Carcinoma, Renal Cell
Conditions
Keywords
renal cell carcinoma, Votrient, cancer, pazopanib, patient preference, quality of life
Brief summary
This is a randomised, double-blind, cross-over study of pazopanib versus sunitinib in patients with locally advanced or metastatic renal cell carcinoma (mRCC) who have received no prior systemic therapy for advanced or metastatic RCC. Approximately 160 eligible patients will be stratified based on the ECOG performance status (0 vs. 1) and number of metastatic sites of disease (0 and 1 vs. \>=2). The study consists of two treatment periods of 10 weeks with a 2-week wash-out period between the two treatment periods. Patients will receive pazopanib and sunitinib treatment sequentially in a double-blinded fashion. The primary objective of the study is to assess how the tolerability and safety differences between pazopanib and sunitinib translate into patient preference, defined by the patient's stated preference for which drug they may prefer to continue treatment with at end of study. The secondary objectives are to evaluate the reason for patient preference as assessed by a patient preference questionnaire; to evaluate fatigue as assessed by FACIT-Fatigue and quality of life as assessed by EuroQoL EQ-5D; to evaluate dose modifications and time to dose modification; and to evaluate safety.
Detailed description
This is a randomised, double-blind, cross-over study to evaluate the patient preference of pazopanib versus sunitinib in patients with locally advanced or metastatic RCC who have received no prior systemic therapy for advanced or metastatic RCC. Approximately 160 eligible patients will be stratified based on the ECOG performance status (0 vs. 1) and number of metastatic sites of disease (0 and 1 vs. 2+). The study consists of two 10-weeks treatment periods with a two-week wash-out period between the treatment periods. Patients will receive pazopanib and sunitinib treatment sequentially. At the end of the second treatment period, patient preference and disease assessment are evaluated and the patients are unblinded. Further treatment is at the discretion of the physician. Further treatment with pazopanib is available within the study. Patients requiring other treatments will complete the study at this point. Patients will be randomized in a 1:1 ratio to receive blinded (overencapsulated) study drug: either 800mg pazopanib orally for 10 weeks followed by 50mg sunitinib orally for 10 weeks or 50mg sunitinib orally for 10 weeks followed by 800mg pazopanib orally for 10 weeks. A two-week washout period will separate the treatment periods (the medical monitor should be consulted if ongoing AEs need to be resolved and the wash-out period needs to be extended). The regimen for sunitinib is 4 weeks of treatment followed by 2 weeks off treatment. To maintain the double-blind during the two weeks off drug for patients on sunitinib ('Treatment Holiday'), patients will be taking matching placebo. No study drug will be taken during the wash-out period in either arm. Following the two-week wash-out period and disease assessment, all patients are planned to cross over to the second treatment. Patients will be informed of their disease assessment result and any patient that wishes to come off study at this point due to a very significant response, defined as more than a 50% reduction in tumour size (or complete response if non-measurable disease), will have the option to be unblinded to continue with whichever treatment they were on, however each patient case will need to be discussed with the medical monitor prior to unblinding. Patients who were on sunitinib will leave the study and continue treatment outside the study. Patients who were on pazopanib will continue on pazopanib within the pazopanib open-label part of the study. Conversely, should a patient have a very significant response and wish to cross over or complete the study, this must be documented in the patients notes. Patients crossing over with progressive disease will follow the same visit schedule and assessments and investigators will have the option for these patients to be unblinded or not. The patients' preference will be collected and analysed but will not contribute to the primary, but an exploratory analysis because of the bias caused by progressing on the first treatment. Even if unblinded, patients may continue to receive the second treatment and may receive open label pazopanib after the second treatment within the study if they did not progress on pazopanib. Patients who withdraw from treatment due to unacceptable toxicity or progression during the first treatment period will cross-over directly to the second treatment following a 2-week wash-out period. Actual further treatment at the end of the study will be at the discretion of the investigator taking into account both disease assessments results, laboratory results and the patient preference. Choice and rationale for continuing treatment will be documented. Patients who did not progress on pazopanib and who prefer to continue with pazopanib may continue on pazopanib and will be followed up for safety until the patient comes off pazopanib due to disease progression, toxicity, death or patient choice, which ever is the earliest. Those patients that may benefit from further treatment with sunitinib for the same reasons as above will receive it off study and will not be followed up, as will patients who receive any other treatment. Patients are permitted to receive supportive care throughout the study including transfusion of blood and blood products, treatment with antibiotics, anti-emetics, anti-diarrhoeal agents, analgesics, erythropoietin or bisphosphonates, when appropriate. The study treatment will continue until the end of the two treatment periods or unacceptable toxicity or consent withdrawal or death, whichever occurs first. The patient preference will be ascertained prior to the second disease assessment result being shared with the patient to avoid bias.
