Study of Gemcitabine and Concurrent Radiation Followed by Adjuvant Hysterectomy in Bulky Stage Ib and IIa Cervical Carcinoma

Phase 1

Completed

Brief Summary: The purpose of this study is first to establish what is the ideal dose of gemcitabine, a chemotherapy agent, when given in combination with radiation. In addition, the investigators want to determine the side effects and the effectiveness of this combination. The investigators will also study several markers to try to identify markers or tests that will predict which patients will benefit more from this treatment.

Recruitment & Eligibility

Inclusion Criteria

Patients with histologically confirmed bulky stage Ib or stage IIa cervical cancer. Bulky stage Ib disease is defined as tumor mass greater than 4 cms in diameter.
Cervical lesion which is measurable by physical examination.
No prior therapy for invasive cervical cancer.
GOG performance status 0-2
Signed informed consent
Patients must have adequate:
- Bone marrow function: absolute granulocyte count > or = to 1500, platelet count > 100,000.
- Renal function: creatinine < or = to 1.8 mg/dl
- Hepatic function: bilirubin < or = to 1.5 x normal, SGOT and alkaline phosphatase < or = to 3 x normal

Exclusion Criteria

Patients with a history of prior malignancy, except adequately treated basal cell or squamous cell carcinoma of the skin, or other cancer for which the patient has been disease free for at least five years.
Pregnant or lactating women. Women of reproductive age may not participate unless they have agreed to use an effective method of birth control.
Patients with uncontrolled infection.
Patients who are HIV positive
Patients with psychiatric or social conditions that would interfere with consent or follow-up.
Patients with any other severe concurrent disease, which, in the judgment of the investigator, would make the patient inappropriate for entry into this study.

Arm && Interventions

Group	Intervention	Description
Gemcitabine weekly x 6 wks with concurrent external radiation	Gemcitabine	Gemcitabine 350 mg/m2 IV weekly x 6 weeks with concurrent external radiation

Primary Outcome Measures

Name	Time	Method
Toxicity (Number of Participants With Serious Adverse Events)	Every 3 weeks from start of study until 30 days after the last dose of treatment	Summary of grade 3 or higher toxicities as per Common Toxicity Criteria version 2.0. Phase 1 and 2 Combined (N=35)

Secondary Outcome Measures

Name	Time	Method
Best Overall Response of Either a Complete Response (CR) or Partial Response (PR)	Baseline to response (up to 24 months)	Participants who complete the 6 weeks of chemotherapy and radiation or who experience dose limiting toxicity or who progress at any time prior to completion of the 6 weeks of chemotherapy and radiation will be evaluable for response. Complete response (CR): Complete disappearance of all measurable and evaluable disease. No new lesions. No disease related symptoms. No evidence of nonevaluable disease, including normalization of markers and other abnormal lab values. All measurable, evaluable, and nonevaluable lesions and sites must be assessed using the same technique as baseline. Partial response (PR): Applies only to patients with at least one measurable lesion. Greater than or equal to 50% decrease under baseline in the sum of products of perpendicular diameters of all measurable lesions. No progression of evaluable disease. No new lesions. All measurable and evaluable lesions and sites must be assessed using the same techniques as baseline.