Trial from ClinicalTrials.gov

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Trial ID
NCT00625846
Ethics application status
Date submitted
27/02/2008
Date registered
27/02/2008
Date last updated
13/10/2017

Titles & IDs
Public title
Pazopanib Hydrochloride in Treating Patients With Advanced Thyroid Cancer
Scientific title
A Phase II Study of GW 786034 (Pazopanib) in Advanced Thyroid Cancer
Secondary ID [1] 0 0
NCI-2009-00198
Secondary ID [2] 0 0
NCI-2009-00198
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Recurrent Thyroid Gland Carcinoma 0 0
Stage III Differentiated Thyroid Gland Carcinoma 0 0
Stage III Thyroid Gland Medullary Carcinoma 0 0
Stage IVA Differentiated Thyroid Gland Carcinoma 0 0
Stage IVA Thyroid Gland Medullary Carcinoma 0 0
Stage IVA Thyroid Gland Undifferentiated (Anaplastic) Carcinoma 0 0
Stage IVB Differentiated Thyroid Gland Carcinoma 0 0
Stage IVB Thyroid Gland Medullary Carcinoma 0 0
Stage IVB Thyroid Gland Undifferentiated (Anaplastic) Carcinoma 0 0
Stage IVC Differentiated Thyroid Gland Carcinoma 0 0
Stage IVC Thyroid Gland Medullary Carcinoma 0 0
Stage IVC Thyroid Gland Undifferentiated (Anaplastic) Carcinoma 0 0
Thyroid Gland Undifferentiated (Anaplastic) Carcinoma 0 0
Condition category
Condition code
Cancer 0 0 0 0
Non melanoma skin cancer
Cancer 0 0 0 0
Kidney
Metabolic and Endocrine 0 0 0 0
Other endocrine disorders
Cancer 0 0 0 0
Thyroid
Cancer 0 0 0 0
Neuroendocrine tumour (NET)

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Other interventions - Laboratory Biomarker Analysis
Treatment: drugs - Pazopanib Hydrochloride

Experimental: Treatment (pazopanib hydrochloride) - Patients receive pazopanib hydrochloride PO QD on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity.


