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Pazopanib Hydrochloride in Treating Patients With Stage IV or Recurrent Nasopharyngeal Cancer

Primary Purpose

Recurrent Lymphoepithelioma of the Nasopharynx, Recurrent Squamous Cell Carcinoma of the Nasopharynx, Stage IV Lymphoepithelioma of the Nasopharynx

Status
Completed
Phase
Phase 2
Locations
Singapore
Study Type
Interventional
Intervention
pazopanib hydrochloride
pharmacological study
computed tomography
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Lymphoepithelioma of the Nasopharynx

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Histologically or cytologically confirmed nasopharyngeal carcinoma, meeting the following criteria:

    • World Health Organization (WHO) type II-III disease
    • Stage IV or recurrent disease
  • Must have failed at least 1 prior line of chemotherapy for metastatic or recurrent disease
  • Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm by conventional techniques OR >= 10 mm by spiral CT scan
  • No known brain metastases
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 or Karnofsky PS 70-100%
  • Life expectancy > 3 months
  • WBC >= 3,000/mm³
  • Absolute neutrophil count >= 1,500/mm³
  • Platelet count >= 100,000/mm³
  • Bilirubin normal
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 times upper limit of normal (ULN)
  • Creatinine normal OR creatinine clearance >= 60 mL/min
  • Proteinuria =< 1+ on 2 consecutive dipsticks taken >= 1 week apart
  • Prothrombin time (PT), international normalized ratio (INR), and partial thromboplastin time (PTT) =< 1.2 times ULN
  • Systolic blood pressure (BP) =< 140 mm Hg and diastolic BP =< 90 mm Hg

    • Initiation or adjustment of BP medication allowed provided the average of 3 BP readings are < 140/90 mm Hg prior to study entry
  • No history of allergic reaction attributed to compounds of similar chemical or biological composition to pazopanib hydrochloride or to other study agents
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • No cerebrovascular accident within the past 6 months
  • No history of any of the following diseases within the past 12 weeks:

    • Myocardial infarction
    • Cardiac arrhythmia
    • Admission for unstable angina
    • Cardiac angioplasty or stenting
    • Venous thrombosis
  • No New York Heart Association (NYHA) class III-IV heart failure

    • Patients with a history of NYHA class II heart failure are eligible provided they are asymptomatic on treatment
  • No significant electrocardiogram (ECG) abnormalities, including QTc prolongation (i.e., QTc >= 500 msec)
  • No serious or non-healing wound, ulcer, or bone fracture
  • No condition that would impair the ability to swallow and retain pazopanib hydrochloride, including any of the following:

    • Gastrointestinal tract disease resulting in an inability to take oral medication
    • Requirement for IV alimentation
    • Prior surgical procedures affecting absorption
    • Active peptic ulcer disease
  • No concurrent uncontrolled illness including, but not limited to, the following:

    • Coagulopathy
    • Ongoing or active infection
    • Psychiatric illness or social situation that would preclude study compliance
  • No known allergy to CT contrast agents
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • More than 4 weeks since prior radiotherapy
  • At least 4 weeks since prior surgery
  • No prior antiangiogenesis therapy
  • No other concurrent investigational agents
  • No other concurrent anticancer therapy
  • No concurrent medications or substances known to affect or with the potential to affect the activity or pharmacokinetics of pazopanib hydrochloride, as determined by the Principal Investigator
  • No concurrent medications that have the potential to interact with the cytochrome P450 (CYP) isoenzymes CYP2C9 and CYP3A4
  • No concurrent therapeutic warfarin

    • Low molecular weight heparin or prophylactic low-dose warfarin allowed
  • No concurrent antiretroviral therapy for human immunodeficiency virus (HIV)-positive patients

Sites / Locations

  • Cancer Therapeutics Research Group
  • National University Hospital
  • National Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment (pazopanib hydrochloride)

Arm Description

Patients receive pazopanib hydrochloride PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Pharmacological study will be done on Day 1 and Day 28. Computed tomography will be done at baseline and day 28.

