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    Clinical Trial Results:
    Pazopanib in advanced gastrointestinal stromal tumors refractory to imatinib and sunitinib . A non-comparative phase II multicenter study by the Scandinavian Sarcoma Group

    Summary
    EudraCT number
    2011-004404-37
    Trial protocol
    SE   FI   DE   DK   IS  
    Global end of trial date
    07 Jan 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    26 Sep 2020
    First version publication date
    26 Sep 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    SSGXXI
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01524848
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Scandinavian Sarcoma Group
    Sponsor organisation address
    Barngatan 2B, Lund, Sweden, SE-22185
    Public contact
    SSG secretariat, Scandinavian Sarcoma Group, 46 46275 21 82, ssg@med.lu.se
    Scientific contact
    SSG secretariat, Scandinavian Sarcoma Group, 46 46275 21 82, mikael.eriksson@med.lu.se
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    06 Dec 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    07 Jan 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Jan 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Calculate the disease control rate (DCR)=complete remission (CR)+partial remission (PR) + stable disease (SD) at 12 weeks
    Protection of trial subjects
    Adverse drug reactions, adverse events and laboratory tests was graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Adverse events was monitored continuosly during the treatment phase and for 30 days after the last intake of study drug. Haematology and blood chemistry was performed before treatment start, at week 4,8,12 and every 8 weeks thereafter. Proteinuria (dipstick urinanalysis) was peformed before start of treament, at week 4,8,12 and every 8 weeks thereafter. Left Ventricular Ejection Fraction was performed before treatment start, at week 12 and every 16 weeks thereafter. For women with childbearing potential a pregnancy test was performed before start of treament and those women had to accept the use of adequate contraception throughout the study period. The trial was performed according to ICH-GCP guidelines, as well as the Declaration of Hesinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    15 Mar 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Norway: 10
    Country: Number of subjects enrolled
    Sweden: 27
    Country: Number of subjects enrolled
    Denmark: 6
    Country: Number of subjects enrolled
    Finland: 5
    Country: Number of subjects enrolled
    Germany: 24
    Worldwide total number of subjects
    72
    EEA total number of subjects
    72
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    35
    From 65 to 84 years
    37
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 72 patients was enrolled in the study as per plan if the interim analysis after 22 patients showed that at least six patients achieved disease control rate (DCR=CR+PR+SD) at 12 weeks according to RECIST version 1.1

    Pre-assignment
    Screening details
    Patients with metastatic and/or locally advanced GIST and with a history of progressive disease after both imatinib and sunitinib treatment, and also nilotinib if this drug has been given was screened for eligibility.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Pazopanib
    Arm description
    This is a single arm study with Pazopanib. Pazopanib is a tyrosin kinase receptor inhibitor given as tablets of 400 mg with the standard dose being two tablets given at one occasion at the same time each day without food at least one hour before or two hours after a meal.
    Arm type
    Single

    Investigational medicinal product name
    Pazopanib
    Investigational medicinal product code
    Other name
    Votrient
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    800 mg (two tablets á 400 mg) taken once daily orally without food for at least one hour before or two hours after a meal.

    Number of subjects in period 1
    Pazopanib
    Started
    72
    Completed
    72

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall trial
    Reporting group description
    Treatment with 800 mg Pazopanib orally once a day.

    Reporting group values
    Overall trial Total
    Number of subjects
    72 72
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    35 35
        From 65-84 years
    37 37
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    64.2 (32 to 83) -
    Gender categorical
    Units: Subjects
        Female
    25 25
        Male
    47 47
    Subject analysis sets

    Subject analysis set title
    Pazopanib
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Pazopanib is a tyrosin kinase inhibitor given as tablets of 400 mg with the standard dose being two tablets given at one occasion at the same time each day without food at least one hour before or two hours after a meal. This is a single arm study.

    Subject analysis sets values
    Pazopanib
    Number of subjects
    72
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
    35
        From 65-84 years
    37
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    Gender categorical
    Units: Subjects
        Female
        Male

    End points

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    End points reporting groups
    Reporting group title
    Pazopanib
    Reporting group description
    This is a single arm study with Pazopanib. Pazopanib is a tyrosin kinase receptor inhibitor given as tablets of 400 mg with the standard dose being two tablets given at one occasion at the same time each day without food at least one hour before or two hours after a meal.