Other interventions: Laboratory Biomarker Analysis
Correlative studies

Treatment: drugs: Pazopanib Hydrochloride
Given PO

Intervention code [1] 0 0
Other interventions
Intervention code [2] 0 0
Treatment: drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Confirmed tumor response (differentiated thyroid cancer expanded cohort) - Tumor response (complete or partial response) as assessed by Response Evaluation Criteria in Solid Tumors criteria noted as objective status on 2 consecutive evaluations at least 8 weeks apart for patients with differentiated thyroid cancer who are thyroglobulin antibody negative.
Timepoint [1] 0 0
Up to 3 years
Primary outcome [2] 0 0
Proportion of patients who have achieved an objective response to the study agent - Objective response as assessed by Response Evaluation Criteria in Solid Tumors criteria.
Timepoint [2] 0 0
Up to 3 years
Secondary outcome [1] 0 0
Biomarker-based response - Rates will be summarized assuming they are binomially distributed, and the biomarker levels themselves will be explored both quantitatively and graphically before and after treatment
Timepoint [1] 0 0
Up to 3 years
Secondary outcome [2] 0 0
Duration of response - Duration of response will be assessed.
Timepoint [2] 0 0
From the date of documentation of partial or complete response until the date of progression or last follow-up (whichever comes first) in the subset of patients with confirmed response, assessed up to 3 years
Secondary outcome [3] 0 0
Incidence of toxicity - Toxicity will be assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The maximum grade for each type of toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns.
Timepoint [3] 0 0
Up to 3 years
Secondary outcome [4] 0 0
Overall survival - Estimated using the method of Kaplan-Meier.
Timepoint [4] 0 0
Time from registration to date of last follow-up or death due to any cause, assessed up to 3 years
Secondary outcome [5] 0 0
Proportion of patients achieving a biochemical response in appropriate tumor markers - Levels of free VEGF and PDGF will be explored in a graphical manner in pre-treatment and multiple on-treatment samples.
Timepoint [5] 0 0
Up to 3 years
Secondary outcome [6] 0 0
Proportion of patients in which the radioactive iodine scan have changed from "no uptake" to "any uptake" - The proportion of patients will be calculated.
Timepoint [6] 0 0
At 6 months (at 3 months for patients with anaplastic thyroid cancer)
Secondary outcome [7] 0 0
Proportion of patients with differentiated thyroid cancer and medullary thyroid cancer who have not failed treatment at 6 months (3 months for anaplastic thyroid cancer) - The proportion of patients who have not failed treatment due to disease progression, adverse reactions, refusal for further participation, or who went on to alternate therapy at 6 months (3 months for anaplastic thyroid cancer patients) will be calculated and summarized independently within each of the patient groups. Assuming that the incidence of response is binomially distributed, 90% binomial confidence intervals will also be calculated.
Timepoint [7] 0 0
Up to 6 months
Secondary outcome [8] 0 0
Time to subsequent therapy - Estimated using the method of Kaplan-Meier.
Timepoint [8] 0 0
Up to 3 years
Secondary outcome [9] 0 0
Time to treatment failure - Estimated using the method of Kaplan-Meier.
Timepoint [9] 0 0
Time from registration to the date the patient discontinues treatment, assessed up to 3 years
Secondary outcome [10] 0 0
Times to progression - Time to progression will be estimated using the method of Kaplan-Meier. In addition, the 6-month progression-free rate will be evaluated using the 6-month rates and associated confidence intervals. Competing risk analyses may be done to evaluate time to progression, allowing for going on to alternate treatment or death prior to progression as competing risks.
Timepoint [10] 0 0
Time from registration to the date of progression or last follow-up, whichever comes first, assessed up to 3 years

Eligibility
Key inclusion criteria
- Histologically or cytologically confirmed differentiated, medullary or anaplastic
thyroid cancer that is now advanced or metastatic; NOTE: patients with thyroid
lymphomas or sarcomas are specifically excluded, as are patients with metastatic
disease from other sites of origin to thyroid

- Patients with confirmed differentiated thyroid cancer to be enrolled in the
expanded/additional differentiated thyroid cancer (DTC) cohort must be thyroglobulin
antibody negative

- Zero, one or two prior therapeutic regimens (this includes cytotoxic plus
non-cytotoxic therapeutic regimens)

- Absence of sensitivity to therapeutic radioiodine (differentiated only)

- Measurable disease, defined as at least one lesion that can be accurately measured in
at least one dimension (longest diameter to be recorded) as > 20 mm with conventional
techniques or as > 10 mm with spiral computed tomography (CT) scan; NOTE: disease that
is measurable by physical examination only is not eligible

- Life expectancy > 3 months

- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
(Karnofsky >= 60%)

- Leukocytes > 3,000/mcL

- Absolute neutrophil count > 1,500/mcL

- Platelets > 100,000/mcL

- Total bilirubin =< 1.5 X institutional upper limit of normal (ULN) (if there is reason
to believe that the patient has Gilbert's syndrome, the bilirubin can be fractionated;
if the fractionated bilirubin is consistent with Gilbert's syndrome and there is no
other possible explanation for the elevated indirect bilirubin, the patient may be
eligible for the study if and only if the direct bilirubin is =< 1.5 X institutional
ULN)

- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) <
2.5 X institutional ULN

- Creatinine =< 1.5 X ULN

- Proteinuria =< + on urinalysis (may re-check)

- International normalized ratio (INR) =< 1.2 X the ULN

- Blood pressure (BP) < 140 mmHg (systolic) and < 90 mmHg (diastolic); initiation or
adjustment of BP medication is permitted prior to registration provided that the
average of three BP readings at a visit prior to registration is < 140/90 mmHg

