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Ovarian CancerPhase 2TAPAZNCT02383251

Paclitaxel/Pazopanib for Platinum Resistant/Refractory Ovarian Cancer

A Phase 2 study testing Pazopanib and Paclitaxel in people with Ovarian Cancer, run by ARCAGY/ GINECO GROUP at 36 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Study of Pazopanib and weekly Paclitaxel in patients with platinum resistant/refractory ovarian cancer who relapse during bevacizumab maintenance. Read more about this study

Who is it for?
Ages 18 to 95 years, women only
Conditions the study is for
Ovarian Cancer
What is being tested?
Pazopanib and Paclitaxel
Could I receive a placebo?
No, everyone receives an active treatment
How many people
118 participants
Where
36 sitesFrance
Study dates
15 Jun 2015to 31 Dec 2020
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 95 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Performance status ECOG < 2
  • Histological documented ovarian, tubal or peritoneum carcinoma (stage IC to IV)
  • Patient treated at least with one line of platinum-based chemotherapy who have relapsed within 6 months after trhe last administration of platinum-based chemotherapy and taking bevacizumab for maintenance NB: Penultimate line of chemotherapy could contain chemotherapy without platinum and the last line should contain platinum-based chemotherapy (followed by bevacizumab for maintenance)
  • Patients must have disease that is measurable and/or evaluable according to RECIST criteria and requires chemotherapy treatment
  • Patients with liver metastasis can be included
Show all 15Show fewer
  • Subjects must provide written informed consent prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up.
  • Life expectancy of more than 3 months
  • Able to swallow and retain oral medication
  • Adequate organ system function like:
  • Total bilirubin ≤ 1.5 X ULN Alanine amino transferase (ALT) and Aspartate aminotransferase (AST)c ≤ 2.5 X ULN
  • Subjects may not have had a transfusion within 7 days of screening assessment.
  • Subjects receiving anticoagulant therapy are eligible if their INR is stable and within the recommended range for the desired level of anticoagulation.
  • Concomitant elevations in bilirubin and AST/ALT above 1.0 x ULN (upper limit of normal) are not permitted.
  • If UPC <1, then a 24-hour urine protein must be assessed. Subjects must have a 24-hour urine protein value <1 g to be eligible. Use of urine dipstick for renal function assessment is not acceptable. 10. Women of childbearing potential must agree to use effective contraception 11. Negative serum pregnancy test (if applicable) 12. Affiliated to or a beneficiary of a social security category

Who cannot join

  • Prior malignancy over the past 5 years with the exception of in situ carcinomas of the cervix or basal and squamous cell carcinoma or nonmelanoma skin cancer properly treated, or all solid tumor, considered as in completed remission without relapse for at least 5 years
  • Central nervous system (CNS) metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases (surgery ± radiotherapy) and who meet both of the following criteria: a) are asymptomatic and b) have no requirement for steroids or enzyme-inducing anticonvulsants of P3A4 cytochrom
  • Previous treatment with monotherapy weekly paclitaxel
  • Previous treatment with bevacizumab within three weeks before start of studt treatment
  • Patients with severe hypersensitivity to a product containing castor oil polyoxyl 35 or paclitaxel solvent: the Chremophor
  • Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding including, but not limited to:
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  • Active peptic ulcer disease
  • Known intraluminal metastatic lesion/s with risk of bleeding
  • Inflammatory bowel disease (e.g. ulcerative colitis, Chrohn's disease), or other gastrointestinal conditions with increased risk of perforation
  • History of abdominal fistula, gastrointestinal perforation, or intra abdominal abscess within 28 days prior to beginning study treatment.
  • Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product including, but not limited to:
  • Malabsorption syndrome
  • Major resection of the stomach or small bowel.
  • Corrected QT interval (QTc) > 450 msecs or > 480 msecs for patient with block branch
  • History of any one or more of the following cardiovascular conditions within the past 6 months:
  • Cardiac angioplasty or stenting
  • Myocardial infarction
  • Unstable angina
  • Coronary artery bypass graft surgery
  • Symptomatic peripheral vascular disease
  • Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA)
  • Poorly controlled hypertension [defined as systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥ 90mmHg].
  • History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months. Note: Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible
  • Major surgery or trauma within 28 days prior to first dose of investigational product and/or presence of any non-healing wound, fracture, or ulcer (procedures such as catheter placement not considered to be major surgery).
  • to 14: All risk of bleeding
  • 15 Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures. 16 Unable or unwilling to discontinue use of prohibited medications 17 Treatment with any of the following anti-cancer therapies:
  • radiation therapy, surgery or tumor embolization within 14 days prior to the first dose of pazopanib (out of bevacizumab) OR
  • chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of pazopanib (out of bevacizumab) 18 Administration of any non-oncologic investigational drug within 30 days or 5 half lives whichever is longer prior to receiving the first dose of study treatment 19 Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia. 20 Patient deprived of liberty or state-controlled 21 Inability to participate to medical follow up for geographic