    Subject analysis set title
    Pazopanib
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Pazopanib is a tyrosin kinase inhibitor given as tablets of 400 mg with the standard dose being two tablets given at one occasion at the same time each day without food at least one hour before or two hours after a meal. This is a single arm study.

    Primary: Disease control rate (DCR=CR+PR+SD) at 12 weeks according to RECIST 1.1

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    End point title
    Disease control rate (DCR=CR+PR+SD) at 12 weeks according to RECIST 1.1
    End point description
    End point type
    Primary
    End point timeframe
    Disease control rate (DCR=CR+PR+SD) evaluated at 12 weeks and every 8 weeks as long as treatment continues by CT abdomen/pelvic region.
    End point values
    Pazopanib Pazopanib
    Number of subjects analysed
    72
    72 [1]
    Units: Procentage
    72
    72
    Notes
    [1] - Note that this is a single arm study with a total of 72 patients.
    Statistical analysis title
    Non-comparative statistical analysis of pazopanib
    Statistical analysis description
    Demographic and prognostic variables were presented by means of descriptive statistics. Whenever appropriate, results are illustrated with a graph. The primary endpoint was Disease control rate (DCR=CR+PR+SD) at 12 weeks from start of pazopanib treatment according to RECIST version 1.1. The primary endpoint was analysed using Simon's two stage analysis will be used. Since sample size calculation is an integral part of Simon’s method, no separate section on sample size was made.
    Comparison groups
    Pazopanib v Pazopanib
    Number of subjects included in analysis
    144
    Analysis specification
    Pre-specified
    Analysis type
    superiority [2]
    Method
    Simon`s two stage method
    Parameter type
    Proportion with clinical benefit
    Point estimate
    44.4
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    34
         upper limit
    60
    Notes
    [2] - Superiority to a fixed value

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From start of treatment, and 30 days after end of treatment.
    Adverse event reporting additional description
    All AEs was documented on the case report forms (CRF) where a lot of AEs was listed including the most common described in relation with pazopanib treatment. For AEs not specifically listed, space for "other" was created.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    NCI-CTCAE
    Dictionary version
    4.0
    Reporting groups
    Reporting group title
    All patients
    Reporting group description
    -

