Stage IV Adult Soft Tissue Sarcoma Clinical Trial
Official title:
The Effect of Antiangiogenic Therapy With Pazopanib Prior to Preoperative Chemotherapy for Subjects With Extremity Soft Tissue Sarcomas: A Randomized Study to Evaluate Response by Imaging
This randomized pilot clinical trial studies pazopanib hydrochloride followed by chemotherapy and surgery in treating patients with soft tissue sarcoma. Pazopanib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes that are needed for cell growth and may also stop the growth of soft tissue sarcoma by blocking blood flow to the tumor. Giving pazopanib hydrochloride and chemotherapy before surgery may make the tumor smaller and reduce the amount of tissue that needs to be removed.
PRIMARY OBJECTIVES:
I. To determine the absolute values and changes in standardized uptake values (SUV) by
fludeoxyglucose F18 (FDG)-positron emission tomography (PET) before and after a 14 day Run-in
period of pazopanib (pazopanib hydrochloride) versus placebo, and to compare this to the
change in SUV following pre-operative chemotherapy.
II. To evaluate the correlation between antiangiogenic activity and pazopanib drug exposure.
III. To assess the response rate by Response Evaluation Criteria In Solid Tumors (RECIST)
criteria after the 14 day Run-in period of pazopanib versus placebo and compare this to the
response rate following pre-operative chemotherapy.
SECONDARY OBJECTIVES:
I. To examine the activity of antiangiogenic therapy with pazopanib combined with
pre-operative chemotherapy for high risk extremity soft tissue sarcomas as measured by:
histological necrosis at surgery; change in plasma and tumor biomarker assays of angiogenesis
II. To evaluate the safety of sequential treatment with pazopanib and pre-operative
chemotherapy with doxorubicin (doxorubicin hydrochloride) and ifosfamide.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive pazopanib hydrochloride orally (PO) once daily (QD). Treatment
continues for 14 days in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive placebo PO QD. Treatment continues for 14 days in the absence of
disease progression or unacceptable toxicity.
All patients then receive neoadjuvant chemotherapy comprising doxorubicin hydrochloride
intravenously (IV) continuously over days 1-3 and ifosfamide IV on days 1-5. Treatment
repeats every 21 days for 4 courses. Beginning 2-4 weeks later, all patients undergo surgery
followed by 2 more courses of chemotherapy 2-4 weeks after completion of surgery. Some
patients may also undergo adjuvant external beam radiation therapy 5 days a week for 5 days
followed by a boost. Patients treated on Arm I may resume pazopanib hydrochloride 1 week
after completion of all adjuvant therapy for up to 1 year. Treatment continues in the absence
of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at 30 days.
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