Trial locations and contacts

36 sites in 1 country.

36 sites in 1 country

France36 sites
  • Hôpital Henri Duffaut

    Avignon, 84902

  • Institut Bergonié

    Bordeaux, 33076

  • Polyclinique Bordeaux Nord

    Bordeaux, 33300

  • Centre François Baclesse

    Caen, 14000

  • Centre Jean Perrin

    Clermont-Ferrand, 63000

  • Centre Hospitalier Intercommunal de Créteil

    Créteil, 94010

  • Centre Hospitalier de Dax

    Dax, 40107

  • Centre Georges François Leclerc

    Dijon, 21079

  • Groupe Hospitalier Mutualiste de Grenoble

    Grenoble, 38028

  • Hôpital Michallon - Centre Hospitalier Universitaire de Grenoble

    Grenoble, 38043

  • Hôpital André Mignot

    Le Chesnay, 78157

  • Centre Jean Bernard - Clinique Victor Hugo

    Le Mans, 72000

  • Centre Oscar Lambret

    Lille, 59200

  • Hôpital de la Croix Rousse

    Lyon, 69317

  • Centre Léon Bérard

    Lyon, 69373

  • Hôpital Européen

    Marseille, 13003

  • Institut Paoli Calmettes

    Marseille, 13009

  • Hôpital de Mont-de-Marsan

    Mont-de-Marsan, 40024

  • ICM Val d'Aurelle

    Montpellier, 34298

  • ORACLE - Centre d'Oncologie de Gentilly

    Nancy, 54100

  • Centre Catherine de Sienne

    Nantes, 44202

  • Centre ONCOGARD - Institut de Cancérologie du Gard

    Nîmes, 30029

  • Centre Hospitalier Régional d'Orléans

    Orléans, 45067

  • Université Paris Descartes, AP-HP, Hôpitaux Universitaires Paris Centre, Site Cochin

    Paris, 75014

  • Clinique Francheville

    Périgueux, 20004

  • Centre Hospitalier Lyon Sud

    Pierre-Bénite, 69495

  • HPCA - Hôpital Privé des Côtes d'Armor

    Plerin SUR MER, 22190

  • "Hôpital de la Milétrie - Centre Hospitalier Universitaire de Poitiers - Pôle Régional de Cancérologie"

    Poitiers, 86021

  • Institut du Cancer Courlancy Reims

    Reims, 51100

  • ICO Centre René Gauducheau

    Saint-Herblain, 44805

  • Hôpitaux Universitaires de Strasbourg

    Strasbourg, 67000

  • Centre Paul Strauss

    Strasbourg, 67065

  • Centre Hospitalier de Thonon-les-Bains

    Thonon-les-Bains, 74203

  • Centre Hospitalier Universitaire Bretonneau

    Tours, 37000

  • ICL Institut de Cancérologie de Lorraine

    Vandœuvre-lès-Nancy, 54511

  • Gustave Roussy

    Villejuif, 94805

Other trials in France

About this study

Official title: A Randomized Phase II Study of Pazopanib and Weekly Paclitaxel in Patients With Platinum Resistant/Refractory Ovarian Cancer Who Relapse During Bevacizumab Maintenance

Study of Pazopanib and weekly Paclitaxel in patients with platinum resistant/refractory ovarian cancer who relapse during bevacizumab maintenance.

