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A Randomized Phase IIB Evaluation of Weekly Paclitaxel (NSC #673089) Plus Pazopanib (NSC #737754) (IND #75648) Versus Weekly Paclitaxel Plus Placebo in the Treatment of Persistent or Recurrent Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma


Phase 2
18 Years
N/A
Open (Enrolling)
Female
Recurrent Fallopian Tube Cancer, Recurrent Ovarian Epithelial Cancer, Recurrent Primary Peritoneal Cavity Cancer

Thank you

Trial Information

A Randomized Phase IIB Evaluation of Weekly Paclitaxel (NSC #673089) Plus Pazopanib (NSC #737754) (IND #75648) Versus Weekly Paclitaxel Plus Placebo in the Treatment of Persistent or Recurrent Epithelial Ovarian, Fallopian Tube or Primary Peritoneal Carcinoma


PRIMARY OBJECTIVES:

I. To estimate the progression-free survival hazard ratio of the combination of weekly
paclitaxel and pazopanib (pazopanib hydrochloride) compared to weekly paclitaxel and placebo
in patients with persistent or recurrent ovarian, fallopian tube, or primary peritoneal
cancer.

SECONDARY OBJECTIVES:

I. To determine the frequency and severity of adverse events as assessed by CTCAE.

II. To estimate and compare the proportion of patients responding to therapy by RECIST,
CA125 response, the overall survival (OS), and the duration of response in each arm.

EXPLORATORY OBJECTIVES:

I. To explore the association between plasma cytokines and angiogenic markers and
progression-free and overall survival.

II. To explore the association between single-nucleotide polymorphisms (SNPs) and
progression-free and overall survival.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive paclitaxel IV over 1 hour on days 1, 8, and 15 and placebo orally
(PO) daily on days 1-28.

ARM II: Patients receive paclitaxel as in arm I and pazopanib hydrochloride PO daily on days
1-28.

In both arms, treatment repeats every 28 days in the absence of disease progression or
unacceptable toxicity.

After completion of study therapy, patients are followed up every 3 months for 2 years and
then every 6 months for 3 years.


Inclusion Criteria:



- Patients must have recurrent or persistent epithelial ovarian, fallopian tube, or
primary peritoneal carcinoma

- Histologic documentation of the original primary tumor is required via the
pathology report

- Patients must have measurable disease or non-measurable (detectable) disease

- Measurable disease is defined as at least one lesion that can be accurately
measured in at least one dimension (longest diameter to be recorded)

- Each lesion must be greater than or equal to 10 mm when measured by CT,
MRI, or caliper measurement by clinical exam; or greater than or equal to
20 mm when measured by chest x-ray

- Lymph nodes must be greater than or equal to 15 mm in short axis when
measured by CT or MRI

- Patients with measurable disease must have at least one "target lesion" to
be used to assess response on this protocol as defined by RECIST 1.1

- Tumors within a previously irradiated field will be designated as
"non-target" lesions unless progression is documented or a biopsy is
obtained to confirm persistence at least 90 days following completion
of radiation therapy

- Non-measurable (detectable) disease in a patient is defined in this protocol as
one who does not have measurable disease but has at least one of the following
conditions:

- Ascites and/or pleural effusion attributed to tumor

- Solid and/or cystic abnormalities on radiographic imaging that do not meet
RECIST 1.1

- Patients must not be eligible for a higher priority GOG protocol, if one exists

- Patients must not be eligible for a currently active, phase II cytotoxic
protocol in platinum-resistant disease

- Patients must have had one prior platinum-based chemotherapeutic regimen for
management of primary disease containing carboplatin, cisplatin, or another
organoplatinum compound

- This initial treatment may have included intraperitoneal therapy, consolidation,
biologic/targeted (non-cytotoxic) agents (e.g., bevacizumab), or extended
therapy administered after surgical or non-surgical assessment

- If patients were treated with paclitaxel for their primary disease, this can
have been given weekly or every 3 weeks

- Treatment with weekly paclitaxel for recurrent or persistent disease is NOT
allowed

- No history or evidence upon physical examination of CNS disease, including primary
brain tumor or any brain metastases

- Patients who have received one prior regimen must have a GOG performance status of 0,
1, or 2

- Patients who have received two or three prior regimens must have a GOG performance
status of 0 or 1

- Absolute neutrophil count (ANC) greater than or equal to 1,500/µL

- Platelets greater than or equal to 100,000/µL

- Hemoglobin greater than or equal to 9 g/dL

- Creatinine less than or equal to 1.5 x institutional upper limit of normal (ULN)

