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Gulmez A. Bilateral Significant Pneumotorax During Pazopanib Treatment. Arch Bronconeumol 2023; 59:44-45. [PMID: 36156256 DOI: 10.1016/j.arbres.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Ahmet Gulmez
- Adana City Education and Research Hospital, Medical Oncology Department, Adana, Turkey.
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Aiba H, Kimura H, Yamada S, Okamoto H, Hayashi K, Miwa S, Kawaguchi Y, Saito S, Sakai T, Tatematsu T, Nakanishi R, Murakami H. Different patterns of pneumothorax in patients with soft tissue tumors treated with pazopanib: A case series analysis. PLoS One 2021; 16:e0254866. [PMID: 34270626 PMCID: PMC8284672 DOI: 10.1371/journal.pone.0254866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/05/2021] [Indexed: 11/19/2022] Open
Abstract
To investigate pneumothorax patterns in pazopanib treatment by focusing on the positional relationship between the visceral pleura and metastatic lung tumor, we examined 20 patients with advanced soft tissue tumors who developed lung metastases and underwent pazopanib treatment between 2012 and 2019. Pneumothorax was classified into two types based on the location of the metastatic lesion around the visceral pleural area before pazopanib treatment: subpleural type, within 5 mm from the pleura; and central type, >5 mm from the pleura. We investigated the rates of pneumothorax and the associated risk factors. Five patients experienced pneumothorax (three subpleural and two central types). Cavitation preceded pneumothorax in 83% of patients and led to connection of the cavitated cyst of the metastatic lesion to the chest cavity in the shorter term in patients with the subpleural type. Conversely, a more gradual increase in the cavity size and sudden cyst rupture were observed in the central type. The risk factors for pneumothorax were cavitation after initiating pazopanib and intervention before pazopanib, either ablation or surgery. The location of the metastatic lesions was not a risk factor for the occurrence of pneumothorax. In conclusion, pneumothorax is an adverse event associated with pazopanib treatment. Therefore, attention must be paid to predisposing factors such as the formation of cavitation after pazopanib initiation and previous interventions to the lungs. Moreover, because subpleural pneumothorax tends to occur earlier than the central type, a different time course can be anticipated based on the positional relationships of the metastatic lesions to the visceral pleura.
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Affiliation(s)
- Hisaki Aiba
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
- * E-mail:
| | - Hiroaki Kimura
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
| | - Satoshi Yamada
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
| | - Hideki Okamoto
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
| | - Katsuhiro Hayashi
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Yohei Kawaguchi
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
| | - Shiro Saito
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
- Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takao Sakai
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
| | - Tsutomu Tatematsu
- Department of Oncology, Immunology and Surgery, Nagoya City University, Nagoya, Japan
| | - Ryoichi Nakanishi
- Department of Oncology, Immunology and Surgery, Nagoya City University, Nagoya, Japan
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Nagoya City University, Nagoya, Japan
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Tian Z, Liu H, Zhao Y, Wang X, Ren H, Zhang F, Li P, Zhang P, Wang J, Yao W. Secondary pneumothorax as a potential marker of apatinib efficacy in osteosarcoma: a multicenter analysis. Anticancer Drugs 2021; 32:82-87. [PMID: 33105152 PMCID: PMC7748035 DOI: 10.1097/cad.0000000000001016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 12/14/2022]
Abstract
This study was performed to investigate pneumothorax characteristics and association with clinical outcomes in patients with osteosarcoma treated with apatinib. We retrospectively reviewed the medical records of osteosarcoma patients treated with apatinib between January 2016 and April 2020 at three institutions. We evaluated the prevalence, healing time, recurrence, severity, clinical management, and prognosis of pneumothorax in these patients. A total of 54 osteosarcoma patients who received apatinib treatment were enrolled in this study. Among them, 14 patients had pneumothorax. There were significant differences between the patients with and without pneumothorax with regard to the cavitating rate of lung metastases (92.86 vs. 32.50%, respectively, P < 0.001), objective response rate (42.86 vs. 10.00%, P = 0.013), disease control rate (85.71 vs. 42.50%, P = 0.006), 4-month progression-free survival (PFS) rate (57.10 vs. 20.00%, P < 0.001), and median PFS (5.65 vs. 2.90 months, P = 0.011). Compared with pneumothorax patients treated with chest tube drainage only [non-staphylococcal enterotoxin C (SEC) group], those treated with chest tube drainage and SEC thoracic perfusion in parallel (SEC group) had a shorter pneumothorax healing time (12.00 ± 4.50 days vs. 24.00 ± 14.63 days for SEC group and non-SEC group, respectively, P = 0.103), a lower recurrence rate of pneumothorax (25.00% vs. 66.67%, P = 0.277), and a longer median PFS (5.9 months vs. 4.75 months, P = 0.964). however, these numerical differences for the SEC/non-SEC data did not reach statistical significance. Pneumothorax and cavitation in lung metastases may be effective prognostic markers for patients with osteosarcoma treated with apatinib. SEC may be effective for treatment of such pneumothorax patients, warranting further study.
