Adaptive ChemoTherapy for Ovarian cancer: A multicentre phase II randomised controlled trial to evaluate the efficacy of Adaptive Therapy (AT) with carboplatin, based on changes in CA125, in patients with relapsed platinum-sensitive high grade serous or high grade endometrioid ovarian cancer
Recipient organisationNIHR Leicester Clinical Research Facility
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Ongoing
In plain English
AI plain-English summary
A UK trial is testing whether giving chemotherapy in pulses—letting drug-sensitive cancer cells regrow between doses—can keep ovarian cancer treatable for longer. The ACTOv trial compares standard six-course carboplatin treatment with an “adaptive therapy” schedule of up to twelve courses, where the dose is raised or lowered based on each patient’s CA125 blood levels. The problem is that standard chemotherapy kills sensitive cells but leaves slower-growing resistant ones behind, so most women eventually die from drug-resistant disease. Adaptive therapy exploits this: by pausing treatment, it allows sensitive cells to outcompete resistant ones, re-sensitising the tumour. If it works, patients could receive less drug overall, experience fewer side effects, and live longer before the cancer becomes untreatable. The trial is recruiting 80 women across nine UK hospitals, with follow-up for one year after treatment ends. This is a pragmatic, patient-centred trial testing a simple scheduling change—not a new drug—that could transform how recurrent ovarian cancer is managed without requiring new infrastructure or manufacturing.
View original technical description
We are conducting the ACTOv trial in 9 sites in the UK to find out whether a new way of giving chemotherapy doses called ‘adaptive therapy’ (AT), can work better than standard dose chemotherapy and improve treatment in women with advanced stage ovarian cancer that has come back (recurrent). To be eligible, women must have been previously treated with chemotherapy and need treatment again with carboplatin chemotherapy. With standard dose chemotherapy, drug sensitive cancer cells are killed, leaving resistant cells behind and so most patients eventually die with drug-resistant cancer. It is known that drug-resistant cells usually grow more slowly than their drug-sensitive counterparts. AT will prescribe periods without drug to allow faster-growing sensitive cells to take over the tumour, thereby re-sensitising the cancer to the next round of treatment. In this trial, the proposed adaptive therapy is to either increase or decrease the dose of carboplatin, according to changes in CA125 in each individual patient. CA125 is a chemical that is released by some cancer cells and measured by a blood test which is already used routinely to monitor ovarian cancer growth and response to treatment.The women who consent to take part are put into one of the following treatment groups by computer: 1) control group to receive usual standard of care 6 courses of chemotherapy or 2) AT group to receive 12 courses of chemotherapy. Each woman will be followed up for 12 months after receiving their last treatment. Translational research including mandatory blood samples and optional tumour samples forms part of the trial.The proposed AT could transform cancer care: patients could receive less drug, less often, and live longer with fewer treatment-related side effects.The target accrual is 80 patients from 9 hospitals in the UK. The trial is funded by Barts Charity and Anticancer Fund, sponsored by University College London and coordinated by the CR UK & UCL Cancer Trials Centre.
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