Interventions
DRUGpazopanib
oral anti-angiogenic treatment
DRUGsunitinib
oral anti-angiogenic treatment
Sponsors
Novartis Pharmaceuticals
Study design
Allocation
RANDOMIZED
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients must provide written informed consent prior to performance of any study-specific procedures or assessments and must be willing to comply with treatment and follow up. Procedures conducted as part of the patient's routine clinical management (e.g. blood count, imaging study) and obtained prior to signing of informed consent may be utilised for screening or baseline purposes provided these procedures are conducted as specified in the protocol. * Received no prior systemic therapy (including interleukin-2, interferon-alpha, chemotherapy, bevacizumab, mTOR inhibitor, sunitinib, sorafenib or other VEGF TKI) for advanced or metastatic RCC. Patients who received adjuvant treatment with a cancer vaccine are eligible. * Locally advanced (defined as disease not amenable to curative surgery or radiation therapy) or metastatic renal cell carcinoma of any histology (equivalent to Stage IV RCC according to AJCC staging). Patients with non-measurable disease are allowed if metastatic disease can be confirmed. * ECOG PS of 0 or 1 * Age \>= 18 years * A female is eligible to enter and participate in this study if she is of: Non-childbearing potential (i.e. physiologically incapable of becoming pregnant) Childbearing potential, including any female who has had a negative serum pregnancy test within two weeks prior to the first dose of study treatment, preferably as close to the first dose as possible and agrees to use adequate contraception. * Adequate organ system functions * Total serum calcium concentration \<12.0mg/dL * Left ventricular ejection fraction (LVEF) \>=lower limit of institutional normal (LLN) as assessed by echocardiography (ECHO) or multigated acquisition (MUGA) scan. The same modality used at baseline must be applied for subsequent evaluations. * Patient is able to swallow and retain oral tablets
Exclusion criteria
* Poor MSKCC risk group * History of another malignancy. Note: Patients who have had another malignancy and have been disease-free for 3 years or patients with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma are eligible. * History or clinical evidence of central nervous system (CNS) metastases. Note: Patients who have previously-treated CNS metastases (surgery +/- radiotherapy, radiosurgery, or gamma knife) and meet all 3 of the following criteria are eligible: * Are asymptomatic, * Have had no evidence of active CNS metastases for \>=6 months prior to enrolment , * Have no requirement for steroids or enzyme-inducing anticonvulsants (EIAC). * Any clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding or affect absorption of investigational product including, but not limited to: * Malabsorption syndrome * Major resection of the stomach or small bowel that could affect the absorption of study drug * Active peptic ulcer disease * Inflammatory bowel disease * Ulcerative colitis, or other gastrointestinal conditions with increased risk of perforation * History of abdominal fistula, gastrointestinal perforation, or intra abdominal abscess within 28 days prior to beginning study treatment. * Presence of uncontrolled infection. * Corrected QT interval (QTc) \>480 msecs using Bazett's formula * History of one or more of the following cardiovascular conditions within the past 6 months: * Cardiac angioplasty or stenting * Myocardial infarction * Unstable angina * Coronary artery bypass graft surgery * Symptomatic peripheral vascular disease * Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA) * Poorly controlled hypertension (defined as systolic blood pressure (SBP) of \> 150mmHg or diastolic blood pressure (DBP) of \> 90mmHg) at baseline. Note: Initiation or adjustment of antihypertensive medication(s) is permitted prior to study entry. Blood pressure must be re-assessed on two occasions that are separated by a minimum of 1 hour within a visit. The mean SBP/DBP values from each blood pressure assessment must be \<=150/90mmHg in order for a patient to be eligible for the study. \- History of cerebrovascular accident (CVA) including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months. Note: Patients with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible. * Prior major surgery or trauma within 28 days prior to first dose of study drug and/or presence of any non-healing wound, fracture, or ulcer (procedures such as catheter placement not considered to be major). * Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels. * Evidence of active bleeding or bleeding diathesis. * Significant haemoptysis within 6 weeks prior to first dose of study drug. * Any serious and/or unstable pre-existing medical, psychiatric, or other conditions that could interfere with patient's safety, obtaining informed consent or compliance to the study. * Use any prohibited medications within 14 days of the first dose of study medication. * Use of an investigational agent, including an investigational anti-cancer agent, within 28 days or 5 half-lives, whichever is longer, prior to the first dose of study drug. * Radiation therapy, surgery or tumour embolisation within 14 days prior to the first dose of study treatment. * Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib or sunitinib. * Pregnant or lactating female Female patients who are