Study With Pazopanib and Weekly Paclitaxel in Penile Carcinoma (PAZOPEN-SOGUG) (PAZOPEN-SOGUG)
Primary Purpose
Penile Squamous Cell Carcinoma Stage IV
Status
Terminated
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
Pazopanib
Paclitaxel
Sponsored by
About this trial
This is an interventional treatment trial for Penile Squamous Cell Carcinoma Stage IV focused on measuring Penile squamous cell carcinoma, Pazopanib, Weekly paclitaxel
Eligibility Criteria
Inclusion Criteria:
- Written informed consent
- Age >= 18 years
- Histologically confirmed diagnosis of squamous cell carcinoma of the penis
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
- Measurable disease criteria according to RECIST criteria (version 1.1)
- Progressive disease after treatment with cisplatin or carboplatin based chemotherapy.
- Archived tumor tissue must be provided for all subjects for biomarker analysis before and/or during treatment with investigational product.
- Adequate organ system function - Haemoglobin >= 9.0 gr/dl (5.6 mmol/L) and stable in the previous 4 weeks to start study treatment - Neutrophils >= 1.5 x 10*9/L - Platelets >= 100 x 10*9/L - Total bilirubin <= 1.5 x UNL - AST/SGOT and ALT/SGPT <= 2.5 x UNL - serum creatinine <= 1.5 mg/dL - Urine protein to creatinine ratio < 1.
- Normal coagulation tests: - Prothrombin time (PT) or international normalized ratio (INR) <= 1.2 X ULN - Activated partial thromboplastin time (aPTT) <= 1.2 X ULN 10. Are able to swallow and retain oral tablets
Exclusion Criteria:
- Prior malignancy.
- Central nervous system metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases (surgery ± radiotherapy, radiosurgery, or gamma knife) and who meet both of the following criteria: a) are asymptomatic and b) have no requirement for steroids or enzyme-inducing anticonvulsants
- Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding.
- Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product.
- Corrected QT interval (QTc) > 480 ms
- History of any 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 >= 140 mmHg or diastolic blood pressure (DBP) of >= 90 mmHg].
- History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
- Evidence of active bleeding or bleeding diathesis.
- Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage
- Recent hemoptysis (>= 1/2 teaspoon [2.5 mL]) of red blood within 8 weeks before first dose of study drug).
- Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subjects safety, provision of informed consent, or compliance to study procedures.
- Unable or unwilling to discontinue use of prohibited medications 14 days prior to the first dose of study drug and for the duration of the study.
- Treatment with any of the following anti-cancer therapies: - radiation therapy, surgery or tumor embolization within 14 days prior to the first dose of pazopanib OR - chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days prior to the first dose of Pazopanib
- Administration of any non-oncologic investigational drug within 30 days prior to receiving the first dose of study treatment
- Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia.
- Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib or paclitaxel and/or excipients that contraindicates their participation.
- Previous taxane or/and antiVEGF treatment would not allow patient to participate in the study.
Sites / Locations
- Institut Català D'Oncologia L'Hospitalet
- Complejo Hospitalario de Navarra
- Hospital de La Santa Creu I Sant Pau
- Complejo Hospitalario Regional Reina Sofía
- Hospital Universitario Lucus Augusti
- Hospital Clínico San Carlos
- Hospital General Universitario J.M. Morales Meseguer
- Instituto Valenciano de Oncología
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Pazopanib plus weekly paclitaxel
Arm Description
Pazopanib 800mg /day continuously administered plus paclitaxel 65 mg/m2 in weekly administration, 3 administrations (D1, D8 and D15) every 4 weeks period.
