Votrient maintenance for ovarian cancer – pro
Pazopanib is an oral multikinase inhibitor of the vascular endothelial growth factor receptor (VEGFR), platelet-derived growth factor receptor (PDGFR), and c-Kit.
Maintenance therapy with the oral agent pazopanib improved progression free survival (PFS) by a median of 5.6 months in patients with advanced ovarian cancer but did not impact overall survival, according to the results of a phase III randomized trial reported in the 2014 Journal of Clinical Oncology.
The international Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom trial 16 (AGO-OVAR 16) trial was sponsored by UK-based GlaxoSmithKline (GSK) which manufactures pazopanib. A total of 940 patients with ovarian, fallopian tube, or peritoneum cancers were randomized 1:1 to receive either 800 mg of pazopanib once daily or placebo for up to 24 months. Patients had stage II through IV disease and had to have not progressed after first-line platinum-based chemotherapy.
This is stage I, so teh study does nto speak to this situation, and anyway it ws an essentially negative study.
n an exploratory analysis, pazopanib appeared to have superior benefit in the 78% of patients who were not of East Asian descent (HR = 0.69; median PFS benefit, 5.9 months). In contrast, the 22% of patients of East Asian descent had an HR of 1.16.
In an editorial accompanying the study, Kate E. Oliver, MD, of Walter Reed National Military Medical Center in Bethesda, Maryland, and William P. McGuire, MD, of Inova Fairfax Hospital, Annandale in Virginia, highlighted the relatively high discontinuation rate of patients in the pazopanib arm and its unfavorable benefit-to-risk profile. Noting that owing to previous study results, GSK had withdrawn its application in the European Union for approval of pazopanib as a maintenance therapy for ovarian cancer.
Andreas du Bois, Anne Floquet, Jae-Weon Kim, Joern Rau, Josep M. del Campo, Michael Friedlander, Incorporation of Pazopanib in Maintenance Therapy of Ovarian Cancer. Journal of Clinical Oncology 32, no. 30 (October 2014) 3374-3382.
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