Read the detailed description

Standard of treatments:

  • In Europe, advanced ovarian cancer patients are treated in first line with optimal debulking surgery followed by carboplatin/paclitaxel regimen plus bevacizumab during chemotherapy and as maintenance for a total à 15 months. The addition of bevacizumab is a standard for the patients with residual disease.
  • The addition of bevacizumab to carboplatin/gemcitabine chemotherapy was also recently approved for patients with platinum sensible relapse [Aghajanian, 2012]. The bevacizumab is maintained until progression.

Rationale to use anti-angiogenic agents in early relapse:

  • The recent AURELIA trial comparing paclitaxel, topotecan or liposomal doxorubicin alone versus combined to bevacizumab after early failure of the first-line with carboplatin/paclitaxel revealed that targeting angiogenesis was beneficial in recurrent platinum-resistant ovarian cancer [Pujade-Lauraine, 2012 and 2013], with higher progression-free survival (PFS). Thus, the strategy of inhibiting angiogenesis in recurrent resistant-platinum ovarian cancer is very promising.
  • The recent changes of the standard of treatment of first line and platinum-sensible relapse of patients with ovarian cancer highlights the question of inhibiting angiogenesis for relapse during/after bevacizumab maintenance. In this last situation, the strategy of continuation of antiangiogenesis therapy, just in changing chemotherapy despite recurrence, showed benefit in other types of cancer (colon, lung). In ovarian cancer, no study has been performed to answer to the question. In Aurelia trial, However, patients did not previously receive bevacizumab.

The choice of the best antiangiogenic agent in alternative to bevacizumab needs to be assessed. Small molecular inhibitor of tyrosine-protein-kinases (TK) could be used with efficacy after a first-line of antiangiogenesis treatment as it was demonstrated in renal cancer [Escudier, 2011].

  • Pazopanib is an oral, potent multi-targeted small-molecule inhibitor of VEGF-receptor TKs (VEGFR-1 -2 -3 PDGFR and c-KIT; it is the first targeted small molecule that it has demonstrated an important activity in ovarian cancer. At ASCO 2013, the AGO-OVAR16 trial of maintenance of pazopanib in first line ovarian cancer has shown a benefit in progression free survival (difference of 5.6 months of median PFS in favour of pazopanib compared to placebo) [Dubois, ASCO 2013 LBA5503]; in this trial, the majority of the patients had few residual disease and patients did not receive bevacizumab.
  • In ovarian cancer, the standard treatment for patients relapsing during bevacizumab maintenance (15 to 20% of patients) is still a mono-chemotherapy. Weekly paclitaxel is one oh the most commonly used chemotherapy in this situation of early relapse. However, the promising results of pazopanib in first line led to develop protocols in second-line in combination with chemotherapy.

The combination of weekly paclitaxel and pazopanib is feasible and the dose proposed for further phase 2 studies is pazopanib 800 mg daily and paclitaxel 65 mg/m2 at day 1, 8, 15 every 28 days [Tan, the oncologist 2010]. The dosage of paclitaxel was justified on results from previous studies, demonstrating that co-administration of pazopanib and paclitaxel increases the systemic exposure to paclitaxel. An Italian group has just closed a phase 2 study (MITO11) that evaluated this association among ovarian patients with early relapse. In this study, patients did not receive previously bevacizumab.

Thus, pazopanib is the best molecule to be associated to chemotherapy in ovarian cancer patients who early relapse after a treatment including bevacizumab.