- PT such that international normalized ratio (INR) is less than or equal to 1.5 x ULN
(or an in-range INR, usually between 2 and 3, if a patient is on a stable dose of
therapeutic warfarin)

- PTT less than or equal to 1.5 x ULN

- If urine protein is 2+ or higher, 24-hour urine protein should be obtained and the
level must be < 1000 mg (<1.0 g/24hrs) for patient enrollment

- Bilirubin less than or equal to 1.5 x ULN

- AST and ALT less than or equal to 2.5 x ULN

- Subjects who have BOTH bilirubin greater than ULN and AST/ALT greater than ULN are
not eligible

- Alkaline phosphatase less than or equal to 2.5 x ULN

- Patients must have normal baseline thyroid function tests (TSH, T3, T4)

- A history of hypothyroidism and/or hyperthyroidism is allowed, as long as the
patient has stable well-controlled thyroid function for a minimum of 2 months

- Neuropathy (sensory and motor) less than or equal to grade 1

- Patients should be free of active infection requiring antibiotics (with the exception
of uncomplicated UTI)

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use an effective form of contraception

- Patients must be capable of taking and absorbing oral medications and be clear of the
following:

- Any lesion, whether induced by tumor, radiation, or other conditions, that makes
it difficult to swallow tablets

- Active peptic ulcer disease

- Malabsorption syndrome

- Patients with personal or family history of congenital long QTc syndrome are NOT
eligible

- Patients with a history of other invasive malignancies, with the exception of
non-melanoma skin cancer and other specific malignancies, are excluded if there is
any evidence of other malignancy being present within the last three years

- No clinically significant cardiovascular disease including any of the following:

- Uncontrolled hypertension, defined as systolic greater than 140 mm Hg or
diastolic greater than 90 mm Hg despite antihypertensive medications

- Congenital long QT syndrome or baseline QTc greater than 480 milliseconds

- Myocardial infarction or unstable angina within 6 months prior to registration

- New York Heart Association (NYHA) class II or greater congestive heart failure

- History of serious ventricular arrhythmia (i.e., ventricular tachycardia or
ventricular fibrillation) or serious cardiac arrhythmia requiring medication

- This does not include asymptomatic atrial fibrillation with controlled
ventricular rate

- Patients who have received prior treatment with an anthracycline (including
doxorubicin and/or liposomal doxorubicin) must have an echocardiogram assessment
and are excluded if they have an ejection fraction less than 50%

- CTCAE Grade 2 or greater peripheral vascular disease (at least brief less than
24 hrs) episodes of ischemia managed non-surgically and without permanent
deficit)

- History of cardiac angioplasty or stenting within 6 months prior to registration

- History of coronary artery bypass graft surgery within 6 months prior to
registration

- Arterial thrombosis within 6 months prior to registration

- No serious non-healing wound, ulcer, or bone fracture

- Includes history of abdominal fistula, gastrointestinal perforation, or
intra-abdominal abscess within 28 days prior to the first date of study
treatment

- No patients with active bleeding or pathologic conditions that carry high risk of
bleeding, such as known bleeding disorder, coagulopathy, or tumor involving major
vessels

- No seizures that are not controlled with non-enzyme-inducing anticonvulsants

- No transient ischemic attack (TIA) or subarachnoid hemorrhage within six months prior
to the first date of study treatment

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to pazopanib

- No known HIV-positive subjects on combination antiretroviral therapy

- No condition that may increase the risk of gastrointestinal bleeding or
gastrointestinal perforation, including:

- Active peptic ulcer disease

- Known gastrointestinal intraluminal metastatic lesions (gastrointestinal serosa
metastatic lesions are permitted)

- Inflammatory bowel disease (e.g., ulcerative colitis, Crohn disease)

- Patients with clinical symptoms or signs of gastrointestinal obstruction

- Patients who require parenteral hydration and/or nutrition

- No history of hemoptysis in excess of 2.5 mL (½ teaspoon) within 8 weeks prior to
first dose of pazopanib

- No uncontrolled intercurrent illness including, but not limited to, psychiatric
illness/social situations that would limit compliance with study requirements

- Grapefruit juice and St. John wort are not allowed on this study

- Recovered from effects of recent surgery, radiotherapy, or chemotherapy

- Patients are allowed to receive, but are not required to receive, two additional
cytotoxic regimens for management of recurrent or persistent disease, with no more
than 1 non-platinum, non-taxane regimen