lactating should discontinue nursing prior to the first dose of study drug and should refrain from nursing throughout the treatment period and for 14 days following the last dose of study drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | End of treatment of both study drugs (maximum of 22 weeks) | The PPQ is used to measure participants' preference for pazopanib or sunitinib for renal cell carcinoma management and is used to determine a participant's preference for 1 of the 2 drugs given in the 2 double-blind treatment periods. Participants were asked to select 1 of the following: 1. prefer the drug taken as the first treatment; 2. prefer the drug taken as the second treatment; or 3, no preference. Those participants who indicated a preference were asked to select the factors that had an influence on their treatment preference, as well as the most important reason for their preference. |
| Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | End of treatment of both study drugs (maximum of 22 weeks) | The PPQ is used to measure participants' preference for pazopanib or sunitinib for renal cell carcinoma management and is used to determine a participant's preference for 1 of the 2 drugs given in the 2 double-blind treatment periods. Participants were asked to select 1 of the following: 1. prefer the drug taken as the first treatment; 2. prefer the drug taken as the second treatment; or 3, no preference. Those participants who indicated a preference were asked to select the factors that had an influence on their treatment preference, as well as the most important reason for their preference. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to Dose Modification | End of second treatment period (maximum of 22 weeks) | For the subset of participants who had a dose modification, time to dose modification was defined as the time from the first dose in each period until the first reduction in dose within a period. |
| Number of Participants With the Indicated Number of Dose Reductions | End of second treatment period (maximum of 22 weeks) | Participants are recorded under the treatment they were receiving at the time the dose reduction was reported. |
| Number of Participants With the Indicated Reason for Receiving a Dose Reduction | End of second treatment period (maximum of 22 weeks) | Dose reduction of study drug was a stepwise reduction of the dose of the study drug: one less capsule was received at each step reduction. Participants were monitored for approximately 10 to 14 days at each dose level. Participants are recorded under the treatment they were receiving at the time the dose reduction was reported. |
| Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score | Day 1 (Period [P] 1 Pre-dose); Weeks 2, 4, 6, 8, and 10 of P 1; during 2-week Wash-out Period (Study Weeks 11 and 12); Weeks 2, 4, 6, and 8 of P 2 (Study Weeks 14, 16, 18, 20, and 22, respectively); End of Study (Week 10 of P 2 [Study Week 22]) | Change from period (P) BL is computed as participants' (par.) average post-BL fatigue score within each P minus their P-specific BL score. P 1 BL is the P 1 Pre-Dose assessment; P 2 BL is the wash-out assessment. Crossover analyses compared par. average scores on each treatment, adjusting for sequence. FACIT-Fatigue Scale: overall score (0 to 52)=the sum of scores for 13 questions. For each question, par. rated their condition for the past week on a 5-point scale: 0 (not at all) to 4 (very much). A high score indicates low fatigue. A negative change from BL represents a worsening of condition. |
| Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Baseline to end of study (maximum of 22 weeks) | An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE that spans more than one period is considered to be an AE for each period during which the AE increased in grade. There is only one action with respect to study drug recorded for the whole event. As such, it is not always possible to determine in which study period treatment was discontinued due to the AE. |
| Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | Baseline of Period (P) 1 (Screening); Period 1 Weeks 2 and 6 (Study Weeks 2 and 6); Baseline of Period 2 (Washout=Study Week 12); Period 2 Weeks 2, 6, and 10 (Study Weeks 14, 18, and 22) | When the heart beats, it contracts and pushes blood through the arteries to the rest of body. This force creates pressure on the arteries called SBP. DBP is the pressure in the arteries when the heart rests between beats. Normal levels: SBP (120 mmHg or less); DBP (80 mmHg or less). Mean change from BL for each assessment week was calculated as the average change from period BL at the specified visits (combining data across P 1 and 2 for Weeks 2 and 6). Study weeks are approximate; participants could have crossed over from P 1 to P 2 at earlier time points than specified in the protocol. |
| Change From Baseline (BL) in Heart Rate | Baseline of Period (P) 1 (Screening); Period 1 Weeks 2 and 6 (Study Weeks 2 and 6); Baseline of Period 2 (Washout=Study Week 12); Period 2 Weeks 2, 6, and 10 (Study Weeks 14, 18, and 22) | Heart rate (HR) is the number of heartbeats per unit of time, typically expressed as beats per minute. HR can vary as the body's need to absorb oxygen and excrete carbon dioxide changes, such as during exercise or sleep. A normal resting HR ranges from 60 to 100 beats per minute. Mean change from BL for each assessment week was calculated as the average change from period BL at the specified visits (combining data across P 1 and 2 for Weeks 2 and 6). Study weeks are approximate; participants could have crossed over from P 1 to P 2 at earlier time points than specified in the protocol. |
| Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Baseline to end of study (maximum of 22 weeks) | AEs were graded using the Common Toxicity Criteria from the Cancer Therapy Evaluation Program, Division of Cancer Therapy, National Cancer Institute. Grades: 0 = No AE or within normal limits; 1 = Mild AE; 2 = Moderate AE; 3 = Severe and undesirable AE; 4 = Life-threatening or disabling AE; 5 = Death related to AE. |
| Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Day 1 (Period 1 Pre-dose); during 2-week Wash-out Period (Study Weeks 11 and 12); and End of Study (Week 10 of Period 2 [Study Week 22]) | The EQ-5D is a participant-answered questionnaire measuring 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D has two separate components: utility score and thermometer score. The EQ-5D total utility score ranges from 0 (worst health state) to 1 (perfect health state); 1 reflects the best outcome. The thermometer score ranges from 0 (worst imaginable health state) to 100 (best imaginable health state). |
Countries
Finland, France, Germany, Italy, United Kingdom
Participant flow
Recruitment details
There were169 participants randomized and one participant randomized in error with no data available
Participants by arm
| Arm | Count |
|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg Period 1: Participants received 4 overencapsulated capsules of sunitinib, each containing 12.5 milligrams (mg) of sunitinib, once daily (OD) orally for 4 weeks, followed by 2 weeks off treatment (matching placebo capsules to maintain blind), followed by 50 mg (4 x 12.5 mg) OD orally for 4 weeks. Period 1 was followed by a 2-week wash-out period in which no treatment was given. Period 2: Participants received 4 overencapsulated tablets of pazopanib, each containing 200 mg of pazopanib, OD orally for 10 weeks. Study drugs were taken without food at least one hour before or two hours after a meal. The capsules were swallowed whole and not crushed or broken. The time of day the study drugs were taken remained relatively constant. | 82 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg Period 1: Participants received 4 overencapsulated tablets of pazopanib, each containing 200 mg of pazopanib, OD orally for 10 weeks. Period 1 was followed by a 2-week wash-out period in which no treatment was given. Period2: Participants received 4 overencapsulated capsules of sunitinib, each containing 12.5 mg of sunitinib, OD orally for 4 weeks, followed by 2 weeks off treatment (matching placebo capsules to maintain blind), followed by 50 mg (4 x 12.5 mg) OD orally for 4 weeks. Study drugs were taken without food at least one hour before or two hours after a meal. The capsules were swallowed whole and not crushed or broken. The time of day the study drugs were taken remained relatively constant. | 86 |
| Total | 168 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Open Label Pazopinib | Adverse Event | 0 | 0 | 12 |
| Open Label Pazopinib | Lack of Efficacy | 0 | 0 | 51 |
| Open Label Pazopinib | Physician Decision | 0 | 0 | 20 |
| Open Label Pazopinib | Withdrawal by Subject | 0 | 0 | 1 |
| Period 1 | Adverse Event | 7 | 10 | 0 |
| Period 1 | Entered Open-label Period | 1 | 1 | 0 |
| Period 1 | Lack of Efficacy | 3 | 5 | 0 |
| Period 1 | Physician Decision | 1 | 0 | 0 |
| Period 1 | Withdrawal by Subject | 2 | 2 | 0 |
| Period 2 | Adverse Event | 2 | 1 | 0 |
| Period 2 | Entered Open-label Period | 1 | 0 | 0 |
| Period 2 | Lack of Efficacy | 1 | 4 | 0 |
| Period 2 | Physician Decision | 0 | 1 | 0 |
Baseline characteristics
| Characteristic | Sunitinib 50 mg Followed by Pazopanib 800 mg | Pazopanib 800 mg Followed by Sunitinib 50 mg | Total |
|---|---|---|---|
| Age, Continuous | 62.1 Years STANDARD_DEVIATION 9.56 | 62.2 Years STANDARD_DEVIATION 11.35 | 62.2 Years STANDARD_DEVIATION 10.48 |
| Race/Ethnicity, Customized African American/African Heritage | 1 participants | 0 participants | 1 participants |
| Race/Ethnicity, Customized Asian-Central/South Asian Heritage | 1 participants | 0 participants | 1 participants |
| Race/Ethnicity, Customized Missing | 6 participants | 3 participants | 9 participants |
| Race/Ethnicity, Customized White | 74 participants | 83 participants | 157 participants |
| Sex: Female, Male Female | 30 Participants | 25 Participants | 55 Participants |
| Sex: Female, Male Male | 52 Participants | 61 Participants | 113 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 143 / 148 | 142 / 153 | 73 / 84 |
| serious Total, serious adverse events | 35 / 148 | 30 / 153 | 15 / 84 |
Outcome results
Primary
Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire
The PPQ is used to measure participants' preference for pazopanib or sunitinib for renal cell carcinoma management and is used to determine a participant's preference for 1 of the 2 drugs given in the 2 double-blind treatment periods. Participants were asked to select 1 of the following: 1. prefer the drug taken as the first treatment; 2. prefer the drug taken as the second treatment; or 3, no preference. Those participants who indicated a preference were asked to select the factors that had an influence on their treatment preference, as well as the most important reason for their preference.
