Carcinoma, Renal Cell
Conditions
Keywords
Angiogenesis, Renal Cell Carcinoma, Solid tumors, Pazopanib(GW786034)
Brief summary
Phase II, multi-center, two-stage study utilising a randomised discontinuation design to evaluate the safety and efficacy of GW786034 (pazopanib) in adult subjects with locally recurrent or metastatic clear-cell Renal Cell Carcinoma (RCC). After the interim analysis, the design was changed to an open label, single arm study with all subjects receiving pazopanib.
Interventions
DRUGGW786034
All patients receive GW786034. At week 12, some subjects will be randomized based on response (SD) and the others will remain on drug. After the interim analysis, the design was changed to an open label, single arm study with all subjects receiving pazopanib.
DRUGPlacebo
All patients receive GW786034. At week 12, some subjects will be randomized based on response (SD) and the others will remain on drug. After the interim analysis, the design was changed to an open label, single arm study with all subjects receiving pazopanib.
Sponsors
GlaxoSmithKline
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically or cytologically confirmed diagnosis of Renal Cell Carcinoma of predominantly clear-cell histology (excluding chromophobe, papillary, collecting duct, and undifferentiated tumors) which is metastatic or locally recurrent * Either no prior systemic therapy or failed only 1 prior cytokine-based or bevacizumab-based therapy * Evidence of documented measurable disease by RECIST criteria * Male or female at least 21 years of age A woman is eligible to enter and participate in the study if she is of: 1. Non-childbearing potential (i.e., physiologically incapable of becoming pregnant), including any female who: * Has had a hysterectomy, * Has had a bilateral oophorectomy (ovariectomy), * Has had a bilateral tubal ligation, * Is post-menopausal (total cessation of menses for \>= 1 year). 2. Childbearing potential, has a negative serum pregnancy test at Screening Period and serum or urine pregnancy test at Day1, and agrees to use adequate contraception. GSK acceptable contraceptive methods, when used consistently and in accordance with both the product label and the instructions of the physician, are as follows: * An intrauterine device (IUD) with a documented failure rate of less than 1% per year. * Vasectomized partner who is sterile prior to the female subject's entry and is the sole sexual partner for that female. * Complete abstinence from sexual intercourse for 14 days before exposure to investigation product, through the clinical trial, and for at least 21 days after the last dose of investigational product. * Double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm with spermicide). A man with a female partner of childbearing potential is eligible to enter and participate in the study if he uses a barrier method of contraception (e.g. condom) or abstinence during the study and for 28 days following the last dose of investigational drug. * Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 or 1. * Adequate bone marrow function. * Adequate hepatic function. * Adequate renal function. * Adequate PT/PTT or INR/aPTT. * Able to swallow and retain oral medications. * Written informed consent.
Exclusion criteria
* Received prior non-cytokine or non-bevacizumab therapies . * Received chemotherapy for renal cell carcinoma. * Have had any major surgery, radiotherapy, or immunotherapy within the last 28 days and/or not recovered from prior therapy. * History of hypercalcemia within two months of start of therapy. * Patients who are pregnant or lactating. * Poorly controlled hypertension. * QTc prolongation defined as a QTc interval ≥ 480 msecs or other significant ECG abnormalities. * Has Class II, III or IV heart failure as defined by the New York Heart Association functional classification system. A subject who has a history of Class II heart failure and is asymptomatic on treatment may be considered eligible. * Any history of cerebrovascular accident \[CVA\]. * History of myocardial infarction, admission for unstable angina, cardiac angioplasty or stenting within the last 12 weeks. * History of venous thrombosis in last 12 weeks. * Current use of therapeutic warfarin. * Use of antiplatelet agents other than aspirin (≤ 325 mg/day). * Leptomeningeal or brain metastases. * Prior history of malignancies other than renal cell carcinoma (except for basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the cervix or breast, or the subject has been free of any other malignancies for \> 5 years). * Any serious and/or unstable pre-existing medical, psychiatric, or other condition (including lab abnormalities) that could interfere with subject safety or obtaining informed consent. * History of malabsorption syndrome, disease significantly affecting gastrointestinal function or major resection of the stomach or small bowel that could affect absorption, distribution, metabolism or excretion of study drugs. Has any unresolved bowel obstruction or diarrhea. * Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol. * Is on any specifically prohibited medication or requires any of these medications during treatment with GW786034.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall Response by RECIST Criteria | Baseline to Response (up to 2.40 years). Assessments occurred at Week 12 and every 8 weeks thereafter. | The overall response is the number of participants who experience a confirmed complete (CR) or partial response (PR) of the total analysis population. Per the Response Evaluation Criteria In Solid Tumors (RECIST): CR = all detectable tumor has disappeared, PR = a \>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum, Progressive disease (PD) = a \>=20% increase in target lesions, Stable Disease = small changes that do not meet previously given criteria. |
| Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Week 12 | The protocol called for an interim analysis of the first 60 participants to determine their status at Week 12, and to determine the number of participants with stable disease, although all categories were reported. Stable disease is defined as a disease that has not grown enough to be called progressive disease and has not shrunk enough to be called partial/complete response. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Response | First response until progression of disease (up to 2.40 years). Assessments occurred at Week 12 and every 8 weeks thereafter. | Using RECIST criteria: date of first confirmed tumor response (CR or PR) to date of tumor progression or to death. Participants who did not progress or die were censored at their last radiologic assessment. Only participants who had a response were analyzed. |
| Progression-free Survival | From the first day of treatment to the earliest date of disease progression or death due to any cause (up to 2.40 years) | Progression-free Survival is defined as the interval between the first day of treatment and the earliest date of disease progression or death due to any cause, whichever occurred first. Progressive disease is defined as a \>=20% increase in target lesions. |
Countries
Australia, Belgium, China, Czechia, Hong Kong, Israel, Taiwan, United States
Participant flow
Recruitment details
This study was originally designed as a Phase II, multi-centre study utilizing a randomized discontinuation design. In the original study design, a 12-week Lead-in Phase was an open-label period during which all enrolled participans received pazopanib.
