Radiotherapy (RT) alone is able to induce a clinically significant effect with a variable pathologic response (a pathological complete remission, pCR, defined as ≥ 95%, or ≤ 5% remaining visible tumour cells) in only about 10% of cases. A prior phase I study (PASART-1; NCT01985295) suggested that 25 x 2 Gy preoperative RT in combination with once daily 800mg oral pazopanib is feasible, while inducing tissue replacing tumor that can consist of fibrosis and necrosis in 40% of thus treated patients. During this study, the interim analysis showed that the combination treatment of preoperative radiation with orally pazopanib is more effective than was anticipated. For this reason, the pazopanib dose of 800 mg once daily is maintained but the RT dose is reduced to 18x2Gy instead of 25x2Gy. Predominant aim of this RT dose reduction is lowering the wound complication risk after preoperative radiotherapy.
Patients of the first part of the study received radiotherapy (25x2Gy) and pazopanib (QD 800 mg). Patients of the second part of the study received/ will receive radiotherapy (18x2Gy) and pazopanib (QD 800 mg).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
25
external beam radiotherapy 25 x 2 Gy / 18 x 2 Gy
pazopanib QD 800 mg
Antoni van Leeuwenhoek
Amsterdam, Netherlands
Leids Universitair Medisch Centrum
Leiden, Netherlands
Royal Marsden Hospital
London, United Kingdom
pathological near complete remission of the resected specimen which has been treated with radiotherapy
Proportion of patients with resection specimens demonstrating induction of a pathological (near) complete remission (≥ 95% tumor regression). Pathological (near) complete remission is defined as ≥ 95% replacement of tumor with other tissue, usually fibrosis and) in the resection specimen post combined pazopanib and radiotherapy treatment
Time frame: 6 weeks post treatment
Incidence toxicities measured by NCI-CTCAE v4.0 (radiotherapy alone, pazopanib alone or both) measured from start of treatment until 6 weeks post-treatment
Time frame: during treatment and up to 6 weeks post treatment
Rate of response as measured by RECIST v 1.1 at 4 weeks after completing radiotherapy
Time frame: 4 weeks post treatment
Incidence of acute post-operative wound complications up to 3 weeks (+/- 1 week) after surgery as defined in section 6.1.3 and reference 29 (see also appendix XII)
Time frame: up to 3 weeks post surgery
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