- No previous treatment with weekly paclitaxel for recurrent or persistent disease

- No previous cancer treatment that contraindicates this protocol therapy

- Patients are allowed to receive, but are not required to receive, biologic/targeted
(non-cytotoxic) therapy as part of their primary treatment regimen

- Patients are allowed to receive, but are not required to receive, poly (ADP-ribose)
polymerase (PARP) inhibitors for management of primary or recurrent/persistent
disease (either alone or in combination with cytotoxic chemotherapy)

- For the purposes of this study, PARP inhibitors will be considered "cytotoxic"

- PARP inhibitors will NOT count as a prior regimen when given alone

- Any hormonal therapy directed at the malignant tumor must be discontinued at least
one week prior to registration

- Any other prior therapy directed at the malignant tumor, including chemotherapy,
biological/targeted (non-cytotoxic) agents, and immunologic agents, must be
discontinued at least three weeks prior to registration

- Chimeric or human or humanized monoclonal antibodies (including bevacizumab) or
VEGF-receptor fusion proteins (including VEGF TRAP/aflibercept) must be discontinued
for at least 12 weeks prior to registration

- At least 4 weeks must have elapsed since the patient underwent any major surgery
(e.g., major: laparotomy, laparoscopy, thoracotomy, video-assisted thorascopic
surgery [VATS]); there is no restriction on minor procedures (e.g., minor: central
venous access catheter placement, ureteral stent placement or exchange, paracentesis,
thoracentesis)

- No prior surgical procedures affecting absorption including, but not limited to,
major resection of stomach or small bowel

- Patients must have NOT received any biologic/targeted (non-cytotoxic) therapy
targeting the VEGF and/or PDGF pathways for management of recurrent or persistent
disease

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

- Strong inhibitors of CYP3A4 are prohibited

- Strong inducers of CYP3A4 are prohibited

- No previous treatment with pazopanib

- No prior radiotherapy to any portion of the abdominal cavity or pelvis within the
last three years

- Prior radiation for localized cancer of the breast, head and neck, or skin is
permitted, provided that it was completed more than three years prior to
registration and the patient remains free of recurrent or metastatic disease

- No prior chemotherapy for any abdominal or pelvic tumor OTHER THAN for the treatment
of ovarian, fallopian tube, or primary peritoneal cancer within the last three years

- Patients may have received prior adjuvant chemotherapy for localized breast
cancer, provided that it was completed more than three years prior to
registration and the patient remains free of recurrent or metastatic disease

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Outcome Measure:

Efficacy of each treatment regimen

Outcome Description:

Evaluated using the Cox proportional hazards and stratified by platinum-free interval, measurable disease status, and prior use of bevacizumab. Maximum likelihood estimate of the logarithm of the hazard ratio of Arm 2 to Arm 1 for disease progression or death (PFS endpoint) will be calculated.

Outcome Time Frame:

Up to 5 years

Safety Issue:

No

Principal Investigator

Debra Richardson

Investigator Role:

Principal Investigator

Investigator Affiliation:

Gynecologic Oncology Group

Authority:

United States: Food and Drug Administration

Study ID:

NCI-2011-03635

NCT ID:

NCT01468909

Start Date:

December 2011

Completion Date:

Related Keywords:

  • Recurrent Fallopian Tube Cancer
  • Recurrent Ovarian Epithelial Cancer
  • Recurrent Primary Peritoneal Cavity Cancer
  • Peritoneal Neoplasms
  • Fallopian Tube Neoplasms
  • Neoplasms, Glandular and Epithelial
  • Ovarian Neoplasms