Time frame: End of treatment of both study drugs (maximum of 22 weeks)
Population: mITT Population. Responses to some categories of the PPQ may be missing for some participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, No | 8 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, NA | 7 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, Yes | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, No | 11 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, NA | 9 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, Yes | 11 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, No | 7 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, NA | 7 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, Yes | 16 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, No | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, NA | 4 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, Yes | 9 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, No | 4 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, NA | 12 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, Yes | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, No | 14 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, NA | 6 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, Yes | 15 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, No | 6 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, NA | 4 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, Yes | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, No | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, NA | 20 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, Yes | 12 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, No | 8 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, not applicable (N | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, Yes | 6 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, No | 7 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, NA | 12 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, Yes | 6 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, No | 8 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, NA | 11 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, Yes | 10 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, not applicable (N | 6 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, Yes | 65 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, NA | 22 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, No | 28 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, Yes | 9 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, No | 12 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, No | 51 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, Yes | 30 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Change in hair color had less impact, NA | 20 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Quality of life better, NA | 2 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, Yes | 32 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, No | 25 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, No | 30 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, Yes | 14 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Nausea/vomiting had less impact, NA | 17 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, No | 22 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, Yes | 21 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, No | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, No | 44 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Loss of appetite had less impact, Yes | 28 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Diarrhea had less impact, NA | 15 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Other, NA | 66 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, Yes | 23 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in hands/feet had less impact, NA | 28 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, No | 30 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, Yes | 47 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Pain in stomach area had less impact, NA | 27 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, NA | 23 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, Yes | 44 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Fatigue had less impact on life, No | 26 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, No | 23 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Soreness in mouth/throat had less impact, Yes | 32 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants Answering Yes, no, or Not Applicable (N/A) to the Question of Whether the Indicated Factors Influenced Their Preference for Sunitinib or Pazopanib Treatment as Assessed by the Patient Preference Questionnaire | Changes in food tastes had less impact, NA | 12 participants |
Primary
Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ)
The PPQ is used to measure participants' preference for pazopanib or sunitinib for renal cell carcinoma management and is used to determine a participant's preference for 1 of the 2 drugs given in the 2 double-blind treatment periods. Participants were asked to select 1 of the following: 1. prefer the drug taken as the first treatment; 2. prefer the drug taken as the second treatment; or 3, no preference. Those participants who indicated a preference were asked to select the factors that had an influence on their treatment preference, as well as the most important reason for their preference.
Time frame: End of treatment of both study drugs (maximum of 22 weeks)
Population: Modified-Intent-to-Treat (mITT) Population (used for the primary analysis): participants who received at least one dose of study treatment from each treatment period and who did not have documented progressive disease (PD) at the end of Treatment Period 1 and completed the patient preference questionnaire.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | Sunitinib | 19 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | Pazopanib | 37 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | No preference | 4 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | Sunitinib | 6 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | Pazopanib | 43 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Preference for Pazopanib Versus Sunitinib as Assessed by the Patient Preference Questionnaire (PPQ) | No preference | 5 participants |
p-value: <0.00190% CI: [37, 61.5]Prescotts test
Secondary
Change From Baseline (BL) in Heart Rate
Heart rate (HR) is the number of heartbeats per unit of time, typically expressed as beats per minute. HR can vary as the body's need to absorb oxygen and excrete carbon dioxide changes, such as during exercise or sleep. A normal resting HR ranges from 60 to 100 beats per minute. Mean change from BL for each assessment week was calculated as the average change from period BL at the specified visits (combining data across P 1 and 2 for Weeks 2 and 6). Study weeks are approximate; participants could have crossed over from P 1 to P 2 at earlier time points than specified in the protocol.
