MITO-6: Capecitabine in Platinum Resistant Ovarian Cancer

Ovarian cancer is the second most frequent and the most deadly gynaecologic cancer. Standard combination chemotherapy with a platinum derivative (cisplatin or carboplatin) and a taxane are effective in causing remission in 60 - 80 % of cases, yet recurrences are frequent and 5-year survival is only 20%. Current therapies for second line treatment of recurrence in patients who have platinum refractory (who experienced progression of the disease during first line platinum based therapy) or platinum resistant (who experienced a recurrence of the disease within 6 months of completing platinum based therapy)ovarian cancer are limited. Capecitabine, an oral chemotherapy already used in colon and breast cancers, has shown some promise in early clinical trials for treating recurrent ovarian cancer.

Patients entered into this trial will receive oral capecitabine 1250 mg/m2 on days 1-14 every 21 days for up to 6 cycles, depending on response.

Inclusion criteria

• Cytologic or histologic diagnosis of relapsed ovarian cancer
• Refractory or resistant to platinum salts disease
• Age < 75 years
• At least one measurable lesion (³ 20 mm with conventional techniques or ³ 10 mm with spiral CT scan)
• Life expectancy of at least 3 months
• Written informed consent

Exclusion criteria

• Previous or concomitant malignant neoplasia within 5 years prior to basal evaluation (excluding adequately treated basocellular or spinocellular skin carcinoma or in situ carcinoma of the uterine cervix).
• Performance Status (ECOG) ³ 3
• Previous chemotherapy treatment with capecitabine
• More than 3 lines of chemotherapy
• Heart disease (heart failure, heart attack during the 6 months prior to the trial, atrioventricular block of any degree, serious arrhythmia)
• Leukocytes < 4000/mm3, platelets < 100000/mm3
• Modifications of renal function (Creatinine ³ 1.25 times the upper normal limit) or liver function (SGOT or SGPT ³ 1.25 times the upper normal limit)
• Present or suspected haemorrhagic syndromes
• Uncooperative and/or unreliable patients
• Patients' inability to access the centre