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Affiliation(s)
- Zhichao Tian
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
| | - Huimin Liu
- Department of Medical Oncology, the Affiliated People’s Hospital of Zhengzhou University
| | | | - Xiaofeng Wang
- Department of Medical Oncology, the First Affiliated Hospital of Zhengzhou University
| | - Hongyan Ren
- Pneumology Department, the Affiliated People’s Hospital of Zhengzhou University, Zhengzhou 450003, Henan Province, China
| | - Fan Zhang
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
| | - Po Li
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
| | - Peng Zhang
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
| | - Jiaqiang Wang
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
| | - Weitao Yao
- Department of Orthopedics, the Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital
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Sabath B, Muhammad HA, Balagani A, Ost DE, Vakil E, Ahmed T, Vial MR, Grosu HB. Secondary spontaneous pneumothorax in patients with sarcoma treated with Pazopanib, a case control study. BMC Cancer 2018; 18:937. [PMID: 30285733 PMCID: PMC6167904 DOI: 10.1186/s12885-018-4858-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/26/2018] [Indexed: 11/16/2022] Open
Abstract
Background The tyrosine kinase inhibitor pazopanib is used for treatment of sarcoma. Recent studies have suggested that the use of pazopanib may lead to the development of pneumothorax, an unexpected adverse effect in patients with sarcoma metastatic to the chest. Methods We conducted a retrospective case control study of patients with sarcoma with metastases to the chest with pneumothorax (cases) and without pneumothorax (controls). The control population was selected from tumor registry in a 1:4 (cases to controls) ratio. The primary outcome of interest was the association between pazopanib and pneumothorax risk in patients with sarcoma metastatic to the chest. Secondary objective was to evaluate risk factors for pneumothorax. Results We identified 41 cases and 164 controls. Using purposeful selection method the odds of developing pneumothorax while being on pazopanib was not significant in univariate (p = .06) and multivariable analysis (p = .342). On univariate analysis risk factors of pneumothorax in patients with sarcoma were age, male sex, African American race, the presence of cavitary lung nodules/masses, and the presence of pleural-based nodules/masses. On multivariate analysis, only the presence of cavitary lung nodules/masses (P < .001) and the presence of pleural-based nodules/masses (P < .001) remained as risk factors for developing pneumothorax. Conclusion Pazopanib does not increase the risk of pneumothorax in patients with sarcoma and evidence of metastatic disease to the chest. Presence of cavitary lung nodules/masses and the presence of pleural-based nodules/masses were found to be risk factors for pneumothorax.