Time frame: Baseline of Period (P) 1 (Screening); Period 1 Weeks 2 and 6 (Study Weeks 2 and 6); Baseline of Period 2 (Washout=Study Week 12); Period 2 Weeks 2, 6, and 10 (Study Weeks 14, 18, and 22)
Population: Safety-Randomized Study Population. All participants who received sunitinib or pazopanib either during Period 1 or Period 2 were counted in both treatment groups (sunitinib and pazopanib). Only those participants contributing data at the indicated time points were evaluated.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Heart Rate | Week 2, n=137, 145 | -3.1 Beats per minute | Standard Deviation 12.39 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Heart Rate | Week 6, n=106, 131 | 0.8 Beats per minute | Standard Deviation 11.43 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Heart Rate | Week 10, n=60, 64 | -3.8 Beats per minute | Standard Deviation 13.54 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Heart Rate | Week 2, n=137, 145 | -2.7 Beats per minute | Standard Deviation 13.09 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Heart Rate | Week 6, n=106, 131 | -3.3 Beats per minute | Standard Deviation 12.41 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Heart Rate | Week 10, n=60, 64 | -1.8 Beats per minute | Standard Deviation 13.84 |
Secondary
Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP)
When the heart beats, it contracts and pushes blood through the arteries to the rest of body. This force creates pressure on the arteries called SBP. DBP is the pressure in the arteries when the heart rests between beats. Normal levels: SBP (120 mmHg or less); DBP (80 mmHg or less). Mean change from BL for each assessment week was calculated as the average change from period BL at the specified visits (combining data across P 1 and 2 for Weeks 2 and 6). Study weeks are approximate; participants could have crossed over from P 1 to P 2 at earlier time points than specified in the protocol.
Time frame: Baseline of Period (P) 1 (Screening); Period 1 Weeks 2 and 6 (Study Weeks 2 and 6); Baseline of Period 2 (Washout=Study Week 12); Period 2 Weeks 2, 6, and 10 (Study Weeks 14, 18, and 22)
Population: Safety-Randomized Study Population. All participants who received sunitinib or pazopanib either during Period 1 or Period 2 were counted in both treatment groups (sunitinib and pazopanib). Only those participants contributing data at the indicated time points were evaluated.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 10; n=61, 64 | 3.1 Millimeters of mercury (mmHg) | Standard Deviation 10.69 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 6; n=109, 134 | -0.4 Millimeters of mercury (mmHg) | Standard Deviation 9.48 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 2; n=139, 147 | 6.3 Millimeters of mercury (mmHg) | Standard Deviation 15.26 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 10; n=61, 64 | 4.5 Millimeters of mercury (mmHg) | Standard Deviation 18.43 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 6; n=109, 134 | -0.4 Millimeters of mercury (mmHg) | Standard Deviation 18.65 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 2; n=139, 147 | 6.5 Millimeters of mercury (mmHg) | Standard Deviation 9.91 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 6; n=109, 134 | 7.5 Millimeters of mercury (mmHg) | Standard Deviation 17.21 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 2; n=139, 147 | 6.5 Millimeters of mercury (mmHg) | Standard Deviation 10.49 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 10; n=61, 64 | 5.6 Millimeters of mercury (mmHg) | Standard Deviation 11.44 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 10; n=61, 64 | 4.7 Millimeters of mercury (mmHg) | Standard Deviation 20.45 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | DBP, Week 6; n=109, 134 | 6.9 Millimeters of mercury (mmHg) | Standard Deviation 10.87 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Baseline (BL) in Systolic Blood Pressure (SBP) and Diastolic BP (DBP) | SBP, Week 2; n=139, 147 | 7.5 Millimeters of mercury (mmHg) | Standard Deviation 16.36 |
Secondary
Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score
Change from period (P) BL is computed as participants' (par.) average post-BL fatigue score within each P minus their P-specific BL score. P 1 BL is the P 1 Pre-Dose assessment; P 2 BL is the wash-out assessment. Crossover analyses compared par. average scores on each treatment, adjusting for sequence. FACIT-Fatigue Scale: overall score (0 to 52)=the sum of scores for 13 questions. For each question, par. rated their condition for the past week on a 5-point scale: 0 (not at all) to 4 (very much). A high score indicates low fatigue. A negative change from BL represents a worsening of condition.