Outcomes

Primary Outcome Measures

Clinical Benefit Rate
Clinical benefit rate (CBR) as defined by Response Evaluation Criteria in Solid Tumors (RECIST ver 1.0) and assessed by CT or MRI. CBR includes 1) Complete response (CR): disappearance of all lesions; 2) partial response (PR): >=30% decrease in the sum of the longest diameter of target lesions and 3) stable disease (SD): non-PR and non progressive disease.

Secondary Outcome Measures

Response Rate (PR)
Per response evaluation criteria in solid tumors (RECIST v1.0) and assessed by MRI or CT: Partial response (PR), >=30% decrease in the sum of the longest diameter of target lesions and non-PD (PD: progressive disease) of non-target lesions.
Progression-free Survival
Progression will be evaluated in this study using the new international criteria proposed by RECIST Committee. The sample proportion and associated 95% confidence interval will be reported.
Overall Survival
Toxicity Profile: Percentage of Participants With Significant (Grade 3/4) Related Adverse Event (AE)
The frequencies of grade 3/4 related toxicities were recorded among all participants, and the percentage of participants who experienced significant AEs were reported.
Pharmacodynamic Study: Tumor Blood Flow at Baseline
Dynamic-contrast enhanced computed tomography (DCE-CT) was performed at baseline and Day 28, tumor blood flow was measured.19 of 33 patients had evaluable DCE-CT data.
Pharmacodynamic Study: Tumor Blood Flow on Day 28
DCE-CT was performed on Day 28 and tumor blood flow was measured. 19 of 33 patients had evaluable DCE-CT data.
Pharmacokinetic Study: Percentage of Participants With Trough Concentration at Steady State (Day 28) Above 15 µg/mL
Pazopanib pharmacokinetic parameters were estimated on Day 1 and Day 28 (steady state). Trough concentration of pazopanib was measured on Day 28 with blood sampling at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after Day 28 dose.
Pharmacokinetic Study: AUC0-24h/Dose on Day 1
AUC 0-24h/dose were measured on day 1 for 26 evaluable participants. Blood sampling is done at zero (pre-dose), 0.5 hr, 1, 2, 3, 4, 5, 6 and 8 hrs after the first dose.
Pharmacokinetic Study: Area Under Curve (AUC) 0-24h/Dose on Day 28
AUC 0-24h/dose were measured on day 28 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after day 28 dose.
Pharmacokinetic Study: Volume of Distribution (Vd/F/Dose) on Day 1
Volume of distribution (Vd/F/dose) were measured on day 1 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 hrs after first dose.
Pharmacokinetic Study: Volume of Distribution at Steady State (Vss/F/Dose) on Day 28
Volume of distribution at steady state (Vss/F/Dose) were measured on day 28 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after day 28 dose.

Full Information

First Posted
March 27, 2007
Last Updated
November 16, 2015
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00454142
Brief Title
Pazopanib Hydrochloride in Treating Patients With Stage IV or Recurrent Nasopharyngeal Cancer
Official Title
A Phase 2 Study of GW786034 (Pazopanib) in Asian Patients With Recurrent/Metastatic Nasopharyngeal Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
August 2007 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This phase II trial studies the side effects and how well pazopanib hydrochloride works in treating patients with stage IV or recurrent nasopharyngeal cancer. Pazopanib hydrochloride 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.
Detailed Description
PRIMARY OBJECTIVES: I. Determine the efficacy of pazopanib hydrochloride in patients with stage IV or recurrent nasopharyngeal carcinoma. II. Determine the progression-free survival of patients treated with this drug. III. Determine the toxicity of this drug in these patients. IV. Determine the effect of this drug on angiogenesis inhibition using dynamic contrast-enhanced computed tomography (CT) scan. V. Determine the pharmacokinetic profile of this drug in these patients. VI. Correlate the effect of this drug on angiogenesis inhibition with the clinical benefit rate and pharmacokinetics. OUTLINE: Patients receive pazopanib hydrochloride orally (PO) once daily (QD) on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up periodically for up to 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Lymphoepithelioma of the Nasopharynx, Recurrent Squamous Cell Carcinoma of the Nasopharynx, Stage IV Lymphoepithelioma of the Nasopharynx, Stage IV Squamous Cell Carcinoma of the Nasopharynx

