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Pazopanib Hydrochloride With or Without Bicalutamide in Treating Patients With Prostate Cancer That Did Not Respond to Hormone Therapy

A Phase 2 Study of GW786034 (Pazopanib) With or Without Bicalutamide in Hormone Refractory Prostate Cancer

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00486642
Enrollment
23
Registered
2007-06-14
Start date
2007-09-30
Completion date
2015-09-30
Last updated
2017-05-24

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hormone-Resistant Prostate Cancer, Recurrent Prostate Carcinoma

Brief summary

This randomized phase II trial is studying how well giving pazopanib with or without bicalutamide works in treating patients with prostate cancer that did not respond to hormone therapy. Pazopanib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as bicalutamide, may lessen the amount of androgens made by the body. Giving pazopanib hydrochloride together with bicalutamide may be an effective treatment for prostate cancer.

Detailed description

PRIMARY OBJECTIVES: I. To determine the therapeutic activity of GW786034 (pazopanib hydrochloride) with and without bicalutamide in the treatment of hormone-refractory prostate cancer using prostate specific antigen (PSA)-response rate. SECONDARY OBJECTIVES: I. To estimate objective tumor response in patients with measurable disease. II. To estimate the median time to progression. III. To investigate the safety and tolerability of GW786034 with and without bicalutamide. IV. To estimate the median duration of PSA-response. V. To determine the steady state levels of GW786034 with and without bicalutamide. VI. To investigate the correlation between prior exposure to bicalutamide and non-steroidal anti-androgens with response and survival outcomes. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive pazopanib hydrochloride orally (PO) once daily (QD) on days 1-28. ARM II: Patients receive pazopanib hydrochloride PO QD on days 1-28. Patients also receive bicalutamide PO QD on days 8-28 of course 1 and on days 1-28 in all subsequent courses. Courses in both arms repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 4 weeks for 12 weeks.

Interventions

DRUGBicalutamide

Given PO

OTHERLaboratory Biomarker Analysis

Correlative studies

DRUGPazopanib Hydrochloride

Given PO

OTHERPharmacological Study

Correlative studies

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
MALE
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Histologically or cytologically confirmed prostate cancer * Must have received prior hormonal therapy, including either medical (luteinizing hormone-releasing hormone \[LHRH\] agonist) or surgical (orchiectomy) castration * Castrate level of testosterone (\< 50 ng/dL) * Patients treated with LHRH agonists must continue or restart this therapy * Must have radiological documentation of either measurable or non-measurable disease * Must show documented progression of prostate cancer while on hormonal therapy as indicated by PSA increase * Rising PSA is defined as ≤ 2 consecutive rises in PSA taken ≥ 1 week and ≤ 2 months apart * PSA \>= 5 ng/mL * No known brain metastases * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 OR Karnofsky PS 60-100% * Life expectancy \> 3 months * White blood cell (WBC) \>= 3,000/mm\^3 * Absolute neutrophil count (ANC) \>= 1,500/mm\^3 * Platelet count \>= 100,000/mm\^3 * International normalized ratio (INR) =\< 1.2 * Activated partial thromboplastin time (PTT) =\< 1.2 times upper limit of normal (ULN) * Bilirubin normal * Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 1.5 times ULN * Creatinine normal OR creatinine clearance \>= 60 mL/min * Fertile patients must use effective contraception * No history of allergic reactions attributed to compounds of similar chemical or biological composition to pazopanib hydrochloride or bicalutamide * Proteinuria =\< 1+ on 2 consecutive dipsticks taken \>= 1 week apart * QTc \< 480 msec * No significant electrocardiogram (ECG) abnormalities * No poorly controlled hypertension (systolic blood pressure \[BP\] \> 150 mm Hg or diastolic BP \> 90 mm Hg) * No condition (e.g., gastrointestinal \[GI\] tract disease resulting in an inability to take oral medication or a requirement for intravenous (IV) alimentation; prior surgical procedures affecting absorption; or active peptic ulcer disease) that impairs the ability to swallow and retain pazopanib hydrochloride tablets * No serious or nonhealing wound, ulcer, or bone fracture * No abdominal fistula, gastrointestinal (GI) perforation, or intra-abdominal abscess within the past 28 days * No cerebrovascular accident within the past 6 months * No myocardial infarction, cardiac arrhythmia, admission for unstable angina, cardiac angioplasty, or stenting within the past 12 weeks * No venous thrombosis within the past 12 weeks * No New York Heart Association (NYHA) class III-IV heart failure * Patients with a history of NYHA class II heart failure who are asymptomatic on treatment are eligible * No concurrent uncontrolled illness, including, but not limited to, ongoing or active infection * No psychiatric illness or social situation that would preclude study compliance * Recovered from all prior therapy * Prior neoadjuvant or adjuvant chemotherapy allowed * More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) or radiotherapy * At least 4 weeks since prior antiandrogens * At least 4 weeks since prior surgery * No prior bicalutamide therapy lasting \> 3 months in duration * Concurrent steroids allowed if no change in steroid dosage within the past 4 weeks * No other concurrent investigational agents * No concurrent therapeutic warfarin * Concurrent low molecular weight heparin or prophylactic low-dose warfarin allowed * No concurrent combination antiretroviral therapy for human immunodeficiency virus (HIV)-positive patients