Outcomes
Primary Outcome Measures
Overall response rate
Evaluate response rate in terms of complete and partial response (RECIST criteria version 1.1)
Secondary Outcome Measures
Clinical benefit rate
Clinical benefit rate (complete and partial response and stable disease) evaluated according RECIST criteria version 1.1
Progression free survival
Time from patient inclusion until progression disease (RECIST criteria version 1.1) or death from any cause, whichever came first, assessed up to 12 months
Response duration
Time from first response to progression disease (RECIST criteria version 1.1) or death from any cause, whichever came first, assessed up to 12 months
Overall survival
Time from patient inclusion to death assessed up to 18 months
Safety tolerability profile as measured by the number of events per patient
Number of events per patient
Full Information
NCT ID
NCT02279576
First Posted
October 27, 2014
Last Updated
October 13, 2016
Sponsor
Spanish Oncology Genito-Urinary Group
1. Study Identification
Unique Protocol Identification Number
NCT02279576
Brief Title
Study With Pazopanib and Weekly Paclitaxel in Penile Carcinoma (PAZOPEN-SOGUG)
Acronym
PAZOPEN-SOGUG
Official Title
Phase II Study With Pazopanib and Weekly Paclitaxel in Metastatic or Locally Advanced Squamous Penile Carcinoma Patients Previously Treated With Cisplatin Based Chemotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
November 2015
Overall Recruitment Status
Terminated
Why Stopped
The low recruitment of patients will not allow to complete the study with the required number of patients within reasonable time.
Study Start Date
January 2015 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
September 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spanish Oncology Genito-Urinary Group
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Penile cancer is an uncommon disease, with devastating physical and psychological effects on patients. Penile carcinoma even in advanced stages is responsive to several chemotherapeutic agents. However, due to the low incidence of penile cancer, no large studies have been reported concerning chemotherapy.
Various single agents were tested for activity en penile cancer in de 70s and 80s. Response rates ranged from 10 to 27% with cisplatin, 20 to 21% with bleomycin, and 0-62% with methotrexate. These agents in combination were tested in different studies. Other chemotherapy schemes have been studied, as combination of cisplatin with 5 fluorouracil with or without taxol, and cisplatin plus irinotecan. All of them in limited phase II studies, with described higher responses rates in some of them but without results confirmation in phase III studies.
In conclusion, tested regimens so far have not been very successful in advanced stages of the disease.
Antiangiogenic therapy has been demonstrated effective in the treatment of similar cancer types as lung and head and neck, so it can be postulated that antiangiogenic therapy can be effective in the treatment of penile carcinoma. Pazopanib is a new potent oral antiangiogenic therapy.
Cytotoxic agents, such as paclitaxel, when administered at low doses and frequent intervals, may exert antiangiogenic effects, thereby enhancing anticancer activity. Recently, combination of pazopanib and paclitaxel administered in a metronomic schedule (80mg/m2 weekly 3 weeks every 4 weeks cycle) obtained a 40% response rate and an 80% of disease control in the first-line treatment of melanoma patients. Treatment was well tolerated.
As paclitaxel and antiangiogenic drugs seem a very active treatment, combination of pazopanib and paclitaxel seems a good combination to be tested in patients with penile carcinoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Penile Squamous Cell Carcinoma Stage IV
Keywords
Penile squamous cell carcinoma, Pazopanib, Weekly paclitaxel
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Pazopanib plus weekly paclitaxel
Arm Type
Experimental
Arm Description
Pazopanib 800mg /day continuously administered plus paclitaxel 65 mg/m2 in weekly administration, 3 administrations (D1, D8 and D15) every 4 weeks period.
Intervention Type
Drug
Intervention Name(s)
Pazopanib
Other Intervention Name(s)
Daily pazopanib
Intervention Description
Pazopanib 800mg/day continuously administered.
Intervention Type
Drug
Intervention Name(s)
Paclitaxel
Other Intervention Name(s)
Weekly paclitaxel
Intervention Description
Paclitaxel 65 mg/m2 in weekly administration 3 administrations (D1, D8 and D15) every 4 weeks period.
