accrual would proceed to stage two (n=18 patients). There was 42% probability of stopping the trial at stage one if the true OR rate was 5%. With 35 patients, this design had 85% power to detect the 15% difference in OR rates assuming 2-sided type I error rate of 0.05.

Inclusion Criteria:

• Histologically or cytologically confirmed epithelial ovarian, fallopian tube or peritoneal cancer
• Recurrent or refractory disease
• Measurable disease, defined by RECIST
• 0 to 3 prior cytotoxic chemotherapy or biologic regimens for metastatic disease
• Adverse events related to prior tumor-specific therapy must have resolved to less than or equal to grade 1 prior to study entry
• Ability to swallow oral medications
• 18 years of age or older
• ECOG Performance status must be 0-2
• Normal organ and marrow function as outlined in the protocol

Exclusion Criteria:

• Receiving systemic therapy less than 14 days prior to starting sunitinib
• Receiving any other investigational agent
• Received prior sunitinib
• Untreated brain metastases, spinal cord compression, or evidence of symptomatic brain metastases or leptomeningeal disease as noted on screening CT or MRI scans
• Any of the following within the 6 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
• Evidence of a bleeding diathesis. Major surgery or NCI CTCA 3.0 grade 3 or worse hemorrhage within 4 weeks of starting study treatment
• Ongoing cardiac dysrhythmias of NCI CTCAE version 3.0 grade > 2
• Pre-existing thyroid abnormality, with thyroid function tests that cannot be maintained in the normal range with medication
• Prolonged QTc interval on baseline EKG
• Uncontrolled hypertension
• Patients who are taking cytochrome P450 enzyme-inducing antiepileptic drugs, rifampin, theophylline, ketoconazole, or St. John's wort.
• Psychiatric illness or social situations that wold limit compliance with study requirements
• Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or study drug administration
• Pregnant women
• Clinical or radiographical evidence of a small bowel obstruction
• Poor oral intake