Design outcomes

Primary

MeasureTime frameDescription
PSA Response RateUp to 12 weeksProstate-specific antigen (PSA) response rate (defined as a confirmed \> / = 50% decline (minimum 5ng/ml) in PSA from baseline maintained for \>4 weeks, and without other evidence of disease progression documented at time of confirmatory values).

Secondary

MeasureTime frameDescription
Objective Tumor Response Rate as Assessed by RECIST CriteriaTime from start of treatment to time criteria are met for disease progression or death from any cause, whichever came first, assessed up to 5 yearsRECIST PR defined as - At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
Progression-free SurvivalFrom time of treatment initiation to disease progression or death from any cause, whichever came first, assessed up to 5 yearsPFS is defined as the time from treatment initiation to disease progression or death from any cause, whichever came first. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions
Median Duration of PSA-ResponseFrom time PSA response criteria are met until time PSA progression criteria are met or death from any cause, whichever came first, up to 5 yearsDefinition of PSA response: \>= 50% fall (minimum 5 ng/ml) in PSA from baseline maintained for \>4 weeks, and without other evidence of disease progression documented at time of confirmatory values. PSA response duration will commence on the date of the first \>=50% decline in PSA. The response duration ends when PSA progression criteria are met with the second increasing PSA value. PSA progression in PSA responders: rise in PSA of 50% (minimum 5ng/ml) above nadir value and confirmed by a second increasing value at least 1 week later.
Time to Disease ProgressionTime from start of treatment to time criteria are met for disease progression or death from any cause, whichever came first, assessed up to 5 yearsEarliest date on which disease progression was determined by any of the methods listed: PSA progression, objective disease progression (Response Evaluation Criteria in Solid Tumors \[RECIST\] criteria) or cancer-related symptomatic progression.
ToxicityAssessed up to 5 yearsPatients who came off treatment due to toxicity.
Stable Disease Rate as Assessed by RECIST CriteriaMeasured from the start of the treatment until the criteria for progression are met or death from any cause, whichever came first, assessed up to 5 yearsRECIST Stable defined as - Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Other

MeasureTime frameDescription
Median Survival TimeUp to 1 year after completion of treatmentCalculated by Kaplan and Meier
Survival RateAt 1 yearCalculated by Kaplan and Meier.

Countries

Canada

Participant flow

Participants by arm

ArmCount
Arm A - Pazopanib
Patients receive pazopanib hydrochloride PO QD on days 1-28. Laboratory Biomarker Analysis: Correlative studies Pazopanib Hydrochloride: Given PO Pharmacological Study: Correlative studies
10
Arm B - Pazopanib + Bicalutamide
Patients receive pazopanib hydrochloride PO QD on days 1-28. Patients also receive bicalutamide PO QD on days 8-28 of course 1 and on days 1-28 in all subsequent courses. Laboratory Biomarker Analysis: Correlative studies Pazopanib Hydrochloride: Given PO Pharmacological Study: Correlative studies
13
Total23

Baseline characteristics

CharacteristicArm B - Pazopanib + BicalutamideArm A - PazopanibTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
9 Participants2 Participants11 Participants
Age, Categorical
Between 18 and 65 years
4 Participants8 Participants12 Participants
Age, Continuous70 years71 years71 years
Region of Enrollment
Canada
13 participants10 participants23 participants
Sex: Female, Male
Female
0 Participants0 Participants0 Participants
Sex: Female, Male
Male
13 Participants10 Participants23 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 102 / 13
other
Total, other adverse events
10 / 1013 / 13
serious
Total, serious adverse events
2 / 103 / 13

Outcome results

Primary

PSA Response Rate

Prostate-specific antigen (PSA) response rate (defined as a confirmed \> / = 50% decline (minimum 5ng/ml) in PSA from baseline maintained for \>4 weeks, and without other evidence of disease progression documented at time of confirmatory values).