Name

Location

Johns Hopkins University Baltimore, Maryland  21205
Cleveland Clinic Foundation Cleveland, Ohio  44195
University of Mississippi Medical Center Jackson, Mississippi  39216-4505
Washington University School of Medicine Saint Louis, Missouri  63110
Abington Memorial Hospital Abington, Pennsylvania  19001
University of Washington Medical Center Seattle, Washington  98195-6043
Tacoma General Hospital Tacoma, Washington  98405
Hurley Medical Center Flint, Michigan  48503
Sinai Hospital of Baltimore Baltimore, Maryland  21225
Abramson Cancer Center of the University of Pennsylvania Philadelphia, Pennsylvania  19104-4283
Marshfield Clinic Marshfield, Wisconsin  54449
Reading Hospital and Medical Center Reading, Pennsylvania  19612-6052
Hartford Hospital Hartford, Connecticut  06102-5037
Baystate Medical Center Springfield, Massachusetts  01199
Via Christi Regional Medical Center Wichita, Kansas  67214
University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma  73104
Iowa Methodist Medical Center Des Moines, Iowa  50309
Iowa Lutheran Hospital Des Moines, Iowa  50316-2301
Group Health Cooperative Seattle, Washington  98112
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium Seattle, Washington  98109
Cancer Center of Kansas - Chanute Chanute, Kansas  66720
Cancer Center of Kansas - Dodge City Dodge City, Kansas  67801
Cancer Center of Kansas - Newton Newton, Kansas  67114
Cancer Center of Kansas - Salina Salina, Kansas  67042
Cancer Center of Kansas - Wellington Wellington, Kansas  67152
Associates in Womens Health Wichita, Kansas  67203
Cancer Center of Kansas - Winfield Winfield, Kansas  67156
Munson Medical Center Traverse City, Michigan  49684
Cancer Care Northwest - Spokane South Spokane, Washington  99202
University of South Alabama Mitchell Cancer Institute Mobile, Alabama  36604
Methodist Estabrook Cancer Center Omaha, Nebraska  68114-4199
Beebe Medical Center Lewes, Delaware  19958
Mecosta County Medical Center Big Rapids, Michigan  49307
Medical Oncology and Hematology Associates Des Moines, Iowa  50309
Saint Joseph Mercy Hospital Ann Arbor, Michigan  48106
Cancer Center of Kansas - Fort Scott Fort Scott, Kansas  66701
Cancer Center of Kansas-Independence Independence, Kansas  67301
Wenatchee Valley Medical Center Wenatchee, Washington  98801-2028
Marshfield Clinic Cancer Care at Regional Cancer Center Eau Claire, Wisconsin  54701
Marshfield Clinic - Weston Center Weston, Wisconsin  54476
Marshfield Clinic - Wisconsin Rapids Center Wisconsin Rapids, Wisconsin  54494
Seattle Cancer Care Alliance Seattle, Washington  98109
Genesys Regional Medical Center Grand Blanc, Michigan  48439-8066
Greater Baltimore Medical Center Baltimore, Maryland  21204
Union Hospital of Cecil County Elkton MD, Maryland  21921
Cancer Centers of the Carolinas - Seneca Seneca, South Carolina  29672
Cancer Centers of the Carolinas - Spartanburg Spartanburg, South Carolina  29307
Pacific Gynecology Specialists Seattle, Washington  98104
University of North Carolina Chapel Hill, North Carolina  27599
University of Connecticut Farmington, Connecticut  06032
Saint Alphonsus Regional Medical Center Boise, Idaho  83706
Case Western Reserve University Cleveland, Ohio  44106
Riverside Methodist Hospital Columbus, Ohio  43214
Indiana University Medical Center Indianapolis, Indiana  46202
University of Texas Southwestern Medical Center Dallas, Texas  
Wichita CCOP Wichita, Kansas  67214-3882
Northwest Hospital Seattle, Washington  98133
Central Georgia Gynecologic Oncology Macon, Georgia  31201
Providence Saint Joseph Medical Center Burbank, California  91505-4866
Florida Hospital Orlando, Florida  32803
Memorial Health University Medical Center Savannah, Georgia  31404
Hillcrest Hospital Cancer Center Mayfield Heights, Ohio  44124
Harrison Medical Center Bremerton, Washington  98310
University of Cincinnati Cincinnati, Ohio  45267-0502
Saint Francis Hospital and Medical Center Hartford, Connecticut  06105
The Hospital of Central Connecticut New Britain, Connecticut  06050
University of Hawaii Honolulu, Hawaii  96813
McFarland Clinic Ames, Iowa  50010
Iowa Oncology Research Association CCOP Des Moines, Iowa  50309
Mercy Medical Center - Des Moines Des Moines, Iowa  50314
