A trial comparing surgery before and during chemotherapy for ovarian, fallopian tube or primary peritoneal cancer (CHORUS)

Who can enter

You can enter this trial if you

• Have recently been diagnosed with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer that has spread to another part of your body
• Have not had treatment for your cancer yet
• Are well enough to have surgery
• Are due to have carboplatin alone, or carboplatin and paclitaxel (Taxol)
• Are well enough to take part

You cannot enter this trial if you have had

• Treatment for your ovarian, fallopian tube or primary peritoneal cancer already
• Any other cancer in the past, and the doctors feel that either your cancer or the treatment you had will effect this trial

Trial design

This is a randomised trial. It will recruit 550 patients into 2 groups. Neither you nor your doctor will be able to decide which group you are in. If you are in group 1, you will have an operation and then have chemotherapy. If you are in group 2, you will have some chemotherapy first (neo adjuvant chemotherapy), then an operation, and then the rest of the chemotherapy.

You will have carboplatin chemotherapy, either on its own or alongside another drug called paclitaxel (Taxol). The doctors will decide which treatment is best for each individual patient.

You have carboplatin and paclitaxel through a drip into a vein once every 3 weeks (one cycle). You will have a total of 6 cycles. If you are in group 1, you have all 6 cycles after your operation. If you are in group 2, you have 3 cycles before your operation and the other 3 cycles afterwards.

You will fill out a questionnaire before you have treatment, half way through and at various times after you finish treatment. This will ask you how you are feeling, what side effects you have had, and what you think about the treatment. This is called a Quality of Life questionnaire.

Hospital visits

You will have some tests before you take part in the trial. These include blood tests and either a CT scan or an MRI scan. If you are in group 2 and due to have chemotherapy rather than surgery to start with, you will also have a biopsy of your cancer.

If you are in group 1, you start chemotherapy about 6 weeks after your operation. You will go to hospital for one day every 3 weeks for chemotherapy. You have 6 cycles of chemotherapy over about 4 months.

If you are in group 2, you have 3 cycles of chemotherapy over about 2 months to begin with. About 3 weeks later you have the operation. And about 6 weeks after that you have the other 3 cycles of chemotherapy over another 2 months.

After you finish treatment you will see the trial doctors

• 9 months after you are ‘randomised’ into a treatment group, and then
• Every 3 months for 2 years
• Every 6 months for another 3 years
• Every year after that

Side effects

The main side effects of carboplatin and paclitaxel are

• A drop in blood cells causing an increased risk of infection, bleeding or bruising problems, tiredness or shortness of breath
• Feeling or being sick
• Loss of fertility
• Hair loss
• Numbness and tingling in hands and feet (peripheral neuropathy)

There is more information about carboplatin, paclitaxel and surgery for ovarian cancer on CancerHelp UK.