Time frame: Up to 12 weeks

Population: 9 evaluable in Arm A + 12 evaluable in Arm B

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm A - PazopanibPSA Response Rate1 Participants
Arm B - Pazopanib + BicalutamidePSA Response Rate2 Participants
Secondary

Median Duration of PSA-Response

Definition of PSA response: \>= 50% fall (minimum 5 ng/ml) in PSA from baseline maintained for \>4 weeks, and without other evidence of disease progression documented at time of confirmatory values. PSA response duration will commence on the date of the first \>=50% decline in PSA. The response duration ends when PSA progression criteria are met with the second increasing PSA value. PSA progression in PSA responders: rise in PSA of 50% (minimum 5ng/ml) above nadir value and confirmed by a second increasing value at least 1 week later.

Time frame: From time PSA response criteria are met until time PSA progression criteria are met or death from any cause, whichever came first, up to 5 years

Population: 1 patient in Arm A and 2 patients in Arm B had a PSA response.

ArmMeasureValue (MEDIAN)
Arm A - PazopanibMedian Duration of PSA-Response8.3 months
Arm B - Pazopanib + BicalutamideMedian Duration of PSA-Response13.1 months
Secondary

Objective Tumor Response Rate as Assessed by RECIST Criteria

RECIST PR defined as - At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Time frame: Time from start of treatment to time criteria are met for disease progression or death from any cause, whichever came first, assessed up to 5 years

Population: 5 evaluable patients in Arm A + 9 evaluable patients in Arm B

ArmMeasureValue (NUMBER)
Arm A - PazopanibObjective Tumor Response Rate as Assessed by RECIST Criteria0 patient
Arm B - Pazopanib + BicalutamideObjective Tumor Response Rate as Assessed by RECIST Criteria1 patient
Secondary

Progression-free Survival

PFS is defined as the time from treatment initiation to disease progression or death from any cause, whichever came first. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions

Time frame: From time of treatment initiation to disease progression or death from any cause, whichever came first, assessed up to 5 years

ArmMeasureValue (MEDIAN)
Arm A - PazopanibProgression-free Survival7.3 months
Arm B - Pazopanib + BicalutamideProgression-free Survival11.3 months
Secondary

Stable Disease Rate as Assessed by RECIST Criteria

RECIST Stable defined as - Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.

Time frame: Measured from the start of the treatment until the criteria for progression are met or death from any cause, whichever came first, assessed up to 5 years

Population: 5 evaluable patients in Arm A + 9 evaluable patients in Arm B

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm A - PazopanibStable Disease Rate as Assessed by RECIST Criteria2 Participants
Arm B - Pazopanib + BicalutamideStable Disease Rate as Assessed by RECIST Criteria8 Participants
Secondary

Time to Disease Progression

Earliest date on which disease progression was determined by any of the methods listed: PSA progression, objective disease progression (Response Evaluation Criteria in Solid Tumors \[RECIST\] criteria) or cancer-related symptomatic progression.

Time frame: Time from start of treatment to time criteria are met for disease progression or death from any cause, whichever came first, assessed up to 5 years

ArmMeasureValue (MEDIAN)
Arm A - PazopanibTime to Disease Progression7.3 months
Arm B - Pazopanib + BicalutamideTime to Disease Progression11.3 months
Secondary

Toxicity

Patients who came off treatment due to toxicity.

Time frame: Assessed up to 5 years

ArmMeasureValue (NUMBER)
Arm A - PazopanibToxicity3 participants
Arm B - Pazopanib + BicalutamideToxicity6 participants
Other Pre-specified

Median Survival Time

Calculated by Kaplan and Meier

Time frame: Up to 1 year after completion of treatment

Population: Very little death information is captured for this study so OS analysis was not done.

Other Pre-specified

Survival Rate

Calculated by Kaplan and Meier.

Time frame: At 1 year

Population: Very little death information is captured for this study so OS analysis was not done.

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026