Time frame: Day 1 (Period [P] 1 Pre-dose); Weeks 2, 4, 6, 8, and 10 of P 1; during 2-week Wash-out Period (Study Weeks 11 and 12); Weeks 2, 4, 6, and 8 of P 2 (Study Weeks 14, 16, 18, 20, and 22, respectively); End of Study (Week 10 of P 2 [Study Week 22])
Population: Safety-Randomized Study Population: participants who received at least one dose of either drug regardless of treatment period. Participants who received mixed treatment within a period were excluded. Only those participants contributing data at the indicated time points were evaluated.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score | Period 1 Average; n=77, 79 | -4.4 Scores on a scale | Standard Deviation 7.73 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score | Period 2 Average; n=63, 65 | -3.6 Scores on a scale | Standard Deviation 7.11 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score | Period 1 Average; n=77, 79 | -4.6 Scores on a scale | Standard Deviation 9.22 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Change From Period Baseline (BL) in Fatigue as Assessed by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score | Period 2 Average; n=63, 65 | -7.3 Scores on a scale | Standard Deviation 11.16 |
Secondary
Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs)
AEs were graded using the Common Toxicity Criteria from the Cancer Therapy Evaluation Program, Division of Cancer Therapy, National Cancer Institute. Grades: 0 = No AE or within normal limits; 1 = Mild AE; 2 = Moderate AE; 3 = Severe and undesirable AE; 4 = Life-threatening or disabling AE; 5 = Death related to AE.
Time frame: Baseline to end of study (maximum of 22 weeks)
Population: Safety-Randomized Study Population
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 0 | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 1 | 20 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 2 | 57 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 3 | 58 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 4 | 11 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 5 | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 4 | 8 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 0 | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 3 | 51 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 1 | 25 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 5 | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With Grade 1 to Grade 5 Adverse Events (AEs) | Grade 2 | 63 participants |
Secondary
Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment
An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE that spans more than one period is considered to be an AE for each period during which the AE increased in grade. There is only one action with respect to study drug recorded for the whole event. As such, it is not always possible to determine in which study period treatment was discontinued due to the AE.
Time frame: Baseline to end of study (maximum of 22 weeks)
Population: Safety-Randomized Study Population. Only those participants with adverse events leading to permanent discontinuation of study treatment were evaluated.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Epistaxis | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pain in extremity | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Fatigue | 5 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Palmar-plantar erythrodysaesthesia syndrome | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hepatic function abnormal | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pancytopenia | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hypertension | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Proteinuria | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Diarrhoea | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pyrexia | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Nasal congestion | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Rash | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Renal failure | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Transient ischaemic attack | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Thrombocytopenia | 3 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Respiratory failure | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Sinusitis | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Blood potassium decreased | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hepatotoxicity | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Skin ulcer | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Alanine aminotransferase increased | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Infection | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Spinal cord compression | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Acute myocardial infarction | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Stomatitis | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Infectious peritonitis | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Tooth infection | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pleural effusion | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cardiac disorder | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Influenza | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cardiac failure | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Asthenia | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cough | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Influenza like illness | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Decreased appetite | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Vomiting | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dizziness | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Mucosal inflammation | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dysgeusia | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Back pain | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematemesis | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Myocardial ischaemia | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematoma | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Atrial flutter | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematuria | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Nausea | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haemorrhage intracranial | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dyspnoea | 2 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Headache | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Transaminases increased | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Neutropenic infection | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Aspartate aminotransferase increased | 0 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Urine protein/creatinine ratio decreased | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Ovarian cyst | 1 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Weight decreased | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Atrial flutter | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Respiratory failure | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Weight decreased | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pleural effusion | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Transient ischaemic attack | 2 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Fatigue | 3 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Alanine aminotransferase increased | 4 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Vomiting | 3 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Aspartate aminotransferase increased | 3 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Diarrhoea | 2 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Thrombocytopenia | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Acute myocardial infarction | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Asthenia | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Back pain | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dyspnoea | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Epistaxis | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hypertension | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Nasal congestion | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hepatic function abnormal | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Hepatotoxicity | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Infection | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Infectious peritonitis | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Influenza | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Influenza like illness | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Mucosal inflammation | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Myocardial ischaemia | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Nausea | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Neutropenic infection | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Ovarian cyst | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pain in extremity | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Palmar-plantar erythrodysaesthesia syndrome | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pancytopenia | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Proteinuria | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Pyrexia | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Rash | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Renal failure | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Sinusitis | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Skin ulcer | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Blood potassium decreased | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Spinal cord compression | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Stomatitis | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Tooth infection | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cardiac disorder | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cardiac failure | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Cough | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Decreased appetite | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dizziness | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Dysgeusia | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematemesis | 1 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematoma | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haematuria | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Haemorrhage intracranial | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Transaminases increased | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Headache | 0 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated AEs Leading to Permanent Discontinuation of Study Treatment | Urine protein/creatinine ratio decreased | 0 participants |
Secondary
Number of Participants With the Indicated Number of Dose Reductions
Participants are recorded under the treatment they were receiving at the time the dose reduction was reported.