Medical Oncology and Hematology Associates-Des Moines Des Moines, Iowa  50309
Cancer Center of Kansas - El Dorado El Dorado, Kansas  67042
Cancer Center of Kansas-Kingman Kingman, Kansas  67068
Cancer Center of Kansas - Parsons Parsons, Kansas  67357
Cancer Center of Kansas - Pratt Pratt, Kansas  67124
Cancer Center of Kansas-Wichita Medical Arts Tower Wichita, Kansas  67208
Cancer Center of Kansas - Main Office Wichita, Kansas  67214
Michigan Cancer Research Consortium Community Clinical Oncology Program Ann Arbor, Michigan  48106
Oakwood Hospital Dearborn, Michigan  48123
Saint John Hospital and Medical Center Detroit, Michigan  48236
Grand Rapids Clinical Oncology Program Grand Rapids, Michigan  49503
Saint Mary's Health Care Grand Rapids, Michigan  49503
Spectrum Health at Butterworth Campus Grand Rapids, Michigan  49503
Allegiance Health Jackson, Michigan  49201
Sparrow Hospital Lansing, Michigan  48912
Saint Mary Mercy Hospital Livonia, Michigan  48154
Mercy Health Partners-Mercy Campus Muskegon, Michigan  49443
Saint Joseph Mercy Oakland Pontiac, Michigan  48341-2985
Saint Joseph Mercy Port Huron Port Huron, Michigan  48060
Saint Mary's of Michigan Saginaw, Michigan  48601
Saint John Macomb-Oakland Hospital Warren, Michigan  48093
Freeman Health System Joplin, Missouri  64804
Ozark Health Ventures LLC dba Cancer Research for The Ozarks Springfield Springfield, Missouri  65802
Saint John's Hospital Springfield, Missouri  65804
Cox Medical Center Springfield, Missouri  65807
Cooper Hospital University Medical Center Camden, New Jersey  08103
Kettering Medical Center Kettering, Ohio  45429
Greenville CCOP Greenville, South Carolina  29615
Harrison Bremerton Hematology and Oncology Bremerton, Washington  98310
Swedish Medical Center-First Hill Seattle, Washington  98122-4307
Saint Joseph Medical Center Tacoma, Washington  98405
Saint Vincent Hospital Green Bay, Wisconsin  54301
Green Bay Oncology Limited at Saint Mary's Hospital Green Bay, Wisconsin  54303
Green Bay Oncology at Saint Vincent Hospital Green Bay, Wisconsin  54301-3526
Bay Area Medical Center Marinette, Wisconsin  54143
Marshfield Clinic-Minocqua Center Minocqua, Wisconsin  54548
Marshfield Clinic at James Beck Cancer Center Rhinelander, Wisconsin  54501
Marshfield Clinic-Rice Lake Center Rice Lake, Wisconsin  54868
Cancer Care Associates-Yale Tulsa, Oklahoma  74136-1929
Women and Infants Hospital Providence, Rhode Island  02905
Lake University Ireland Cancer Center Mentor, Ohio  44060
Women's Cancer Associates Saint Petersburg, Florida  33701
Stony Brook University Medical Center Stony Brook, New York  11794
Lahey Clinic Medical Center Burlington, Massachusetts  01805
Cancer Center of Kansas-Liberal Liberal, Kansas  67901
Cancer Centers of the Carolinas - Faris Greenville, South Carolina  29605
Holy Family Memorial Hospital Manitowoc, Wisconsin  54221
Marshfield Clinic Cancer Care at Saint Michael's Hospital Stevens Point, Wisconsin  54481
Hawaii Minority Based CCOP Honolulu, Hawaii  96813
Maine Medical Center-Bramhall Campus Portland, Maine  04102
Women's Cancer Center of Nevada Las Vegas, Nevada  89109
Providence Regional Cancer Partnership Everett, Washington  98201
Gynecologic Oncology Group of Arizona Phoenix, Arizona  85012
Sudarshan K Sharma MD Limted-Gynecologic Oncology Hinsdale, Illinois  60521
Saint Vincent Oncology Center Indianapolis, Indiana  46260
PeaceHealth Medical Group PC Bellingham, Washington  98226
Skagit Valley Hospital Regional Cancer Care Center Mount Vernon, Washington  98274
Olympic Medical Cancer Care Center Sequim, Washington  98384
Rockwood Cancer Treatment Center Spokane, Washington  99204
Providence Saint Mary Regional Cancer Center Walla Walla, Washington  99362
Christiana Care Health System-Christiana Hospital Newark, Delaware  19718
Bronson Battle Creek Battle Creek, Michigan  49017
Cleveland Clinic Cancer Center/Fairview Hospital Cleveland, Ohio  44111
Women's Cancer Care Associates LLC Albany, New York  12208
Harrison Poulsbo Hematology and Oncology Poulsbo, Washington  98370
Baylor All Saints Medical Center at Fort Worth Fort Worth, Texas  76104
Gynecologic Oncology Associates-Newport Beach Newport Beach, California  92663