Overview

This trial is active, not recruiting.

Condition ovarian, fallopian tube, and primary peritoneal cancer
Treatment metformin
Phase phase 2
Sponsor University of Michigan Cancer Center
Start date October 2011
End date April 2017
Trial size 90 participants
Trial identifier NCT01579812, HUM 47900, UMCC 2011.037

Summary

The primary objective of this study is to determine if metformin administered in combination with chemotherapy to women with advanced ovarian, primary peritoneal or fallopian tube cancer will improve recurrence-free survival at 18 months compared to controls.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Endpoint classification efficacy study
Intervention model single group assignment
Masking open label
Primary purpose treatment
Arm
(Experimental)
metformin Fortamet, Glucophage, Glumetza, Riomet
Patients receiving primary surgical debulking followed by adjuvant chemotherapy will initiate metformin prior to primary surgery. Following surgery patients will be initiated on metformin prior to the initiation of chemotherapy. Patients treated with neoadjuvant chemotherapy will be initiated on metformin prior to the initiation of chemotherapy. Following surgery patients will be initiated on metformin prior to the re-initiation of chemotherapy.

Primary Outcomes

Measure
Improved Recurrence-Free Survival
time frame: 5 years

Secondary Outcomes

Measure
Overall Survival
time frame: 6 years

Eligibility Criteria

Female participants from 19 years up to 79 years old.

Inclusion Criteria: 1. Patients with potential diagnosis of ovarian, fallopian, or primary peritoneal cancer. 2. Care plan including surgical debulking and traditional adjuvant or neo-adjuvant chemotherapy (6-9 cycles of platinum and taxane based therapy). 3. Eastern Cooperative Oncology Group performance status 0-2. 4. Age > 18 years or < 80 years. 5. Adequate renal function (serum creatinine <1.4mg/dL). 6. Adequate liver function (bilirubin < 1.5 times ULN). - Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) < 5 times the upper limit of normal in case of liver metastases. - ALT or AST < 2.5 times the ULN in absence of liver metastases. 7. Ability to understand and complete written informed consent. 8. Mentally, physically, and geographically able to undergo treatment and follow up. Exclusion Criteria: 1. Patients diabetes mellitus. (Patients with only a history of gestational diabetes will be allowed to be included in the study.) 2. Metformin use in the last 6 months. 3. A known hypersensitivity to metformin. 4. A history of metabolic acidosis, including ketoacidosis or increased risk of lactic acidosis. 5. Pregnancy or Lactation. 6. Patients who have any severe and/or uncontrolled medical conditions. 7. Patients with a history of renal disease. 8. Patients with other known active malignancy (excluding adequately treated basal cell / squamous cell skin cancer, in situ cancer, or other cancer for which the patient has been disease free for 2 years). 9. Patients receiving any other investigational agents.

Additional Information

Official title A Phase II Evaluation of Metformin, Targeting Cancer Stem Cells for the Prevention of Relapse in Patients With Stage IIC/III/IV Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Principal investigator Ronald J. Buckanovich, MD, PhD
Description Despite 70% remission rates with surgery and chemotherapy, the majority of patients with stage III/IV ovarian cancer will relapse and die of their disease. This is consistent with a cancer stem cell (CSC) model in which a few residual treatment resistant stem cells persist and initiate disease recurrence. Laboratory studies indicate therapies targeting CSC will greatly improve cancer outcomes. We have recently characterized a population of CSC in ovarian cancer. Importantly, similar to that observed in breast cancer, we have found that the diabetes drug metformin can restrict ovarian CSC growth and proliferation. In addition metformin increases tumor cell sensitivity to chemotherapy. Consistent with this, epidemiologic studies demonstrate that diabetic patients with ovarian cancer taking metformin have better outcomes than those not taking metformin. However, metformin has not been tested as an anti-cancer stem cell agent in ovarian cancer. Thus we propose to perform a phase II clinical trial using metformin as an anti-cancer stem cell agent in ovarian cancer patients. Patients who plan to receive primary surgical debulking will initiate metformin therapy prior to surgery and then continue after surgery along with chemotherapy. Patients who will be treated neoadjuvantly will initiate metformin with chemotherapy prior to surgery and then continue both metformin and chemotherapy after surgery. Tumor specimens will be acquired for all patients at the time of primary surgery. The primary objective of this study will be to determine if metformin improves the recurrence-free survival (RFS) of patients relative to historical controls. Secondary objectives of this study will be: (a) to compare the amount of CSC in primary tumor specimens in metformin treated patients versus matched controls from our tumor bank, (b) to determine if metformin improves overall survival relative to historical controls, (c) to confirm the safety of metformin in non-diabetic ovarian cancer patients, and (d) as laboratory studies indicate that metformin is most active in p53 mutant cells and p53 is mutated in ~50% of ovarian cancers, we will assess whether response rates correlate with p53 mutation status. If successful, this well tolerated FDA approved drug could be immediately translated into phase III trials and impact patient outcomes.
Trial information was received from ClinicalTrials.gov and was last updated in June 2016.
Information provided to ClinicalTrials.gov by University of Michigan Cancer Center.
Location data was received from the National Cancer Institute and was last updated in September 2016.