We propose a randomized phase 2 trial to evaluate the combination of pazopanib to weekly paclitaxel among patients with platine resistant relapse after treatment including bevacizumab maintenance

Conditions
Ovarian Cancer
Being tested
Pazopanib, Paclitaxel
Medical subject headings
Ovarian Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PazopanibDrug

    Also called Votrient

    Pazopanib 600mg during the fist cycle. Then, if there is not heptic triuyble, the dose could be increased to 800mg

  • PaclitaxelDrug

    Also called Taxol

    Arm 1 : Paclitaxel 65mg/m² Arm 2: Paclitaxel 80mg/m²

Study groups in NCT02383251
Study groupRoleWhat they receive
Pazopanib/Paclitaxel associationExperimentalArm 1 : Pazopanib alone during 1 week at 600 mg (1x400mg and 1x200mg), per day, taken orally without food at least one hour before or two hours after a meal. Then: * Pazopanib 600 mg (1x400mg and 1x200mg), per day, taken orally without food at least one hour before or two hours after a meal. * Paclitaxel 65 mg/m2 i.v. on days 1, 8, 15 every 28 days until progression of disease or toxicity
Receives: Drug: Pazopanib; Drug: Paclitaxel
Paclitaxel aloneActive comparatorArm 2 : * Paclitaxel 80mg/m2 i.v. on days 1, 8, 15 * every 28 days until progression of disease or toxicity
Receives: Drug: Paclitaxel

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression free survival (PFS)

    Proportion of progression or death 4 months after initiation of treatment

    Measured: 4 months

Secondary outcomes (4)
  1. Overall survival

    Time between randomization and death or last news date for patient alive at the last visit date

    Measured: Up to 2 years

  2. Disease control rate (DCR)

    Proportion of woman in partial, compete or stable desease according to RECIST 1.1. criteria

    Measured: Up to 2 years

  3. Toxicity according to NCI CTCAE v4.3 criteria

    tolerance of the treatment based on AE occurrence according to NCI CTCAE v4.3 criteria

    Measured: Up to 2 years

  4. health-related quality of life

    health-related quality of life and symptomatic state will be evaluated by filing questionnaires by patients

    Measured: Up to 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Mar 2015 (estimated)
  2. Study start15 Jun 2015
  3. Primary completionAug 2019
  4. Study completion31 Dec 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
118 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02383251
Sponsor's protocol ID
GINECO-OV231
Acronym
TAPAZ
Status last verified
Sep 2023
First submitted
4 Mar 2015
Last updated
6 Sep 2023
Results posted
No
Data monitoring committee
Yes

Publications

  • Gaitskell K, Rogozinska E, Platt S, Chen Y, Abd El Aziz M, Tattersall A, Morrison J. Angiogenesis inhibitors for the treatment of epithelial ovarian cancer. Cochrane Database Syst Rev. 2023 Apr 18;4(4):CD007930. doi: 10.1002/14651858.CD007930.pub3.

    PubMed 37185961
  • Joly F, Fabbro M, Berton D, Lequesne J, Anota A, Puszkiel A, Floquet A, Vegas H, Bourgeois H, Bengrine Lefevre L, You B, Pommeret F, Lortholary A, Spaeth D, Hardy-Bessard AC, Abdeddaim C, Kaminsky-Forrett MC, Tod M, Kurtz JE, Del Piano F, Meunier J, Raban N, Alexandre J, Mouret-Reynier MA, Ray-Coquard I, Provansal Gross M, Brachet PE. Paclitaxel with or without pazopanib for ovarian cancer relapsing during bevacizumab maintenance therapy: The GINECO randomized phase II TAPAZ study. Gynecol Oncol. 2022 Sep;166(3):389-396. doi: 10.1016/j.ygyno.2022.06.022. Epub 2022 Jul 26.

    PubMed 35902297

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pazopanib and Paclitaxel in people with Ovarian Cancer, run by ARCAGY/ GINECO GROUP at 36 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 28 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression free survival (PFS) (time frame: 4 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02383251, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Sep 2023.

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