Pazopanib with Topotecan weekly for patients with platinum-resistant or intermediate-sensitive recurrent ovarian cancer: results of a multicentre, open label phase I/II study (TOPAZ)

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • for the NOGGO ovarian cancer study group - (Autor:in)
  • Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe
  • Charité – Universitätsmedizin Berlin
  • Martin-Luther-Universität Halle-Wittenberg
  • Ludwig-Maximilians-Universität München (LMU)
  • Universität Hamburg
  • SLK-Kliniken Heilbronn GmbH
  • Universität Leipzig
  • Staufer Klinikum Schwäbisch Gmünd
  • Dr. Horst Schmidt Klinik GmbH
  • Ernst-Moritz-Arndt-Universität Greifswald
  • Universität Bonn
  • Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe

Abstract

Purpose: Pazopanib has promising antiangiogenetic activity in solid cancers. The investigator-initiated phase I/II trial evaluated the combination of Topotecan with Pazopanib in platinum-resistant or intermediate-sensitive recurrent ovarian cancer (ROC). Methods: Patients (≥ 18 years) with first or second recurrence were enrolled in this multicentre open-label trial. Phase I analysed Topotecan 4 mg/m2 (day 1, 8, 15, ever 28 days) for six cycles to identify the maximum tolerated dose (MTD) of Pazopanib added in a dose-escalating scheme with 400 mg starting dose. The phase II analysed safety and efficacy aspects. For all patients with clinical remission a maintenance with Pazopanib until progression was allowed. This trial is registered with ClinicalTrials.gov, number NCT 01600573. Results: Between June 2012 and February 2017, 11 patients were enrolled in the phase I, and 50 patients in the phase II study. The MTD of Pazopanib was determined by 400 mg/daily. Haematological and liver toxicities determined the dose limiting toxicities (DLT) and the most common grade 3–4 adverse events: leucopenia (25%), neutropenia (22%), thrombocytopenia (19%), accumulation of cholestatic (20%) and hepatocellular damage (15%), which often caused dose modifications, but no new life-threatening events. Overall response was 16% and clinical benefit rate 68%. Median progression-free survival (PFS) was 3.5 months (95% CI 2.0—5.0). Due to early progression only 20% of the patients were able to start with maintenance treatment. Conclusion: The combination of pazopanib and weekly topotecan is feasible, resulting in a manageable haematological and liver toxicity, but despite its encouraging response rate, was not associated with a significant survival benefit.

Details

OriginalspracheEnglisch
Seiten (von - bis)7637-7649
Seitenumfang13
FachzeitschriftJournal of cancer research and clinical oncology
Jahrgang149
Ausgabenummer10
PublikationsstatusVeröffentlicht - Aug. 2023
Peer-Review-StatusJa

Externe IDs

PubMed 37000264

Schlagworte

Ziele für nachhaltige Entwicklung

ASJC Scopus Sachgebiete

Schlagwörter

  • Pazopanib, Platinum-resistant ovarian cancer, Topotecan, Leukopenia/chemically induced, Neoplasm Recurrence, Local/drug therapy, Platinum/pharmacology, Humans, Carcinoma, Ovarian Epithelial/drug therapy, Female, Ovarian Neoplasms, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Topotecan/therapeutic use