Pazopanib Hydrochloride After Leuprolide Acetate or Goserelin Acetate in Treating Patients With Relapsed Prostate Cancer

NCT ID: NCT00454571

Last Updated: 2016-02-10

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 37 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2006-06-30
• Study Completion Date: 2010-12-31

Brief Summary

This randomized phase II trial is studying how well pazopanib hydrochloride works after leuprolide or goserelin in treating patients with relapsed prostate cancer. Pazopanib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Androgens can cause the growth of prostate cancer cells. Antihormone therapy, such as leuprolide acetate or goserelin acetate, may lessen the amount of androgens made by the body. Giving pazopanib after leuprolide or goserelin may be an effective treatment for prostate cancer

Detailed Description

PRIMARY OBJECTIVES:

I. Determine if pazopanib hydrochloride is able to increase time to progression, as measured by prostate-specific antigen (PSA), after 6 months of limited gonadotropin-releasing hormone (GnRH) agonist therapy comprising leuprolide acetate or goserelin in patients with androgen-sensitive relapsed stage D0 prostate cancer.

SECONDARY OBJECTIVES:

I. Determine the adverse events in patients treated with this regimen. II. To monitor for changes in testosterone in relationship to pazopanib therapy versus observation.

OUTLINE:

Patients receive androgen blockade comprising GnRH agonist therapy (e.g., leuprolide acetate or goserelin acetate) for 6 months. Patients who develop metastases or have PSA progression while on GnRH agonist therapy are removed from the study and placed on total androgen blockade. The remaining patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive pazopanib hydrochloride orally (PO) once daily (QD) on days 1-28. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

ARM II: Patients undergo observation.

After completion of study treatment, patients are followed up periodically for up to 12 months.

Conditions

Recurrent Prostate Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Pazopanib

Patients receive pazopanib hydrochloride PO QD on days 1-28 after treatment with leuprolide acetate and goserelin acetate. Treatment repeats every 28 days in the absence of disease progression or unacceptable toxicity.

Group Type: EXPERIMENTAL

pazopanib hydrochloride

Intervention Type: DRUG

Given PO

leuprolide acetate

Intervention Type: DRUG

goserelin acetate

Intervention Type: DRUG

Observation

Patients undergo observation after treatment with leuprolide acetate and goserelin acetate.

Group Type: ACTIVE_COMPARATOR

leuprolide acetate

Intervention Type: DRUG

goserelin acetate

Intervention Type: DRUG

Interventions

pazopanib hydrochloride

Given PO

Intervention Type: DRUG

leuprolide acetate

Intervention Type: DRUG

goserelin acetate

Intervention Type: DRUG

Other Intervention Names

GW786034B; Votrient; Enantone; LEUP; Lupron; Lupron Depot; ICI-118630; ZDX; Zoladex

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Edwin Posadas

Role: PRINCIPAL_INVESTIGATOR

University of Chicago Comprehensive Cancer Center

Locations

University of Chicago Comprehensive Cancer Center

Chicago, Illinois, United States

University of Wisconsin Hospital and Clinics

Madison, Wisconsin, United States

Countries

United States

References

Ward JE, Karrison T, Chatta G, Hussain M, Shevrin D, Szmulewitz RZ, O'Donnell PH, Stadler WM, Posadas EM. A randomized, phase II study of pazopanib in castrate-sensitive prostate cancer: a University of Chicago Phase II Consortium/Department of Defense Prostate Cancer Clinical Trials Consortium study. Prostate Cancer Prostatic Dis. 2012 Mar;15(1):87-92. doi: 10.1038/pcan.2011.49. Epub 2011 Oct 18.

Reference Type: RESULT

PMID: 22006050 (View on PubMed)

Other Identifiers

N01CM62201

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CDR0000538086

Identifier Type: REGISTRY

Identifier Source: secondary_id

14954A

Identifier Type: -

Identifier Source: secondary_id

NCI-2009-00202

Identifier Type: -

Identifier Source: org_study_id