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Affiliation(s)
- Bruce Sabath
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Hasan A Muhammad
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Amulya Balagani
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - David E Ost
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Erik Vakil
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Tahreem Ahmed
- Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Macarena R Vial
- Universidad del Desarrollo Clinica Alemana de Santiago, Santiago, Chile
| | - Horiana B Grosu
- Department of Pulmonary Medicine, Unit 1462, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
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Çelik B, Sürücü ZP, Yılmaz V, Çelik HK. A Case Report of Secondary Simultaneous Bilateral Pneumothorax Due to Pazopanib Treatment. Turk Thorac J 2018; 19:49-51. [PMID: 29404187 DOI: 10.5152/turkthoracj.2018.030118] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/11/2016] [Indexed: 11/22/2022]
Abstract
Secondary spontaneous pneumothorax almost always develops secondary to an underlying lung disease. A pneumothorax secondary to a malignancy is very rare, and is observed most frequently in soft tissue sarcomas. Pazopanib, a tyrosine kinase inhibitor, is used in metastatic soft tissue sarcomas treatment. The rate of pneumothorax that is caused by pazopanib is about 14% in the literature. The patient being presented in this article underwent surgery for soft tissue sarcoma, postoperatively received pazopanib (Votrient® 400 mg, oral, Glaxo Group Ltd, Brentford, UK) treatment due to widespread bilateral lung metastases, and developed synchronous spontaneous pneumothorax.
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Affiliation(s)
- Burçin Çelik
- Department of Thoracic Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Zeynep Pelin Sürücü
- Department of Thoracic Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Volkan Yılmaz
- Department of Thoracic Surgery, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Hale Kefeli Çelik
- Department of Anesthesiology and Reanimation, Samsun Training and Research Hospital, Samsun, Turkey
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Abstract
Spontaneous pneumothoraces and hemothoraces are rare manifestations of sarcomas occurring more commonly in specific histologic types, chemotherapy and/or anti-angiogenic therapy. Early identification of spontaneous pneumothoraces and hemothoraces improves the clinical outcomes. In this article, we present a case series of three patients with soft tissue and bone sarcomas who developed spontaneous pneumothoraces and/or hemothoraces and discuss the current literature highlighting the evidence behind these complications.
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Affiliation(s)
| | - Shadia Jalal
- Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine
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Nakahara Y, Fukui T, Katono K, Nishizawa Y, Okuma Y, Ikegami M, Sasaki J, Masuda N. Pneumothorax during Pazopanib Treatment in Patients with Soft-Tissue Sarcoma: Two Case Reports and a Review of the Literature. Case Rep Oncol 2017; 10:333-338. [PMID: 28559816 PMCID: PMC5436012 DOI: 10.1159/000463380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 02/14/2017] [Indexed: 11/25/2022] Open
Abstract
Pazopanib, a multitargeting tyrosine kinase inhibitor, has single-agent activity in patients with advanced soft-tissue sarcoma. Herein, we describe 2 cases of pneumothorax that occurred during pazopanib treatment in patients with soft-tissue sarcoma. These 2 patients had multiple lung metastases. According to previous reports and our past experience, the risk of pneumothorax may be higher in patients with multiple lung metastases. Although a causal relationship is uncertain, the risk of pneumothorax when prescribing pazopanib for these patients should be considered.
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Affiliation(s)
- Yoshiro Nakahara
- aDepartment of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan.,bDepartment of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Tomoya Fukui
- aDepartment of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Ken Katono
- aDepartment of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yuuki Nishizawa
- bDepartment of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yusuke Okuma
- bDepartment of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Masachika Ikegami
- dDepartment of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Jiichiro Sasaki
- cResearch and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan
| | - Noriyuki Masuda
- aDepartment of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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Nakano K, Motoi N, Tomomatsu J, Gokita T, Ae K, Tanizawa T, Matsumoto S, Takahashi S. Risk factors for pneumothorax in advanced and/or metastatic soft tissue sarcoma patients during pazopanib treatment: a single-institute analysis. BMC Cancer 2016; 16:750. [PMID: 27663525 PMCID: PMC5035441 DOI: 10.1186/s12885-016-2786-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 09/15/2016] [Indexed: 11/17/2022] Open
Abstract
Background After the approval of pazopanib for the treatment of soft tissue sarcoma (STS), pneumothorax was reported as an unexpected adverse event during pazopanib treatment. The incidence and risk factors of pneumothorax during pazopanib treatment for STSs have not been established yet. Methods We retrospectively reviewed the cases of all of the STS patients treated with pazopanib between November 2012 and December 2014 at our institute and evaluated the prevalence, incidence, treatment details and risk factors for pneumothorax in the STS patients during pazopanib treatment. Results A total of 58 patients were enrolled; 45 of them had lung and/or pleural lesions at the start of pazopanib treatment. During the median follow-up time of 219 days (range 23–659), 13 pneumothorax events occurred in six patients; the prevalence and incidence of pneumothorax were 10.3 % and 0.56 per treatment-year, respectively. The median onset of pneumothorax was day 115 (range 6–311). No patients died of pneumothorax, but pazopanib was interrupted in 10 events and chest drainage was performed in eight events. Pazopanib continuation or restart after the recovery from pneumothorax was conducted after 9 of the 13 events. The median progression-free survival of patients with and without pneumothorax events were 144 and 128 days (p = 0.89) and the median overall survival periods were 293 and 285 days (p = 0.69), respectively. By logistic regression analyses, the maximum diameter of the lung metastases ≥ 30 mm (OR 13.3, 95 % CI 1.1–155.4, p = 0.039) and a history of pneumothorax before the pazopanib induction (OR 16.6, 95 % CI 1.1–256.1, p = 0.045) were significantly predictive of pneumothorax. Conclusions In our retrospective analysis, pneumothorax was observed in 10.3 % of 58 STS patients during pazopanib treatment. The diameter of the lung metastases and a history of pneumothorax could be useful for evaluating the risk of pneumothorax in pazopanib treatment.
