Study of Pazopanib and Pemetrexed in Advanced Non-small Cell Lung Cancer

Study Overview
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Brief Summary
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The main purpose of this study is to determine whether the combination of pazopanib and pemetrexed is safe and effective in the treatment of advanced non-small cell lung cancer (NSCLC).

Official Title
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An Open-label, Multicentre, Randomised Phase II Study of Pazopanib in Combination With Pemetrexed in First-line Treatment of Subjects With Predominantly Non-squamous Cell Stage IIIBwet/IV Non-small Cell Lung Cancer

Conditions
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Lung Cancer, Non-Small Cell

Intervention / Treatment
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* Drug: pazopanib and pemetrexed
* Drug: pemetrexed and cisplatin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Written informed consent At least 18 years old Histologically- or cytologically-confirmed diagnosis of predominantly nonsquamous cell Stage IIIBwet (with confirmed malignant pleural effusion) or Stage IV NSCLC No prior systemic first-line therapy for advanced NSCLC Measurable disease Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Life expectancy of at least 12 weeks Able to swallow and retain oral medication Adequate organ system function (hematological, hepatic, and renal) Non-childbearing potential (i.e., physiologically incapable of becoming pregnant) OR childbearing potential, and agrees to use adequate contraception. A male with a female partner of childbearing potential is eligible if he uses a barrier method of contraception or abstinence during the study Exclusion Criteria: Active malignancy or any malignancy in the 3 years prior to first dose of study drug other than NSCLC Central nervous system (CNS) metastases or leptomeningeal carcinomatosis, except for asymptomatic, previously treated CNS metastases Clinically significant gastrointestinal abnormalities Prolongation of corrected QT interval (QTc) > 480 msecs History of any one or more cardiovascular conditions within the past 6 months prior to randomization Poorly controlled hypertension History of cerebrovascular accident (including transient ischemic attacks), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months Major surgery or trauma within 28 days or any non-healing wound, fracture, or ulcer Evidence of active bleeding or bleeding diathesis Recent hemoptysis Endobronchial lesions and/or lesions infiltrating major pulmonary vessels Serious and/or unstable pre-existing medical (e.g., uncontrolled infection), psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures Use of any prohibited medication Use of an investigational agent within 28 days or 5 half-lives, whichever is longer, prior to the first dose of study drug Ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity except alopecia Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib, pemetrexed, and/or cisplatin Inability to interrupt aspirin or other non-steroidal anti-inflammatory drugs during the study Inability or unwillingness to take folic acid, vitamin B12 supplementation, or dexamethasone Clinically significant third-space fluid collections (e.g., ascites or pleural effusions) that cannot be controlled by drainage or other procedures prior to study start Recent or concurrent yellow fever vaccination

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Arm 1<br>Investigational treatment (pazopanib and pemetrexed) | Drug: pazopanib and pemetrexed<br>* oral pazopanib 600 mg once daily and pemetrexed intravenous (IV) 500mg/m^2 once every 3 weeks, then pazopanib 800 mg once daily<br>|
| Active Comparator: Arm 2<br>Standard treatment (pemetrexed and cisplatin) | Drug: pemetrexed and cisplatin<br>* pemetrexed IV 500 mg/m^2 and cisplatin IV 75 mg/m^2 once every 3 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free Survival (PFS) | PFS is defined as the interval between the date of randomization (date on which the investigator evaluated the participant and first determined he/she had disease progression) and the first occurrence of progressive disease (PD) or death from any cause. Per Response Evaluation Criteria in Solid Tumors (RECIST), version 1, PD is defined as a >=20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of >=1 new lesion). | Randomization until progression or death (up to 85 weeks) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall Survival (OS) | OS was determined from the date of randomization to the date of death from any cause. Participants who had not died at the time of the cut-off for the final analysis were censored at the date the participants were last known to be alive. Because enrollment in the study was halted prematurely, the ability to achieve an estimate of OS was compromised. Consequently, OS was not estimated. | Randomization until death (up to 85 weeks) | 
| Best Overall Response, Assessed as the Number of Participants With the Indicated Tumor Response: Investigator Assessed Only | Tumor response was assessed by the Investigator according to the RECIST, version 1.0. A participant was defined as a responder if he/she sustained a complete response (CR; the disappearance of all target lesions) or partial response (PR; >=30% decrease in the sum of the longest diameter of target lesions) for at least 4 weeks at any time during randomized treatment. Stable disease is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started. | Randomization until response or progressive disease (up to 85 weeks) | 
| Percentage of Participants With a Complete Response or a Partial Response | The percentage of participants with a complete response or a partial response was evaluated. | Randomization until response or progressive disease (up to 85 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GW786034, pazopanib, pemetrexed, cisplatin, non-small cell lung cancer, NSCLC