Pazopanib Added to Paclitaxel Does Not Improve Ovarian Cancer Outcomes

Article

The addition of pazopanib to paclitaxel failed to improve outcomes over paclitaxel alone in women with persistent or recurrent epithelial ovarian cancer.

The addition of pazopanib to paclitaxel failed to improve outcomes over paclitaxel alone in a phase II study of women with persistent or recurrent pretreated epithelial ovarian cancer. The results of the study were published in JAMA Oncology.

“Multiple reports have shown that angiogenesis is associated with worse survival for patients with ovarian cancer,” wrote study authors led by Debra L. Richardson, MD, of the University of Texas Southwestern Medical Center in Dallas. Bevacizumab, which targets VEGF, is approved in certain ovarian cancer patients, so researchers hypothesized that pazopanib, which has multiple targets including VEGF receptors 1, 2, and 3; PDGF receptors alpha and beta; and c-KIT, might also improve outcomes for these patients.

The phase II trial was a randomized double-blind study that included 106 women with persistent or recurrent epithelial ovarian, fallopian tube, or primary peritoneal carcinoma. All patients had received 1 to 3 prior regimens, and had a performance status of 0 to 2; they were randomized to receive paclitaxel plus pazopanib (54 patients) or paclitaxel plus placebo (52 patients).

The median follow-up period was 17.7 months, during which time 84 progression-free survival events occurred; 44.4% of pazopanib and 38.5% of placebo patients had died. The median progression-free survival was 7.5 months with the study drug and 6.2 months with placebo, for a hazard ratio (HR) of 0.84 (90% CI, 0.57–1.22; P = .20).

The overall survival was also similar, with a median of 20.7 months with pazopanib and 23.3 months with placebo, for an HR of 1.04 (90% CI, 0.60–1.79; P = .90). The response rate was 31.8% with pazopanib and 22.7% with placebo.

More placebo patients stopped therapy due to disease progression compared with pazopanib patients (65.4% vs 31.5%), while more in the pazopanib group stopped due to adverse events (37% vs 9.6%; P = .001). The most common adverse events that led to treatment discontinuation were neutropenia and neuropathy. Neutropenia was the most common grade 3/4 adverse event, but the authors noted that febrile neutropenia was uncommon in the study.

“This study indicates that the combination of weekly paclitaxel with pazopanib is not superior to weekly paclitaxel alone in women with recurrent ovarian, fallopian tube, and primary peritoneal cancer,” the authors concluded. “Results from this study do not support further investigation of this combination in this patient population at these doses and schedule.”

Related Videos
Brian Slomovitz, MD, MS, FACOG discusses the use of new antibody drug conjugates for treating patients with various gynecologic cancers.
Developing novel regimens may continue to improve survival outcomes of patients with advanced cervical cancer following the FDA approval of pembrolizumab and chemoradiation, says Jyoti S. Mayadev, MD.
Treatment with pembrolizumab plus chemoradiation appears to be well tolerated with no detriment to quality of life among those with advanced cervical cancer.
Jyoti S. Mayadev, MD, says that pembrolizumab in combination with chemoradiation will be seamlessly incorporated into her institution’s treatment of those with FIGO 2014 stage III to IVA cervical cancer following the regimen’s FDA approval.
Domenica Lorusso, MD, PhD, says that paying attention to the quality of chemoradiotherapy is imperative to feeling confident about the potential addition of pembrolizumab for locally advanced cervical cancer.
Guidelines from the Society of Gynecologic Oncology may help with managing the ongoing chemotherapy shortage in the treatment of patients with gynecologic cancers, according to Brian Slomovitz, MD, MS, FACOG.
Interim data reveal favorable responses in patients with low-grade serous ovarian cancer treated with avutometinib plus defactinib, according to Susana N. Banerjee, MD.
Brian Slomovitz, MD, MS, FACOG, notes that sometimes there is a need to substitute cisplatin for carboplatin, and vice versa, to best manage gynecologic cancers during the chemotherapy shortage.
Findings from the phase 3 MIRASOL trial support mirvetuximab soravtansine as a standard treatment option for platinum-resistant ovarian cancer, according to Ritu Salani, MD.
Trastuzumab deruxtecan appears to elicit ‘impressive’ responses among patients with HER2-positive gynecologic cancers regardless of immunohistochemistry in the phase 2 DESTINY-PanTumor02 trial.
Related Content