A trial looking at chemotherapy before and after surgery for advanced peritoneal cancer (Neo-ESCAPE)

Cancer type:

Ovarian cancer

Status:

Results

Phase:

Phase 2

This trial was looking at giving chemotherapy before and after surgery for cancer of the ovary, fallopian tube or peritoneum. The trial was supported by Cancer Research UK.

The first treatment for ovarian cancer is often surgery to remove as much of the cancer as possible. Many women also have chemotherapy after surgery.

But if the cancer is at a more advanced stage when it is diagnosed, it may not be possible to remove it with surgery. You may have chemotherapy first to shrink the tumour so that surgery might be possible later on.

Carboplatin and paclitaxel are 2 chemotherapy drugs that doctors often use. You usually have these drugs at the same time.

But from research, doctors thought that having the drugs separately may be better. Women taking part in this trial had carboplatin first, followed by paclitaxel.

The researchers also wanted to see if adding in another drug called gemcitabine would make it possible for more women to have surgery to remove their cancer. In this trial, women had gemcitabine at the same time as one of the other chemotherapy drugs.

The aims of the trial were to

  • Find out if it was possible to give chemotherapy in this way
  • See how many women were able to complete the treatment
  • See how many of the women were able to have surgery
  • Learn more about the side effects

Summary of results

The trial team found that cancer responded to the chemotherapy in more than 7 out of 10 women who had carboplatin, followed by paclitaxel and gemcitabine. And nearly 8 out of 10 women who had this type of chemotherapy completed their planned treatment.

The trial recruited 75 women who had cancer of the ovary, fallopian tube or peritoneum that was stage 3C or stage 4. They were not able have surgery as their first treatment.

The plan was for women to have 6 cycles of chemotherapy and then an assessment to see if they could have surgery. If they had surgery, they then had another 6 cycles of chemotherapy afterwards.

If they weren’t able to have surgery after 6 cycles of treatment, they carried on and had another 6 cycles of chemotherapy. Their doctors would then see if they could have surgery at the end of the 12th treatment cycle.

The trial was randomised. The women were put into groups by computer. Neither they nor their doctor could decide which group they were in. The plan for the trial was as follows

  • Women in the first group were to have a combination of carboplatin and gemcitabine for the first 6 cycles, followed by paclitaxel alone for the next 6 cycles
  • Women in the second group were to have carboplatin alone for the first 6 cycles, followed by paclitaxel and gemcitabine for the next 6

The trial stopped recruiting women into the first group as some early results showed this was not helping them.  

Of the 28 women in the first group, only half completed all 12 cycles of treatment. The main reason for stopping treatment early was because of bad side effects.

Of the 47 women in the second group, 37 completed all 12 cycles of treatment. The main reason women in this group stopped having treatment early was because their cancer was getting worse.

More than half the women were able to have surgery as planned after 6 cycles of chemotherapy.

The researchers concluded that carboplatin followed by paclitaxel and gemcitabine could be used for women with advanced ovarian, fallopian tube or peritoneal cancer who can’t have surgery as their first treatment.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) but may not have been published in a medical journal.  The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Christopher Poole

Supported by

Cancer Research UK
National Institute for Health Research Cancer Research Network (NCRN)
University of Birmingham
University of Warwick
Warwick Medical School

Other information

This is Cancer Research UK trial number CRUK/06/020.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 541

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Wendy took part in a new trial studying the possible side effect of hearing loss

A picture of Wendy

"I was delighted to take part in a clinical trial as it has the potential to really help others in the future.”

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