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Affiliation(s)
- Kenji Nakano
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Ariake, Tokyo, 135-8550, Japan
| | - Noriko Motoi
- Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junichi Tomomatsu
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Ariake, Tokyo, 135-8550, Japan
| | - Tabu Gokita
- Department of Orthopedic Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisuke Ae
- Department of Orthopedic Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Taisuke Tanizawa
- Department of Orthopedic Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Seiichi Matsumoto
- Department of Orthopedic Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shunji Takahashi
- Department of Medical Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Ariake, Tokyo, 135-8550, Japan.
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Boudou-Rouquette P, Tlemsani C, Blanchet B, Huillard O, Jouinot A, Arrondeau J, Thomas-Schoemann A, Vidal M, Alexandre J, Goldwasser F. Clinical pharmacology, drug-drug interactions and safety of pazopanib: a review. Expert Opin Drug Metab Toxicol 2016; 12:1433-1444. [PMID: 27556889 DOI: 10.1080/17425255.2016.1225038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION In the past decade, treatment options for metastatic renal cell carcinoma and soft-tissue sarcoma have expanded. Pazopanib was discovered during the screening of compounds that suppressed vascular endothelial growth factor receptor-2 (VEGFR-2). As other tyrosine kinase inhibitors (TKI), pazopanib is not totally specific for one target since it also inhibits stem-cell factor receptor (cKIT), platelet-derived growth factor receptors (PDGFRα, β), VEGFR-1 and -3. Areas covered: Clinical pharmacology, drug-drug interactions and safety data published on pazopanib, between January 2006 and April 2016, are reviewed. Expert opinion: This new therapy has been shown to improve progression-free survival compared with previous approaches, in renal cell cancer and soft-tissue sarcoma. However, some specific sub-populations, such as elderly patients, patients with brain metastases or with Eastern Cooperative Oncology Group Performance Status (ECOG PS) 2 or comorbidities, are poorly represented in pivotal pazopanib phase III studies. Pazopanib meets criteria defining therapies as candidates for therapeutic drug monitoring: large intra- and inter-patient pharmacokinetic variability, potential pharmacokinetic drug-drug interactions, pharmacokinetic/pharmacodynamic relationship and narrow therapeutic index. Knowledge of predictors that can be used to guide dosing regimens in the target population and in special populations needs to be improved.