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment (pazopanib hydrochloride)
Arm Type
Experimental
Arm Description
Patients receive pazopanib hydrochloride PO QD on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Pharmacological study will be done on Day 1 and Day 28. Computed tomography will be done at baseline and day 28.
Intervention Type
Drug
Intervention Name(s)
pazopanib hydrochloride
Other Intervention Name(s)
GW786034B, Votrient
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
pharmacological study
Other Intervention Name(s)
pharmacological studies
Intervention Description
Correlative studies
Intervention Type
Procedure
Intervention Name(s)
computed tomography
Other Intervention Name(s)
tomography, computed
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Clinical Benefit Rate
Description
Clinical benefit rate (CBR) as defined by Response Evaluation Criteria in Solid Tumors (RECIST ver 1.0) and assessed by CT or MRI. CBR includes 1) Complete response (CR): disappearance of all lesions; 2) partial response (PR): >=30% decrease in the sum of the longest diameter of target lesions and 3) stable disease (SD): non-PR and non progressive disease.
Time Frame
12 weeks of treatment
Secondary Outcome Measure Information:
Title
Response Rate (PR)
Description
Per response evaluation criteria in solid tumors (RECIST v1.0) and assessed by MRI or CT: Partial response (PR), >=30% decrease in the sum of the longest diameter of target lesions and non-PD (PD: progressive disease) of non-target lesions.
Time Frame
12 weeks of treatment
Title
Progression-free Survival
Description
Progression will be evaluated in this study using the new international criteria proposed by RECIST Committee. The sample proportion and associated 95% confidence interval will be reported.
Time Frame
From the date of enrollment to the date of first documented progression or death, whichever occurs first, or to the date when the patient was last known to be alive, up to 3 years.
Title
Overall Survival
Time Frame
From date of enrollment to the study to the date of death from any cause or to the date when the patient was last known to be alive, up to 3 years.
Title
Toxicity Profile: Percentage of Participants With Significant (Grade 3/4) Related Adverse Event (AE)
Description
The frequencies of grade 3/4 related toxicities were recorded among all participants, and the percentage of participants who experienced significant AEs were reported.
Time Frame
From the time of first treatment with pazopanib hydrochloride to up to 30days after completion of treatment
Title
Pharmacodynamic Study: Tumor Blood Flow at Baseline
Description
Dynamic-contrast enhanced computed tomography (DCE-CT) was performed at baseline and Day 28, tumor blood flow was measured.19 of 33 patients had evaluable DCE-CT data.
Time Frame
Pretreatment
Title
Pharmacodynamic Study: Tumor Blood Flow on Day 28
Description
DCE-CT was performed on Day 28 and tumor blood flow was measured. 19 of 33 patients had evaluable DCE-CT data.
Time Frame
28 days post treatment
Title
Pharmacokinetic Study: Percentage of Participants With Trough Concentration at Steady State (Day 28) Above 15 µg/mL
Description
Pazopanib pharmacokinetic parameters were estimated on Day 1 and Day 28 (steady state). Trough concentration of pazopanib was measured on Day 28 with blood sampling at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after Day 28 dose.
Time Frame
Day 28 of treatment
Title
Pharmacokinetic Study: AUC0-24h/Dose on Day 1
Description
AUC 0-24h/dose were measured on day 1 for 26 evaluable participants. Blood sampling is done at zero (pre-dose), 0.5 hr, 1, 2, 3, 4, 5, 6 and 8 hrs after the first dose.
Time Frame
Day 1 of treatment
Title
Pharmacokinetic Study: Area Under Curve (AUC) 0-24h/Dose on Day 28
Description
AUC 0-24h/dose were measured on day 28 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after day 28 dose.
Time Frame
Day 28 of treatment
Title
Pharmacokinetic Study: Volume of Distribution (Vd/F/Dose) on Day 1
Description
Volume of distribution (Vd/F/dose) were measured on day 1 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 hrs after first dose.
Time Frame
Day 1 of treatment
Title