    Serious adverse events
    All patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    31 / 72 (43.06%)
         number of deaths (all causes)
    5
         number of deaths resulting from adverse events
    1
    Vascular disorders
    Trombosis left leg
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Amputation right foot
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Hospitalisation due to insert of stent
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Heart failure
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Decreased activity
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 1
    Pain in extremity
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Amotio retinae
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Nausea and vomiting
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Diarrhea
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Perforation of colon
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric bleeding
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Ileus
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Ulcer
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Bladder perforation
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    General infection
         subjects affected / exposed
    7 / 72 (9.72%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Wound infection bacterial
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    All patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    72 / 72 (100.00%)
    General disorders and administration site conditions
    Headache
         subjects affected / exposed
    16 / 72 (22.22%)
         occurrences all number
    32
    Hypertension
         subjects affected / exposed
    54 / 72 (75.00%)
         occurrences all number
    228
    Epistaxis
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    27
    Hoarseness
         subjects affected / exposed
    21 / 72 (29.17%)
         occurrences all number
    48
    Stomatitis
         subjects affected / exposed
    12 / 72 (16.67%)
         occurrences all number
    37
    Hair color change
         subjects affected / exposed
    35 / 72 (48.61%)
         occurrences all number
    145
    Fatigue
         subjects affected / exposed
    54 / 72 (75.00%)
         occurrences all number
    117
    Sweating
         subjects affected / exposed
    11 / 72 (15.28%)
         occurrences all number
    23
    Change of voice
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    5
    Fever
         subjects affected / exposed
    4 / 72 (5.56%)
         occurrences all number
    4
    Dry mouth
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Insomnia
         subjects affected / exposed
    7 / 72 (9.72%)
         occurrences all number
    12
    Dyspnoea
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    7
    Investigations
    Increased ALT
         subjects affected / exposed
    17 / 72 (23.61%)
         occurrences all number
    53
    Increased AST
         subjects affected / exposed
    23 / 72 (31.94%)
         occurrences all number
    52
    Increased ALP
         subjects affected / exposed
    26 / 72 (36.11%)
         occurrences all number
    65
    Cardiac disorders
    Left ventricular dysfunction
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences all number
    2
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    15 / 72 (20.83%)
         occurrences all number
    39
    Blood and lymphatic system disorders
    Trombocytopeni
         subjects affected / exposed
    6 / 72 (8.33%)
         occurrences all number
    26
    Neutropenia
         subjects affected / exposed
    11 / 72 (15.28%)
         occurrences all number
    20
    Anemia
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    14
    Hyponatraemia
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    3
    Lymphoblast count increased
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    4
    Embolism
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    1
    Thrombosis
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences all number
    4
    Eye disorders
    Blurred vision
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    6
    Cataract
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    1
    Dry eye
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    2
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    42 / 72 (58.33%)
         occurrences all number
    106
    Nausea
         subjects affected / exposed
    31 / 72 (43.06%)
         occurrences all number
    91
    Vomiting
         subjects affected / exposed
    18 / 72 (25.00%)
         occurrences all number
    24
    Dyspepsia
         subjects affected / exposed
    13 / 72 (18.06%)
         occurrences all number
    31
    Diarrhoea
         subjects affected / exposed
    45 / 72 (62.50%)
         occurrences all number
    212
    Flatulence
         subjects affected / exposed
    19 / 72 (26.39%)
         occurrences all number
    46
    Abdominal distension
         subjects affected / exposed
    13 / 72 (18.06%)
         occurrences all number
    62
    Gastrointestinal haemorrhage
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    5
    Ileus
         subjects affected / exposed
    4 / 72 (5.56%)
         occurrences all number
    6
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    13 / 72 (18.06%)
         occurrences all number
    32
    Gamma-glutamyltransferase abnormal
         subjects affected / exposed
    4 / 72 (5.56%)
         occurrences all number
    17
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    8 / 72 (11.11%)
         occurrences all number
    21
    Skin hypopigmentation
         subjects affected / exposed
    12 / 72 (16.67%)
         occurrences all number
    44
    Rash maculo-papular
         subjects affected / exposed
    9 / 72 (12.50%)
         occurrences all number
    13
    Hand and foot syndrome
         subjects affected / exposed
    17 / 72 (23.61%)
         occurrences all number
    43
    Erythema
         subjects affected / exposed
    10 / 72 (13.89%)
         occurrences all number
    13
    Edema face
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    12
    Edema limbs
         subjects affected / exposed
    13 / 72 (18.06%)
         occurrences all number
    32
    Edema trunk
         subjects affected / exposed
    6 / 72 (8.33%)
         occurrences all number
    6
    Dry skin
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    9
    Sensitive skin
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    10
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    20 / 72 (27.78%)
         occurrences all number
    59
    Creatinine increased
         subjects affected / exposed
    2 / 72 (2.78%)
         occurrences all number
    6
    Haematuria
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    3
    Nocturia
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    2
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    24 / 72 (33.33%)
         occurrences all number
    72
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    30 / 72 (41.67%)
         occurrences all number
    93
    Pain
         subjects affected / exposed
    16 / 72 (22.22%)
         occurrences all number
    27
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 72 (1.39%)
         occurrences all number
    2
    Common cold
         subjects affected / exposed
    5 / 72 (6.94%)
         occurrences all number
    5
    Unknown infection
         subjects affected / exposed
    3 / 72 (4.17%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    37 / 72 (51.39%)
         occurrences all number
    93
    Dysgeusia
         subjects affected / exposed
    16 / 72 (22.22%)
         occurrences all number
    52

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Jun 2013
    The main reasons for this amendment were the following: a) An extra blood sampling for liver tests three weeks after start of the study drug was introduced after a safety warning from the company producing the drug. b) It was made clearer that the trial would encompass in total 72 evaluable patients, whereby two categories of patients could be substituted after registration if they had either not received any dose of the study drug, or were shown not to be eligible. Furthermore, some eligibility criteria were slightly adjusted as a consequence of claims from German authorities when this country joined the trial.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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