An ongoing Phase-II trial investigating Pazopanib ( Votrient ) for metastatic urothelial cancer has generated promising early results.

Urothelial cancers affect the tissue lining the inner surfaces of the bladder and other parts of the urinary system. In cases of metastatic disease, median survival is approximately 12-15 months and there is a 10-15% chance of prolonging it by the use of standard chemotherapy regimens, particularly in otherwise healthy patients with good prognostic factors.
Those whose cancers relapse or do not respond to upfront therapy currently have few second-line treatment options and palliative care is the option in the majority of cases.

Pazopanib is a selective inhibitor of several signaling pathways that contribute to tumor growth and the development of new cancer-related blood vessels ( angiogenesis ).

So far, the researchers have enrolled 18 patients of a total of 41 planned. Each participant had metastatic urothelial cancer that had already failed to respond to at least one prior chemotherapy regimen. This means that investigators treated many patients who had already failed more than two chemotherapy regimens. Patients were administered 800 mg of the drug once daily until their disease progressed or they experienced unacceptable toxicity.

Four patients have seen their tumors shrink but, much more interestingly, the great majority of the patients, twelve out of eighteen, saw their metastases begin to die.
The death of these metastatic tumors, described formally as necrotic evolution, was observed by the researchers on monthly computed tomography and positron emission tomography scans.

These preliminary results underline the value of angiogenesis as a target in bladder cancer.

Source: ESMO Meeting, 2010

XagenaMedicine2010


Link: Xapedia - Medical Encyclopedia