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Affiliation(s)
- Pascaline Boudou-Rouquette
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Camille Tlemsani
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Benoit Blanchet
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Olivier Huillard
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Anne Jouinot
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Jennifer Arrondeau
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - Audrey Thomas-Schoemann
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France.,b UMR8638 CNRS, UFR de Pharmacie , Université Paris Descartes, PRES Sorbonne Paris Cité , Paris , France
| | - Michel Vidal
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France.,b UMR8638 CNRS, UFR de Pharmacie , Université Paris Descartes, PRES Sorbonne Paris Cité , Paris , France
| | - Jérôme Alexandre
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
| | - François Goldwasser
- a Department of Medical Oncology, CERIA , Paris Descartes University, AP-HP, Cochin Hospital , Paris , France
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Kawai A, Araki N, Hiraga H, Sugiura H, Matsumine A, Ozaki T, Ueda T, Ishii T, Esaki T, Machida M, Fukasawa N. A randomized, double-blind, placebo-controlled, Phase III study of pazopanib in patients with soft tissue sarcoma: results from the Japanese subgroup. Jpn J Clin Oncol 2016; 46:248-53. [PMID: 26864131 PMCID: PMC4777611 DOI: 10.1093/jjco/hyv184] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Objective This analysis of the Japanese subpopulation of the PALETTE Phase III, randomized, placebo-controlled study investigated efficacy and safety of pazopanib in patients with metastatic soft tissue sarcoma after failure of standard chemotherapy. Methods Patients were randomly assigned in a 2:1 ratio to receive either pazopanib 800 mg once daily or placebo, with no subsequent cross-over. Primary endpoint was progression-free survival. Secondary endpoints included overall survival and overall response rate. Efficacy analysis was by intent-to-treat. Safety was also investigated. Results Forty-seven patients received either pazopanib (n = 31) or placebo (n = 16). Median progression-free survival was 7.0 weeks (95% confidence interval: 4.0–11.7) for placebo and 24.7 weeks (95% confidence interval: 8.6–28.1) for pazopanib (hazard ratio = 0.41 [95% confidence interval: 0.19–0.90]; P = 0.002). Median overall survival was 14.9 months (95% confidence interval: 6.8—not calculable) for placebo and 15.4 months (95% confidence interval: 7.9–28.8) for pazopanib (hazard ratio = 0.87 [95% confidence interval: 0.41–1.83]; P = 0.687). More patients receiving pazopanib experienced best response of stable disease versus placebo. Adverse events were similar to the global population; those leading to dose reduction were more common and mean daily dose was lower in the Japanese population versus the global population (45 vs. 32% and 624.4 vs. 700.4 mg, respectively). Conclusions The efficacy and safety of pazopanib observed in the Japanese subpopulation of PALETTE were similar to those in the global population. Pazopanib is a new treatment option for Japanese patients with metastatic non-adipocytic soft tissue sarcoma after chemotherapy. Clinical trial Registration number NCT00753688; GSK study ID: VEG110727; http://www.gsk-clinicalstudyregister.com/study/VEG110727#ps.
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Affiliation(s)
- Akira Kawai
- Head of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Tokyo
| | - Nobuhito Araki
- Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - Hiroaki Hiraga
- National Hospital Organization, Hokkaido Cancer Center, Hokkaidō
| | | | | | | | - Takafumi Ueda
- National Hospital Organization, Osaka National Hospital, Osaka
| | | | - Taito Esaki
- National Hospital Organization, Kyushu Cancer Center, Fukuoka City
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Leuzzi G, Alessandrini G, Ferraresi V, Ferretti G, Forcella D, Facciolo F. Bilateral spontaneous pneumothorax and massive pneumomediastinum under Pazopanib therapy. Thorac Cancer 2015; 6:110-1. [PMID: 26273345 PMCID: PMC4448468 DOI: 10.1111/1759-7714.12165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 08/03/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Giovanni Leuzzi
- Department of Surgical Oncology, Thoracic Surgery Unit, Regina Elena National Cancer Institute - IFO Rome, Italy
| | - Gabriele Alessandrini
- Department of Surgical Oncology, Thoracic Surgery Unit, Regina Elena National Cancer Institute - IFO Rome, Italy
| | - Virginia Ferraresi
- Division of Medical Oncology, Regina Elena National Cancer Institute - IFO Rome, Italy
| | - Gianluigi Ferretti
- Division of Medical Oncology, Regina Elena National Cancer Institute - IFO Rome, Italy
| | - Daniele Forcella
- Department of Surgical Oncology, Thoracic Surgery Unit, Regina Elena National Cancer Institute - IFO Rome, Italy
| | - Francesco Facciolo
- Department of Surgical Oncology, Thoracic Surgery Unit, Regina Elena National Cancer Institute - IFO Rome, Italy
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