- Objective evidence of tumor progression in the 6 month period prior to GW786034
initiation as assessed by:

- Unequivocal progression of objectively measured disease on successive appropriate
imaging (e.g. CT scan); in cases of uncertainty of tumor progression, the
Principal Investigator of the study will be available to assist in decisions

- Women of child-bearing potential must have a negative serum pregnancy test =< 7 days
prior to registration; NOTE: women of child-bearing potential and men must agree to
use adequate contraception (hormonal or barrier method of birth control; abstinence)
prior to study entry and for the duration of study participation; should a woman
become pregnant or suspect she is pregnant while participating in this study, she
should inform her treating physician immediately; effective contraception is required
for all fertile participants in the trial

- Ability to understand and the willingness to sign a written informed consent document

- Willingness to comply with the requirement of the study

- Willingness to donate blood for correlative marker studies; (only applicable to sites
within the United States)
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Anaplastic, differentiated, medullary: a total of > 2 prior therapeutic regimens (this
total includes cytotoxic plus non-cytotoxic regimens); Note: enrollment of anaplastic,
differentiated, and medullary patients who have had zero, one or two prior therapeutic
regimens (cytotoxic plus non-cytotoxic regimens) is allowed - provided therapy ceased
> 21 days prior to registration;

- NOTE: the principal investigator of the study should be contacted in the event of
uncertainty related patient eligibility based upon prior therapies

- Disease that is measurable by physical examination only

- Any of the following:

- Radiotherapy =< 4 weeks prior to registration

- Major surgery =< 4 weeks prior to registration

- Radiotherapy to >= 25% of bone marrow

- Concurrent therapy with octreotide unless tumor progression on this therapy has
been demonstrated

- Any other ongoing investigational agents

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to GW786034 (pazopanib) or other agents used in the study

- > +1 proteinuria (< 30 mg/dL) on two consecutive dipstick or other urine assessments
taken at least 1 week apart; NOTE: (in cases where questions arise related to
disparate proteinuria measurements, the study principal investivator [PI] should be
consulted for assistance in determining patient study eligibility)

- Corrected QT interval (QTc) prolongation (defined as a QTc interval >= 480 msecs) or
other significant electrocardiogram (ECG) abnormalities (e.g. frequent ventricular
ectopy, evidence of ongoing myocardial ischemia); NOTE: the principal investigator of
the study should be contacted in the event of uncertainty related patient eligibility
based upon ECG changes

- Receiving cytochrome P450 (CYP) interactive concomitant medications; certain
medications that act through the CYP450 system are specifically prohibited in patients
receiving GW786034 (pazopanib) because in vitro data indicate that the agent has the
potential to interact with the cytochrome P450 isoenzymes cytochrome P450, family 2,
subfamily C, polypeptide 9 (CYP2C9) and cytochrome P450, family 3, subfamily A,
polypeptide 4 (CYP3A4); certain other agents should be used with caution

- Any condition (e.g., gastrointestinal tract disease resulting in an inability to take
oral medication or a requirement for IV alimentation, prior surgical procedures
affecting absorption, or active peptic ulcer disease) that impairs their ability to
swallow and retain GSK786034 (pazopanib)

- Any of the following conditions:

- Serious or non-healing wound, ulcer, or bone fracture

- History of abdominal fistula, gastrointestinal perforation, active
diverticulitis, intra-abdominal abscess or gastrointestinal tract bleeding =< 28
days of registration

- Any history of cerebrovascular accident (CVA) =< 6 months

- Current use of therapeutic warfarin; Note: low molecular weight heparin and
prophylactic low-dose warfarin (INR < 1.2 X ULN) are permitted; prothrombin time
(PT)/partial thromboplastin time (PTT) must meet the inclusion criteria

- History of myocardial infarction, cardiac arrhythmia, admission for unstable
angina, cardiac angioplasty or stenting within the last 12 weeks

