Phase II study of pazopanib monotherapy in metastatic gastroenteropancreatic neuroendocrine tumours

H K Ahn, J Y Choi, K-M Kim, H Kim, S-H Choi, S H Park, J O Park, H Y Lim, W K Kang, J Lee, Y S Park, H K Ahn, J Y Choi, K-M Kim, H Kim, S-H Choi, S H Park, J O Park, H Y Lim, W K Kang, J Lee, Y S Park

Abstract

Background: Treatment options for patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP NETs) are still limited. We investigated the antitumour activity and safety profile of pazopanib--a multitarget drug with anti-angiogenic activity in patients with metastatic GEP NETs.

Methods: This was a nonrandomised, open-labeled, single-center phase II study. Pazopanib was orally administered at a dose of 800 mg daily continuously with a 28-day cycle. The primary end point was an objective response rate according to Response Evaluation Criteria in Solid Tumors (RECIST). The secondary end points were progression-free survival (PFS), overall survival (OS) and safety. An independent review of objective response was planned. The trial is registered with ClinicalTrials.gov, NCT number 01099540. Correlative biomarker analyses were performed.

Results: Between April 2010 and February 2012, a total of 37 patients were enrolled. Thirty-two percent of the enrolled patients had pancreatic primary and 22% of the patients had colorectal primary NETs. This phase II study demonstrated an objective response rate of 18.9% (7 of the 37, 95% CI 8.0-35.2) and a disease control rate (CR+confirmed PR+stable disease) of 75.7% (28 of the 37, 95% CI, 58.8-88.2) in metastatic GEP NETs. The independent review demonstrated a higher overall response rate of 24.3% (95% CI, 11.8-41.2%) with nine confirmed PRs.

Conclusion: Pazopanib showed a comparable efficacy to other targeted agents not only in pancreatic NETs but also in NETs originating from gastrointestinal (GI) tract.

Trial registration: ClinicalTrials.gov NCT01099540.

Figures

Figure 1
Figure 1
A waterfall plot demonstrating the maximum reduction in tumour size (A) by site investigators and (B) after independent review.
Figure 2
Figure 2
Survival curves (A) overall survival; (B) progression survival.
Figure 3
Figure 3
Overall survival according to biomarkers. (A) Overall survival according to serum chromogranin level (n=29). (B) Overall survival according to Ki-67 expression (n=21). (C) Overall survival according to PHH3 expression (n=21). (D) Overall survival according to SUVave of all hypermetabolic lesions (n=18).

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