A trial of cediranib for women with ovarian cancer at risk of bowel obstruction (CEBOC)

Cancer type:

Ovarian cancer

Secondary cancers

Status:

Results

Phase:

Phase 2

This trial looked at adding a drug called cediranib to paclitaxel chemotherapy for ovarian cancer. The aim was to reduce the risk of developing a blockage in the bowel. This can happen if a cancer spreads from the ovary.

It was for women whose ovarian cancer had come back or continued to grow after platinum chemotherapy Open a glossary item . The trial included women who had:

epithelial ovarian cancer
fallopian tube cancer
primary peritoneal cancer

Doctors treat these cancers in the same way. So, when we use the term ovarian cancer in this summary, we are referring to all 3.

The trial was open for people to join between 2018 and 2021. The team published the results in 2024.

More about this trial

Sometimes ovarian cancer spreads to other parts of the body. One of the most common places for ovarian cancer to spread to is the bowel in the tummy (abdomen). This can cause a serious complication called bowel obstruction.

It is usual to have more chemotherapy for ovarian cancer that has spread to the bowel. At the time of this trial one option was paclitaxel chemotherapy. Doctors thought that adding another drug called cediranib could improve treatment.

Cediranib is a targeted cancer drug Open a glossary item . It stops cancers from making new blood vessels that they need to grow. These types of drugs weren’t usually given to people at risk of bowel obstruction. This was because of the risk of damage to the bowel. Doctors weren’t sure how well it would work. So they wanted to find out.

Everyone in the trial started by having paclitaxel once a week. Doctors checked to see if they were developing a bowel obstruction. Symptoms might have included:

feeling bloated and full
tummy (abdominal) pain
vomiting large amounts
constipation
changes in bowel habit

The women could only start taking cediranib tablets if they didn’t have any of the above symptoms.

This was a phase 2 trial. The main aims were to find out:

how safe it is to have cediranib and paclitaxel for women with ovarian cancer who are at risk of bowel obstruction
how well treatment works
what the side effects are

Summary of results

30 women joined the trial and 29 had treatment. Of those:

12 had paclitaxel on its own
17 had paclitaxel and cediranib

The team looked at who had cediranib for more than 5 days and didn’t develop damage to the bowel. This meant that they didn’t have a hole in the bowel or an abnormal opening between the bowel and another organ in the body (a fistula Open a glossary item ). No one developed this problem.

They also looked at the number of women who had a hospital stay for a bowel obstruction. One person needed to go to the hospital for this but they recovered without surgery.

The team also looked at the number of women who had paclitaxel and cediranib and whose cancer had gone away completely or shrunk. They found the cancer:

went away completely in 1 person (a complete response)
had shrunk a bit in 10 people (a partial response)

Side effects
Most women taking part had at least 1 side effect. Some of these were mild or didn’t last long. But some were more severe.

The most common severe side effects of paclitaxel and cediranib were:

tiredness (fatigue)
diarrhoea
low levels of magnesium in the body

We have more information about the side effects of paclitaxel in our Cancer drugs section.

Conclusion
The team found that paclitaxel and cediranib worked for some women and was safe to take together. The side effects were manageable and nobody developed bowel damage in this small trial.

The team say there weren’t enough women who had paclitaxel and cediranib. This was because too many women withdrew from the trial before they started cediranib. This was because the paclitaxel improved the wellbeing of only half of the patients taking part in the trial. So, the team couldn’t fully test the combination of treatment. This meant no firm conclusions could be made about whether the combination of treatment caused bowel damage or not.

The team recommend that more research is done looking at this combination of treatment.

All trials still add to our knowledge and understanding of cancer and how to treat it.

More detailed information
There is more information about this research in the reference below.

Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.

Once daily cediranib and weekly paclitaxel to prevent malignant bowel obstruction in at-risk patients with platinum-resistant ovarian cancer (CEBOC): a single-arm, phase II safety trial
A Murphy and others
International Journal of Gynaecological Cancer, 2024. Volume 34, issue 7, pages 1034-1040.

Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.