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Pazopanib in Treating Patients With Newly Diagnosed Stage II or Stage III Breast Cancer That Can Be Removed By Surgery
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), July 2008
Sponsors and Collaborators: Cancer Institute of New Jersey
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00450879
  Purpose

RATIONALE: Pazopanib 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. Giving pazopanib before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

PURPOSE: This clinical trial is studying how well pazopanib works in treating patients with newly diagnosed stage II or stage III breast cancer that can be removed by surgery.


Condition Intervention
Breast Cancer
Drug: pazopanib hydrochloride
Procedure: biopsy
Procedure: conventional surgery
Procedure: dynamic contrast-enhanced magnetic resonance imaging
Procedure: gene expression profiling
Procedure: immunohistochemistry staining method
Procedure: immunologic technique
Procedure: laboratory biomarker analysis
Procedure: neoadjuvant therapy
Procedure: pharmacological study
Procedure: protein expression analysis

Genetics Home Reference related topics: breast cancer
MedlinePlus related topics: Breast Cancer Cancer
Drug Information available for: Tyrosine Pazopanib Pazopanib Hydrochloride
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Pilot Study of GW786034 (Pazopanib), a Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor, in Patients With Operable Breast Cancer

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Change in molecular parameters, phosphorylated vascular endothelial growth factor (VEGF) receptor-2 (VEGFR-2), microvessel density, tumor proliferation (Ki67), and apoptosis [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change in plasma VEGF and serum VEGFR-2 levels [ Designated as safety issue: No ]
  • Change in circulating endothelial cells [ Designated as safety issue: No ]
  • Change in steady-state plasma concentration of pazopanib hydrochloride [ Designated as safety issue: No ]
  • Evaluation of dynamic contrast-enhanced MRI of the breast [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: January 2007
Estimated Primary Completion Date: February 2009 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the biologic effect of pazopanib hydrochloride, in terms of decreased phosphorylation of vascular endothelial growth factor (VEGF) receptor-2 (VEGFR-2) and/or decreased microvessel density, in patients with newly diagnosed, operable, stage II or III breast cancer.
  • Determine the mechanism of antitumor effect of this drug, in terms of reduced tumor cell proliferation (Ki67) or increased apoptosis, in these patients.

Secondary

  • Determine the change in levels of tissue VEGF in patients treated with this drug.
  • Determine the change in phosphorylation of epidermal growth factor receptor (EGFR), MAPK, and AKT in patients treated with this drug.
  • Evaluate gene expression patterns in patients treated with this drug.
  • Evaluate the change in VEGF and VEGFR-2 as circulating biomarkers in patients treated with this drug.
  • Evaluate the changes in circulating endothelial cells in patients treated with this drug.
  • Determine if steady-state plasma concentration of this drug correlates with inhibition of phospho-VEGFR-2.
  • Evaluate the change in vascular permeability by dynamic contrast-enhanced MRI (DCE-MRI) of the breast in patients treated with this drug.
  • Compare DCE-MRI imaging of the tumor vasculature in the breast before, during, and after treatment with this drug.

OUTLINE: This is an open-label, pilot study.

Patients receive oral pazopanib hydrochloride once daily for 12-20 days. Patients then undergo surgical resection of tumor between days 13 and 21 (24 hours after completion of pazopanib hydrochloride).

Patients undergo dynamic contrast-enhanced MRI at baseline, on day 2 or 3, and at 24-72 hours prior to surgery. Blood samples are collected periodically for analysis of circulating endothelial cells and pharmacokinetic studies. Patients also undergo tumor biopsy at baseline and at the time of surgery. Samples are analyzed by immunohistochemistry, microarray (gene expression profiling), and TUNEL assays to assess vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2), epidermal growth factor receptor (EGFR), MAPK, AKT, phosphorylated (p) VEGFR-2, pEGFR, pMAPK, and pAKT activity, tumor cell proliferation (Ki67) and apoptosis, and microvessel density (using endothelial markers CD31 [PECAM-1], CD34, and CD 133).

PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed invasive breast cancer by core-needle biopsy

    • Stage II (T1 cN1, T2 N0, T2 N1, or T3 N0) disease OR stage III (T1 cN2, T2 N2, T3 N1, or T3 N2) disease
  • Newly diagnosed disease
  • Measurable disease by physical exam or ultrasound

    • Residual tumor ≥ 1 cm at the primary site allowed
  • Able to undergo surgical treatment with either lumpectomy or mastectomy

    • No disease with direct extension to the chest wall or skin (T4a-c)
  • No inflammatory breast cancer (T4d)
  • No stage I (T1a N0 or T1b N0) disease
  • No locally recurrent disease
  • No metastatic disease
  • No brain tumors

PATIENT CHARACTERISTICS:

  • Male or female
  • Menopausal status not specified
  • ECOG performance status 0-2
  • WBC ≥ 3,000/mm³
  • Platelet count ≥ 100,000/mm³
  • Bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • PT, INR, and PTT ≤ 1.2 times ULN
  • Creatinine normal OR creatinine clearance ≥ 60 mL/min
  • Proteinuria ≤ 1+ by 2 consecutive dipsticks ≥ 1 week apart
  • QTc interval < 500 msec
  • No significant ECG abnormalities
  • No condition that would inhibit ability to swallow and retain oral medications, including the following:

    • Gastrointestinal tract disease
    • Requirement for IV alimentation
    • Prior surgical procedures affecting absorption
    • Active peptic ulcer disease
  • No abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the past 28 days
  • No serious or nonhealing wound, ulcer, or bone fracture
  • No history of any of the following within the past 12 months:

    • Myocardial infarction
    • Cardiac arrhythmia
    • Admission for unstable angina
    • Cardiac angioplasty or stenting
  • No venous thrombosis within the past 12 weeks
  • No New York Heart Association class III or IV heart failure
  • No cerebrovascular accident within the past 6 months
  • No uncontrolled hypertension, defined as systolic blood pressure (BP) ≥ 140 mm Hg and diastolic BP ≥ 90 mm Hg
  • No concurrent uncontrolled illness, including but not limited to, ongoing or active infection or psychiatric illness or social situation that would preclude study participation
  • No history of allergic reactions to compounds of similar chemical or biological composition as pazopanib hydrochloride or other agents used in this study
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No prior chemotherapy or hormonal therapy for this primary breast cancer
  • Concurrent medication or substances known to affect or with the potential to affect the activity or pharmacokinetics of pazopanib hydrochloride must be approved by the principal investigator
  • No CYP2C9 inhibitors for ≥ 14 days prior to, during, and for 1-2 weeks after completion of study therapy
  • No concurrent therapeutic warfarin

    • Low molecular weight heparin or prophylactic low-dose warfarin allowed
  • No other concurrent investigational agents
  • No other concurrent anticancer agents or therapies, including chemotherapy, immunotherapy, hormonal therapy, radiotherapy, or surgery
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00450879

Locations
United States, New Jersey
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School Recruiting
New Brunswick, New Jersey, United States, 08903
Contact: Clinical Trials Office - Cancer Institute of New Jersey     732-235-8675        
Sponsors and Collaborators
Cancer Institute of New Jersey
Investigators
Study Chair: Antoinette R. Tan, MD Cancer Institute of New Jersey
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000534258, CINJ-040607, CINJ-GW786034
Study First Received: March 20, 2007
Last Updated: July 23, 2008
ClinicalTrials.gov Identifier: NCT00450879  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
male breast cancer
stage II breast cancer
stage IIIA breast cancer

Study placed in the following topic categories:
Skin Diseases
Breast Neoplasms, Male
Breast Neoplasms
Endothelial Growth Factors
Breast Diseases

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site

ClinicalTrials.gov processed this record on January 14, 2009