A Phase I, Open Label, Study of the Safety, Tolerability and Pharmacokinetics of Pazopanib in Combination With Irinotecan and Cetuximab for the Relapsed or Refractory Metastatic Colorectal Cancer
- Male or female at least 18 years of age.
- Willing and able to sign a written informed consent.
- Is either affiliated to or a beneficiary of a social security category
- Histologically or cytologically confirmed diagnosis of colorectal cancer. Subjects
should have metastatic disease which is refractory or relapsed following prior
- Documented disease progression after prior treatment with 5-FU, oxaliplatin and
irinotecan containing regimens.
- Complete recovery from surgical or radiotherapy procedures.
- Eastern Cooperative Oncology Group performance status of 0 or 1, or Karnofsky score ≥
- Able to swallow and retain oral medications.
- Adequate bone marrow function (absolute neutrophil count greater than or equal to
1,500/mm3, platelet count greater than or equal to 100,000/mm3, hemoglobin levels
greater than or equal to 10g/dL).
- Adequate renal function as determined by a creatinine clearance greater than 50
mL/minute calculated by the Cockcroft-Gault Formula. Measured creatinine clearance
greater than or equal to 50 mL/minute by 24 hour urine collection will be acceptable
in lieu of a calculated value.
- Urine Protein Creatinine (UPC) Ratio of ≤ 1 as assessed in a random or spot urine
- Adequate hepatic function determined by total bilirubin within the normal range and
aspartate aminotransferase (AST or SGOT) or alanine aminotransferase (ALT or SGPT)
less than or equal to 2.5 times the upper limit of normal.
- Prothrombin time (PT), international normalized ratio (INR), and partial
thromboplastin time (PTT) less than or equal to 1.2 times the ULN.
- A female subject is eligible to enter and participate in the study if she is:
·Non-childbearing potential (i.e., physiologically incapable of becoming pregnant)
including any woman who:
- Has had a hysterectomy, or
- Has had a bilateral oophorectomy (ovariectomy), or
- Has had a bilateral tubal ligation, or
- Is post-menopausal (demonstrate total cessation of menses for greater than or equal
to 1 year).
- Childbearing potential, has a negative serum pregnancy test at screening, and agrees
to one of the following:
- An intrauterine device with a documented failure rate of less than 1% per year.
- Vasectomized partner who is sterile prior to the subject's entry and is the sole
sexual partner for that woman.
- Complete abstinence from sexual intercourse for 14 days before exposure to
investigation product, throughout the clinical trial, and for at least 21 days after
the last dose of investigational product.
- Double barrier contraception defined as condom with spermicidal jelly, foam,
suppository, or film; OR diaphragm with spermicide; OR male condom and diaphragm.
- A male patient with a female partner of childbearing potential is eligible to enter
and participate in the study if he uses a barrier method of contraception or
abstinence during the study.
- Predicted life expectancy of at least 12 weeks.
- Able to understand and comply with protocol requirements and instructions and intends
to complete the study as planned.
- Has participated in any study using an investigational drug during the previous 28
- Has had any major surgery, chemotherapy, investigational agent, or radiotherapy
within the last 28 days and/or not recovered from prior therapy.
- Any history of grade III toxicity related to prior treatment with anti VEGF compound
other than grade 3 hypertension subsequently controlled with antihypertensive agents.
- Has received prior treatment with pazopanib / investigational anti-angiogenic
compounds or cetuximab. Prior treatment with Avastin is permitted. Known
contraindications to the use of irinotecan and cetuximab.
- Unable to tolerate 180mg/m2 of irinotecan every two weeks during previous treatment.
- Is unable to discontinue prohibited medications, as stipulated in the protocol for 14
days prior to Visit 1 and for the duration of the study
- Has received Amiodarone for arrythmias within the last 6 months prior to Visit 1
- Has known allergy to penicillin.
- Women who are pregnant or lactating.
- Poorly controlled hypertension (systolic blood pressure [SBP] of 140 mmHg or higher,
or diastolic blood pressure [DBP] of 90 mmHg or higher). Initiation or adjustment of
blood pressure medication is permitted prior to study entry provided the subject has
2 consecutive blood pressure readings less than 140/90 mmHg, each separated by a
minimum of 24 hours. These readings need to be collected prior to the first dose.
- Corrected QT (QTc) prolongation defined as a QTc interval greater than or equal to
480 msec and a prior history of cardiovascular disease, arrhythmias, or significant
- Has Class III or IV heart failure as defined by the New York Heart Association
functional classification system.
- Arterial thrombi, myocardial infarction, admission for unstable angina, uncontrolled
or symptomatic arrhythmia, cardiac angioplasty, or stenting within the last 6 months.
- Any history of cerebrovascular accident (CVA), or pulmonary embolism within the last
- History of untreated deep venous thrombosis (DVT) within the past 6 months (e.g. calf
vein thrombosis). Note: Patients with recent DVT who have been treated with
therapeutic anti-coagulant agents (excluding therapeutic warfarin) for at least 6
weeks are eligible.
- Current use of therapeutic warfarin. NOTE: Low molecular weight heparin and
prophylactic low-dose warfarin (no more than 1mg per day) are permitted. PT/PTT and
INR must be within 1.2 times the upper limit of normal.
- Known history of leptomeningeal or brain metastases. NOTE: Computed tomography or
magnetic resonance imaging (MRI) scans are not required to rule out central nervous
system metastases unless the subject is exhibiting neurologic signs or symptoms. If,
however, CT or MRI scans are performed and document central nervous system disease,
the subject is ineligible, regardless of whether neurologic signs or symptoms are
- Any serious and/or unstable pre-existing medical, psychiatric, or other condition
(including laboratory abnormalities) that could interfere with subject safety or
obtaining informed consent.
- History of mal-absorption syndrome, disease significantly affecting gastrointestinal
function or major resection of the stomach or small bowel that could affect
absorption, distribution, metabolism, or excretion of study drugs.
- History of any unresolved bowel obstruction or diarrhea.
- The subject has a known immediate or delayed hypersensitivity reaction or
idiosyncrasy to drugs chemically related to the study drug, irinotecan, or cetuximab,
unless enrolment is approved by the GSK Medical Monitor following discussion with the
- Psychological, familial, sociological, or geographical conditions that do not permit
compliance with the protocol.
- Is on any specifically prohibited medication or requires any of these medications
during treatment with pazopanib.