Liposome-Encapsulated Doxorubicin Citrate and Carboplatin in Treating Patients With Advanced or Metastatic Recurrent Endometrial Cancer

Phase II Multicenter Trial of the Austrian AGO With the Combination of Liposomal Doxorubicin (Myocet®) and Carboplatin in Primary Advanced or Metastatic and Recurrent Endometrial Cancer

RATIONALE: Drugs used in chemotherapy, such as liposome-encapsulated doxorubicin citrate and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing.

PURPOSE: This phase II trial is studying how well liposome-encapsulated doxorubicin citrate given together with carboplatin works in treating patients with advanced or metastatic recurrent endometrial cancer.

OBJECTIVES:

Primary

• To assess activity of the combination of liposome-encapsulated doxorubicin citrate and carboplatin in patients with primary advanced or metastatic recurrent carcinoma of the endometrium.

Secondary

• To assess the toxicity and feasibility of this regimen in these patients.
• To determine the progression-free survival and overall survival of these patients.

OUTLINE: This is a multicenter study.

Patients receive liposome-encapsulated doxorubicin citrate IV over 1 hour followed by carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 6-9 courses in the absence of disease progression or unacceptable toxicity.

Tissue array and immunohistochemistry analysis are conducted on paraffin-embedded tumor blocks of the primarily operated tissue of all patients for different markers (e.g., progesterone-/estrogen receptor, HER2-receptor, soluble L1-molecule, Topo 2a) to examine tumor characteristics.

Quality of life is assessed at baseline, during study treatment, at completion of study treatment, and then at 1 year after completion of study treatment.

After completion of study therapy, patients are followed up every 3 months for 1 year.

DISEASE CHARACTERISTICS:

• Diagnosis of endometrial carcinoma, including any of the following cellular types:

  • Mixed Mullerian carcinoma
  • Serous carcinoma
  • Clear cell carcinoma

• Primary advanced (FIGO stage III or stage IV) or metastatic recurrent disease

• Disease not curable by surgery

• Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm with x-ray, physical exam, or non-spiral CT scan OR ≥ 10 mm with spiral CT scan or MRI

• No known cerebral metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-2
• Life expectancy ≥ 12 weeks
• Platelet count ≥ 100,000/mm^3
• ANC ≥ 1,500/mm^3
• Hemoglobin ≥ 10 g/dL
• Creatinine ≤ 1.25 times upper limit of normal (ULN)
• Bilirubin ≤ 1.25 times ULN
• AST/ALT < 3 times ULN
• Glomerular filtration rate ≥ 50 mL/min
• LVEF ≥ 50% by ECHO
• Fertile patients must use effective contraception
• No myocardial infarction within the past 6 months
• No NYHA class II-IV congestive heart failure
• No third degree or complete heart block unless a pacemaker is in place
• No other malignancy within the past 5 years
• No concomitant medical illness (e.g., uncontrolled infection, uncontrolled angina, or other relevant illness) that makes the prescribed treatments within this study unfeasible
• No known hypersensitivity to study drugs
• No psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule

PRIOR CONCURRENT THERAPY:

• No prior chemotherapy for disease recurrence

• At least 12 months since prior adjuvant therapy containing anthracyclines with cumulative doses not exceeding the following:

  • Epirubicin 600 mg/m²
  • Doxorubicin 300 mg/m²

• At least 6 months since prior adjuvant therapy containing platinum

• At least 4 weeks since completion of radiotherapy involving the whole pelvis

• No concurrent radiotherapy or planned radiotherapy after study

• No concurrent endocrine, immunological, or other anticancer therapy

• No concurrent participation in another investigational drug study