A Randomized, Phase II Study of GW786034 (Pazopanib) in Stage D0 Relapsed Androgen Sensitive Prostate Cancer Following Limited GnRH Agonist Therapy
Inclusion Criteria:
- Histologically or cytologically confirmed prostate cancer
- Stage D0
- Must have undergone some definitive local therapy for prostate cancer
- Must be free of macrometastatic disease, as evidenced by computed tomography (CT)
scan and bone scan, if serum PSA ≥ 10 ng/mL prior to GnRH agonist therapy
- Progressive disease meeting the following criteria: NOTE: Patients who have undergone
a prostatectomy and have two detectable, rising serum PSA levels are eligible
- Two consecutive rises in PSA above nadir recorded after definite local therapy
- Serum PSA concentrations must have absolute value of > 0.5 ng/mL (separated by ≥
2 weeks) prior to beginning GnRH agonist therapy
- PSA < 0.5 ng/mL
- Testosterone < 30 ng/mL
- No measurable disease
- No brain metastases requiring steroid or anticonvulsant therapy
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 OR Karnofsky PS
60- 100%
- Prothrombin time (PT)/international normalization ratio (INR)/partial thromboplastin
time (PTT) ≤ 1.2 times upper limit of normal (ULN)
- Bilirubin normal
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 times ULN
- Creatinine ≤ 1.5 times ULN OR creatinine clearance > 50 mL/min
- Proteinuria ≤ 1+ on 2 consecutive dipsticks > 1 week apart
- Urine protein: creatinine ratio < 1 OR urine protein < 1.0 g/24 hours
- Fertile patients must use effective double-barrier contraception during study therapy
OR completely abstain from sexual intercourse 14 days prior to, during, and for ≥ 21
days after completion of study therapy
- No history of allergic reactions attributed to compounds of similar chemical or
biological composition to pazopanib hydrochloride or to other agents used in the
study
- No concurrent uncontrolled illness including, but not limited to, any of the
following:
- Ongoing or active infection
- Psychiatric illness or social situations that would preclude compliance with
study requirements
- No human immunodeficiency virus (HIV) positivity
- No condition that impairs the ability to swallow and retain pazopanib hydrochloride
tablets, including any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral medication
- Requirement for intravenous (IV) alimentation
- Prior surgical procedures affecting absorption
- Active peptic ulcer disease
- No other conditions, including any of the following:
- Serious or nonhealing wound, ulcer, or bone fracture
- Abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess
within the past 28 days
- Cerebrovascular accident within the past 6 months
- Myocardial infarction, admission for unstable angina, cardiac angioplasty, or
stenting within the past 6 months
- Venous thrombosis within the past 12 weeks
- New York Heart Association (NYHA) class III or IV heart failure
- History of currently treated asymptomatic NYHA class II heart failure
allowed
- Systolic blood pressure (BP) ≤ 140 mm Hg and diastolic BP ≤ 90 mm Hg
- Prior initiation or adjustment of BP medication allowed provided that the
average of 3 BP readings at a visit prior to enrollment is < 140/90 mm Hg
- More than 3 months since prior antiandrogen
- More than 4 months since prior orchiectomy or implantable luteinizing LHRH agonist
- No prior GnRH agonists except for neoadjuvant or adjuvant therapy associated with
local therapy
- Patients who have started a GnRH agonist for micrometastatic disease after local
therapy allowed provided the following criteria are met:
- Progressive disease
- Willing to discontinue therapy before 6 months have elapsed
- Have signed consent prior to completing 6 months of the initial hormone
therapy
- Are within 4 months of initiating GnRH agonist therapy
- No prior or concurrent GnRH antagonist therapy
- No concurrent ketoconazole
- No concurrent cytochrome P450 2C9 (CYP2C9) substrates, including any of the
following:
- Anticoagulants (e.g., warfarin [therapeutic doses only])
- Low molecular weight heparin or prophylactic low-dose warfarin allowed
- Oral hypoglycemics (e.g., glipizide, glyburide, tolbutamide, glimepiride, or
nateglinide)
- Ergot derivatives (e.g., dihydroergotamine, ergonovine, ergotamine, or
methylergonovine)
- Neuroleptics (e.g., pimozide)
- Erectile dysfunction agents (e.g., sildenafil, tadalafil, or vardenafil)
- Antiarrhythmics (e.g., bepridil, flecainide, lidocaine, mexiletin, amiodarone,
quinidine, or propafenone)
- Immune modulators (e.g., cyclosporine, tacrolimus, or sirolimus)
- Miscellaneous medications (e.g., theophylline, quetiapine, risperidone, tacrine,
clozapine, or atomoxetine)
- No concurrent medications associated with the risk of QTc prolongation and/or
Torsades de Pointes
- Replacement of drugs that do not carry these risks allowed
- No other concurrent non-Food and Drug Administration (FDA)-approved agents