A phase II safety and efficacy study of the vascular endothelial growth factor receptor tyrosine kinase inhibitor pazopanib in patients with metastatic urothelial cancer

Clin Genitourin Cancer. 2013 Dec;11(4):477-83. doi: 10.1016/j.clgc.2013.05.005. Epub 2013 Jul 26.

Abstract

Background: Vascular endothelial growth factor (VEGF) is produced by bladder cancer cell lines in vitro and expressed in human bladder tumor tissues. Pazopanib is a vascular endothelial receptor tyrosine kinase inhibitor with anti-angiogenesis and anti-tumor activity in several preclinical models. A 2-stage phase II study was conducted to assess the activity and toxicity profile of pazopanib in patients with metastatic, urothelial carcinoma.

Methods: Patients with one prior systemic therapy for metastatic urothelial carcinoma were eligible. Patients received pazopanib at a dose of 800 mg orally for a 4-week cycle.

Results: Nineteen patients were enrolled. No grade 4 or 5 events were experienced. Nine patients experienced 11 grade 3 adverse events. Most common toxicities were anemia, thrombocytopenia, leucopenia, and fatigue. For stage I, none of the first 16 evaluable patients were deemed a success (complete response or partial response) by the Response Evaluation Criteria In Solid Tumors criteria during the first four 4-week cycles of treatment. Median progression-free survival was 1.9 months. This met the futility stopping rule of interim analysis, and therefore the trial was recommended to be permanently closed.

Conclusions: Pazopanib did not show significant activity in patients with urothelial carcinoma. The role of anti-VEGF therapies in urothelial carcinoma may need further evaluation in rational combination strategies.

Keywords: Pazopanib; Urothelial cancer; VEGF tyrosine kinase inhibitors.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Carcinoma, Transitional Cell / drug therapy*
  • Carcinoma, Transitional Cell / mortality
  • Disease-Free Survival
  • Female
  • Humans
  • Indazoles
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / drug therapy
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use*
  • Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors*
  • Sulfonamides / adverse effects
  • Sulfonamides / therapeutic use*
  • Treatment Failure
  • Urologic Neoplasms / drug therapy*
  • Urologic Neoplasms / mortality
  • Urothelium / drug effects
  • Urothelium / pathology

Substances

  • Angiogenesis Inhibitors
  • Indazoles
  • Pyrimidines
  • Sulfonamides
  • pazopanib
  • Receptors, Vascular Endothelial Growth Factor