A randomized phase II evaluation of weekly gemcitabine plus pazopanib versus weekly gemcitabine alone in the treatment of persistent or recurrent epithelial ovarian, fallopian tube or primary peritoneal carcinoma

L. R. Duska, G. R. Petroni, N. Varhegyi, J. Brown, D. Jelovac, K. N. Moore, W. P. McGuire, C. Darus, L. M. Barroilhet, A. A. Secord

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Angiogenesis inhibition is a valuable strategy for ovarian cancer (EOC). Pazopanib (paz) is a potent small molecular inhibitor of VEGF-1, -2, -3, PDGFR, c-kit, and has activity as a single agent in ovarian cancer. We designed a trial to assess the benefit of adding paz to gemcitabine (gem) in patients with recurrent EOC. Methods: An open-label, randomized, multi-site, phase 2 trial was conducted (NCT01610206) including patients with platinum resistant or sensitive disease, ≤ 3 prior lines of chemotherapy, and measurable/evaluable disease. Patients were randomly assigned to weekly gem 1000 mg/m2 on days 1 and 8 of a 21 day cycle, with or without paz 800 mg QD, stratified by platinum sensitivity and number of prior lines (1 vs 2 or 3). The primary endpoint was PFS. Results: 148 patients were enrolled 2012–2017. Median age was 63 years (30–82); 60% were platinum resistant; median surveillance was 13 months (0.4–54 months). Median PFS was 5.3 (95% CI, 4.2–5.8) vs 2.9 months (95% CI, 2.1–4.1) in the gem arm. The PFS effect was most pronounced in the platinum resistant group (5.32 vs 2.33 months Tarone-Ware p < 0.001). There was no difference in OS. Overall RR (PR 20% vs 11%, Chi-squre p = 0.02) and DCR (80% vs 60%, Chi-square p < 0.001) were higher in the combination. High grade AEs in the combination arm included ≥ Grade 3: hypertension (15%), neutropenia (35%), and thrombocytopenia (12%). Conclusions: The addition of paz to gem enhanced anti-tumor activity; those with platinum-resistant disease derived the most benefit from combination therapy, even in the setting of receiving prior bevacizumab.

Original languageEnglish (US)
Pages (from-to)585-592
Number of pages8
JournalGynecologic oncology
Volume157
Issue number3
DOIs
StatePublished - Jun 2020

Keywords

  • Angiogenesis
  • Gemcitabine
  • Ovarian cancer
  • Pazopanib

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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