Time frame: End of second treatment period (maximum of 22 weeks)
Population: Safety-Randomized Study Population. Only those participants who had an dose reduction were evaluated.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated Number of Dose Reductions | 1 | 16 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated Number of Dose Reductions | 2 | 10 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated Number of Dose Reductions | 3 or more | 4 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated Number of Dose Reductions | 1 | 8 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated Number of Dose Reductions | 2 | 11 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated Number of Dose Reductions | 3 or more | 1 participants |
Secondary
Number of Participants With the Indicated Reason for Receiving a Dose Reduction
Dose reduction of study drug was a stepwise reduction of the dose of the study drug: one less capsule was received at each step reduction. Participants were monitored for approximately 10 to 14 days at each dose level. Participants are recorded under the treatment they were receiving at the time the dose reduction was reported.
Time frame: End of second treatment period (maximum of 22 weeks)
Population: Safety-Randomized Study Population. Only those participants who had an dose reduction were evaluated. Participants may be counted multiple times for the same reason for a dose reduction if the participant had multiple reductions for the same reason.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated Reason for Receiving a Dose Reduction | Adverse Event | 46 participants |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Number of Participants With the Indicated Reason for Receiving a Dose Reduction | Other | 3 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated Reason for Receiving a Dose Reduction | Adverse Event | 33 participants |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Number of Participants With the Indicated Reason for Receiving a Dose Reduction | Other | 0 participants |
Secondary
Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores
The EQ-5D is a participant-answered questionnaire measuring 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D has two separate components: utility score and thermometer score. The EQ-5D total utility score ranges from 0 (worst health state) to 1 (perfect health state); 1 reflects the best outcome. The thermometer score ranges from 0 (worst imaginable health state) to 100 (best imaginable health state).
Time frame: Day 1 (Period 1 Pre-dose); during 2-week Wash-out Period (Study Weeks 11 and 12); and End of Study (Week 10 of Period 2 [Study Week 22])
Population: Safety-Randomized Study Population. Participants (par.) who received mixed treatment within a period were excluded. Only those par. contributing data at the indicated time points were evaluated. In some instances, par. may have contributed data for one score, but not the other; thus, the number of par. analyzed reflects the entire population.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, Day 1; n=74, 79 | 75.7 Scores on a scale | Standard Deviation 17.65 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, Washout; n=60, 63 | 74.4 Scores on a scale | Standard Deviation 16.76 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, End of Study; n=51, 45 | 71.3 Scores on a scale | Standard Deviation 16.19 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, Day 1; n=76, 81 | 0.7625 Scores on a scale | Standard Deviation 0.25331 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, Washout; n=61, 67 | 0.8103 Scores on a scale | Standard Deviation 0.20776 |
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, End of Study; n=52, 47 | 0.7487 Scores on a scale | Standard Deviation 0.21324 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, Washout; n=61, 67 | 0.7595 Scores on a scale | Standard Deviation 0.26826 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, Day 1; n=74, 79 | 74.8 Scores on a scale | Standard Deviation 18.54 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, Day 1; n=76, 81 | 0.7664 Scores on a scale | Standard Deviation 0.22946 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, Washout; n=60, 63 | 69.8 Scores on a scale | Standard Deviation 19.94 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Utility Score, End of Study; n=52, 47 | 0.6325 Scores on a scale | Standard Deviation 0.29635 |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Quality of Life as Assessed by the EuroQoL-5 Dimensions (EQ-5D) Thermometer and Utility Scores | Thermometer Score, End of Study; n=51, 45 | 65.1 Scores on a scale | Standard Deviation 22.55 |
Secondary
Time to Dose Modification
For the subset of participants who had a dose modification, time to dose modification was defined as the time from the first dose in each period until the first reduction in dose within a period.
Time frame: End of second treatment period (maximum of 22 weeks)
Population: Safety-Randomized Study Population. Only those participants who had a dose modification were evaluated.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Sunitinib 50 mg Followed by Pazopanib 800 mg | Time to Dose Modification | 3.7 weeks |
| Pazopanib 800 mg Followed by Sunitinib 50 mg | Time to Dose Modification | 4.0 weeks |