Primary Outcome Measure Information:
Title
Overall response rate
Description
Evaluate response rate in terms of complete and partial response (RECIST criteria version 1.1)
Time Frame
Up to 6 months
Secondary Outcome Measure Information:
Title
Clinical benefit rate
Description
Clinical benefit rate (complete and partial response and stable disease) evaluated according RECIST criteria version 1.1
Time Frame
Up to 6 months
Title
Progression free survival
Description
Time from patient inclusion until progression disease (RECIST criteria version 1.1) or death from any cause, whichever came first, assessed up to 12 months
Time Frame
Up to 12 months
Title
Response duration
Description
Time from first response to progression disease (RECIST criteria version 1.1) or death from any cause, whichever came first, assessed up to 12 months
Time Frame
Up to 12 months
Title
Overall survival
Description
Time from patient inclusion to death assessed up to 18 months
Time Frame
Up to 18 months
Title
Safety tolerability profile as measured by the number of events per patient
Description
Number of events per patient
Time Frame
Up to 6 months
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Written informed consent
Age >= 18 years
Histologically confirmed diagnosis of squamous cell carcinoma of the penis
Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
Measurable disease criteria according to RECIST criteria (version 1.1)
Progressive disease after treatment with cisplatin or carboplatin based chemotherapy.
Archived tumor tissue must be provided for all subjects for biomarker analysis before and/or during treatment with investigational product.
Adequate organ system function - Haemoglobin >= 9.0 gr/dl (5.6 mmol/L) and stable in the previous 4 weeks to start study treatment - Neutrophils >= 1.5 x 10*9/L - Platelets >= 100 x 10*9/L - Total bilirubin <= 1.5 x UNL - AST/SGOT and ALT/SGPT <= 2.5 x UNL - serum creatinine <= 1.5 mg/dL - Urine protein to creatinine ratio < 1.
Normal coagulation tests: - Prothrombin time (PT) or international normalized ratio (INR) <= 1.2 X ULN - Activated partial thromboplastin time (aPTT) <= 1.2 X ULN 10. Are able to swallow and retain oral tablets
Exclusion Criteria:
Prior malignancy.
Central nervous system metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases (surgery ± radiotherapy, radiosurgery, or gamma knife) and who meet both of the following criteria: a) are asymptomatic and b) have no requirement for steroids or enzyme-inducing anticonvulsants
Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding.
Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product.
Corrected QT interval (QTc) > 480 ms
History of any 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 >= 140 mmHg or diastolic blood pressure (DBP) of >= 90 mmHg].
History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
Evidence of active bleeding or bleeding diathesis.
Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage
Recent hemoptysis (>= 1/2 teaspoon [2.5 mL]) of red blood within 8 weeks before first dose of study drug).
Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subjects safety, provision of informed consent, or compliance to study procedures.
Unable or unwilling to discontinue use of prohibited medications 14 days prior to the first dose of study drug and for the duration of the study.
Treatment with any of the following anti-cancer therapies: - radiation therapy, surgery or tumor embolization within 14 days prior to the first dose of pazopanib OR - chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days prior to the first dose of Pazopanib
Administration of any non-oncologic investigational drug within 30 days prior to receiving the first dose of study treatment
Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia.
Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib or paclitaxel and/or excipients that contraindicates their participation.
Previous taxane or/and antiVEGF treatment would not allow patient to participate in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miguel A Climent, MD
Organizational Affiliation
Instituto Valenciano de Oncología
Official's Role
Study Director
Facility Information:
Facility Name
Institut Català D'Oncologia L'Hospitalet
City
Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08908
Country
Spain
Facility Name
Complejo Hospitalario de Navarra
City
Pamplona
State/Province
Navarra
ZIP/Postal Code
31008
Country
Spain
Facility Name
Hospital de La Santa Creu I Sant Pau
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Complejo Hospitalario Regional Reina Sofía
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Hospital Universitario Lucus Augusti
City
Lugo
ZIP/Postal Code
27003
Country
Spain
Facility Name
Hospital Clínico San Carlos
City
Madrid
ZIP/Postal Code
28040
Country
Spain
Facility Name
Hospital General Universitario J.M. Morales Meseguer
City
Murcia
ZIP/Postal Code
30008
Country
Spain
Facility Name
Instituto Valenciano de Oncología
City
Valencia
ZIP/Postal Code
46009
Country
Spain
12. IPD Sharing Statement
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Study With Pazopanib and Weekly Paclitaxel in Penile Carcinoma (PAZOPEN-SOGUG)
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