Pre-assignment details
All participants began with 12 weeks of open-label treatment. In the original design, participants with stable disease at Week 12 were to be randomized. After the interim analysis, the study was amended to be treated like a single-arm open-label study. Any participants who had been randomized to placebo were to be crossed back to pazopanib.
Participants by arm
| Arm | Count |
|---|---|
| Pazopanib 800 mg Pazopanib 800 milligrams (mg) (tablets) administered orally once a day | 225 |
| Total | 225 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 37 |
| Overall Study | Death | 1 |
| Overall Study | Declining Performance Status | 1 |
| Overall Study | Developed Secondary Malignancy | 1 |
| Overall Study | Disease Progression | 13 |
| Overall Study | Lost to Follow-up | 23 |
| Overall Study | Off Study Medication for >21 Days | 1 |
| Overall Study | Participant was Hospitalized until Death | 1 |
| Overall Study | Primary Investigator Discretion | 2 |
| Overall Study | Protocol Violation | 2 |
| Overall Study | Sponsor Terminated Study | 2 |
| Overall Study | Withdrawal by Subject | 12 |
Baseline characteristics
| Characteristic | Pazopanib 800 mg |
|---|---|
| Age, Continuous | 59.8 years STANDARD_DEVIATION 10.33 |
| Race/Ethnicity, Customized African American/African Heritage (HER) | 4 participants |
| Race/Ethnicity, Customized American Indian or Alaska Native and White | 1 participants |
| Race/Ethnicity, Customized Asian-Central/South Asian Heritage | 2 participants |
| Race/Ethnicity, Customized Asian-Japanese/East Asian/South East Asian HER | 38 participants |
| Race/Ethnicity, Customized Asian-Mixed Asian Heritage | 1 participants |
| Race/Ethnicity, Customized Native Hawaiian or other Pacific Islander | 1 participants |
| Race/Ethnicity, Customized White | 178 participants |
| Sex: Female, Male Female | 69 Participants |
| Sex: Female, Male Male | 156 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 215 / 225 |
| serious Total, serious adverse events | 80 / 225 |
Outcome results
Primary
Overall Response by RECIST Criteria
The overall response is the number of participants who experience a confirmed complete (CR) or partial response (PR) of the total analysis population. Per the Response Evaluation Criteria In Solid Tumors (RECIST): CR = all detectable tumor has disappeared, PR = a \>=30% decrease in the sum of the longest dimensions of the target lesions taking as a reference the baseline sum, Progressive disease (PD) = a \>=20% increase in target lesions, Stable Disease = small changes that do not meet previously given criteria.
Time frame: Baseline to Response (up to 2.40 years). Assessments occurred at Week 12 and every 8 weeks thereafter.
Population: All Enrolled: all participants who received at least one dose of pazopanib
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Not evaluable | 22 participants |
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Complete Response | 3 participants |
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Partial Response | 75 participants |
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Stable Disease | 101 participants |
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Progressive Disease | 24 participants |
| Pazopanib 800 mg | Overall Response by RECIST Criteria | Complete Response + Partial Response | 78 participants |
95% CI: [28.4, 40.9]
Primary
Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants
The protocol called for an interim analysis of the first 60 participants to determine their status at Week 12, and to determine the number of participants with stable disease, although all categories were reported. Stable disease is defined as a disease that has not grown enough to be called progressive disease and has not shrunk enough to be called partial/complete response.
Time frame: Week 12
Population: Subset of the All Enrolled Population including only the first 60 participants
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Pazopanib 800 mg | Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Complete Response | 0 participants |
| Pazopanib 800 mg | Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Partial Response | 23 participants |
| Pazopanib 800 mg | Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Stable Disease | 25 participants |
| Pazopanib 800 mg | Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Progressive Disease | 3 participants |
| Pazopanib 800 mg | Stable Disease at 12 Weeks - Interim Analysis of First 60 Participants | Unknown | 9 participants |
95% CI: [29, 54]
Secondary
Duration of Response
Using RECIST criteria: date of first confirmed tumor response (CR or PR) to date of tumor progression or to death. Participants who did not progress or die were censored at their last radiologic assessment. Only participants who had a response were analyzed.
Time frame: First response until progression of disease (up to 2.40 years). Assessments occurred at Week 12 and every 8 weeks thereafter.
Population: All participants in the Enrolled Population who had a CR or PR
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Pazopanib 800 mg | Duration of Response | 68 weeks |
Secondary
Progression-free Survival
Progression-free Survival is defined as the interval between the first day of treatment and the earliest date of disease progression or death due to any cause, whichever occurred first. Progressive disease is defined as a \>=20% increase in target lesions.
Time frame: From the first day of treatment to the earliest date of disease progression or death due to any cause (up to 2.40 years)
Population: All Enrolled Population. Participants who did not progress or die were censored at their last radiologic assessment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Pazopanib 800 mg | Progression-free Survival | 45.3 weeks |