- History of venous thrombosis in last 12 weeks

- Class III or IV heart failure as defined by the New York Heart Association (NYHA)
functional classification system; NOTE: a patient who has a history of class II
heart failure and is asymptomatic on treatment may be considered eligible

- History of bleeding disorder, including patients afflicted with hemophilia,
disseminated intravascular coagulation, or any other abnormality of coagulation
potentially predisposing patients to bleeding

- Poorly controlled depression or anxiety disorder, or recent (=< 6 months)
suicidal ideation

- Known active and/or untreated brain metastases and/or brain metastases requiring
ongoing therapy (e.g. corticosteroids); NOTE: (because of the poor prognosis often
associated with brain metastases and because of the potential risk of bleeding in
active brain metastases associated with multi-targeted tyrosine kinase inhibitor
therapy, patients with active and/or untreated brain metastases and/or those with
brain metastases requiring ongoing therapy - e.g. corticosteroids - are excluded from
trial enrollment; enrollment will, however, be permitted in cases of patients with
longstanding treated and inactive brain metastases not requiring ongoing therapy,
providing that stability of brain metastases has been demonstrated for a period of 3
months or greater as assessed by intracranial imaging - and providing that there is no
indication of increased vascularity of the treated metastases by magnetic resonance
imaging (MRI) imaging conducted =< 14 days prior to registration; when questions arise
related to these criteria, the PI of the trial, Dr. Keith Bible, should be contacted
for assistance on eligibility)

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection or psychiatric illness/social situations that would or might reasonably be
expected to limit compliance with study requirements

- Pregnant women; NOTE: (breastfeeding should be discontinued if the mother is treated
with GW786034/pazopanib)

- Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral
therapy; NOTE: (appropriate studies will be undertaken in patients receiving
combination antiretroviral therapy when indicated)

- Receiving any medications or substances known to affect or with the potential to
affect the activity or pharmacokinetics of GW786034 (pazopanib); NOTE: the eligibility
of patients will be determined following review of their case by the Principal
Investigator; efforts should be made to switch patients who are taking enzyme-inducing
anticonvulsant agents to other medications

- Receiving any concomitant medications that are associated with a risk of QTc
prolongation and/or Torsades de Pointes; NOTE: these medications should be
discontinued or replaced with drugs that do not carry these risks, if possible

Study design
Purpose of the study
Treatment
Allocation to intervention
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Phase 2
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Active, not recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Current
Final
Recruitment in Australia
Recruitment state(s)
WA
Recruitment hospital [1] 0 0
Sir Charles Gairdner Hospital - Nedlands
Recruitment postcode(s) [1] 0 0
6009 - Nedlands
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Arizona
Country [2] 0 0
United States of America
State/province [2] 0 0
Colorado
Country [3] 0 0
United States of America
State/province [3] 0 0
Florida
Country [4] 0 0
United States of America
State/province [4] 0 0
Iowa
Country [5] 0 0
United States of America
State/province [5] 0 0
Maryland
Country [6] 0 0
United States of America
State/province [6] 0 0
Michigan
Country [7] 0 0
United States of America
State/province [7] 0 0
Minnesota
Country [8] 0 0
United States of America
State/province [8] 0 0
Missouri
Country [9] 0 0
United States of America
State/province [9] 0 0
Wisconsin
Country [10] 0 0
China
State/province [10] 0 0
Hong Kong
Country [11] 0 0
Singapore
State/province [11] 0 0
Singapore
Country [12] 0 0
Taiwan
State/province [12] 0 0
Taipei

Funding & Sponsors
Primary sponsor type
Government body
Name
National Cancer Institute (NCI)
Address
Country

Ethics approval
Ethics application status

Summary
Brief summary
This phase II trial studies the side effects and how well pazopanib hydrochloride works in
treating patients with advanced thyroid cancer. Pazopanib hydrochloride may stop the growth
of tumor cells by blocking some of the enzymes needed for cell growth and by stopping blood
flow to the tumor.
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Keith Bible
Address 0 0
Mayo Clinic
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries
Contact person responsible for updating information