Pharmacokinetic Study: Volume of Distribution at Steady State (Vss/F/Dose) on Day 28
Description
Volume of distribution at steady state (Vss/F/Dose) were measured on day 28 for 26 evaluable participants. Blood sampling was done at zero (pre dose), 0.5 hr, 1, 2, 3, 4, 5, 6, 8 and 24 hrs after day 28 dose.
Time Frame
Day 28 of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed nasopharyngeal carcinoma, meeting the following criteria: World Health Organization (WHO) type II-III disease Stage IV or recurrent disease Must have failed at least 1 prior line of chemotherapy for metastatic or recurrent disease Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm by conventional techniques OR >= 10 mm by spiral CT scan No known brain metastases Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 or Karnofsky PS 70-100% Life expectancy > 3 months WBC >= 3,000/mm³ Absolute neutrophil count >= 1,500/mm³ Platelet count >= 100,000/mm³ Bilirubin normal Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 times upper limit of normal (ULN) Creatinine normal OR creatinine clearance >= 60 mL/min Proteinuria =< 1+ on 2 consecutive dipsticks taken >= 1 week apart Prothrombin time (PT), international normalized ratio (INR), and partial thromboplastin time (PTT) =< 1.2 times ULN Systolic blood pressure (BP) =< 140 mm Hg and diastolic BP =< 90 mm Hg Initiation or adjustment of BP medication allowed provided the average of 3 BP readings are < 140/90 mm Hg prior to study entry No history of allergic reaction attributed to compounds of similar chemical or biological composition to pazopanib hydrochloride or to other study agents No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days No cerebrovascular accident within the past 6 months No history of any of the following diseases within the past 12 weeks: Myocardial infarction Cardiac arrhythmia Admission for unstable angina Cardiac angioplasty or stenting Venous thrombosis No New York Heart Association (NYHA) class III-IV heart failure Patients with a history of NYHA class II heart failure are eligible provided they are asymptomatic on treatment No significant electrocardiogram (ECG) abnormalities, including QTc prolongation (i.e., QTc >= 500 msec) No serious or non-healing wound, ulcer, or bone fracture No condition that would impair the ability to swallow and retain pazopanib hydrochloride, including any of the following: Gastrointestinal tract disease resulting in an inability to take oral medication Requirement for IV alimentation Prior surgical procedures affecting absorption Active peptic ulcer disease No concurrent uncontrolled illness including, but not limited to, the following: Coagulopathy Ongoing or active infection Psychiatric illness or social situation that would preclude study compliance No known allergy to CT contrast agents Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin C) and recovered More than 4 weeks since prior radiotherapy At least 4 weeks since prior surgery No prior antiangiogenesis therapy No other concurrent investigational agents No other concurrent anticancer therapy No concurrent medications or substances known to affect or with the potential to affect the activity or pharmacokinetics of pazopanib hydrochloride, as determined by the Principal Investigator No concurrent medications that have the potential to interact with the cytochrome P450 (CYP) isoenzymes CYP2C9 and CYP3A4 No concurrent therapeutic warfarin Low molecular weight heparin or prophylactic low-dose warfarin allowed No concurrent antiretroviral therapy for human immunodeficiency virus (HIV)-positive patients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wan Teck Lim
Organizational Affiliation
National Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cancer Therapeutics Research Group
City
Singapore
ZIP/Postal Code
119074
Country
Singapore
Facility Name
National University Hospital
City
Singapore
ZIP/Postal Code
119074
Country
Singapore
Facility Name
National Cancer Centre
City
Singapore
ZIP/Postal Code
169610
Country
Singapore

12. IPD Sharing Statement

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Pazopanib Hydrochloride in Treating Patients With Stage IV or Recurrent Nasopharyngeal Cancer

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