(Thyroid Cancer) Is Pazopanib + Paclitaxel + Radiation Therapy Effective?
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This article is a summary of international medical information and is not medical advice; it cannot replace the diagnosis or treatment plan of your attending physician. The medical technologies, drug information and clinical data presented here are compiled from public literature and official statements of major Japanese medical institutions; the applicability and outcome of any therapy vary with each patient and must be assessed individually by a qualified physician.
On January 18, 2023, Eric J Sherman et al. from Memorial Sloan Kettering Cancer Center published in The Lancet Oncology the Phase 2 NRG/RTOG 0912 trial results evaluating the efficacy and safety of pazopanib plus paclitaxel plus radiation therapy in patients with anaplastic thyroid cancer.
Trial Design
NRG/RTOG 0912 was a double-blind, placebo-controlled Phase 2 trial that randomized anaplastic thyroid cancer patients (N=71) in a 1:1 ratio to:
- Arm A: Paclitaxel (80 mg/m² once weekly) + Pazopanib (400 mg once daily) + IMRT (N=36)
- Arm B: Paclitaxel (80 mg/m² once weekly) + Placebo + IMRT (N=35)
Primary endpoint: Overall survival (OS). Secondary endpoint: Safety.
Efficacy Results
At a median follow-up of 2.9 years:
- Median OS: Pazopanib arm 5.7 months vs. Placebo arm 7.3 months — no significant improvement with pazopanib addition
- 1-year OS rate: Pazopanib arm 37.1% vs. Placebo arm 29.0%
Safety Profile
Grade 3–5 adverse event rates were similar between arms:
- Pazopanib arm: 88.9% (N=32/36)
- Placebo arm: 85.3% (N=29/34)
Most common Grade 3–4 adverse events (Pazopanib vs. Placebo):
- Dysphagia: 36% / 29%
- Radiation dermatitis: 22% / 38%
- ALT elevation: 33% / 0%
- AST elevation: 22% / 0%
- Oral mucositis: 14% / 24%
Serious adverse event rates:
- Pazopanib arm: 44% (N=16)
- Placebo arm: 35% (N=12)
- One treatment-related death confirmed in each arm
Conclusions
Based on the NRG/RTOG 0912 trial results, Eric J Sherman et al. concluded that adding pazopanib to paclitaxel plus radiation therapy did not significantly improve overall survival in anaplastic thyroid cancer, though the safety profile was acceptable.
Source: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22)00763-X/fulltext
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