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Pazopanib vs Paclitaxel in Advanced Urothelial Carcinoma

For patients with locally advanced or metastatic urothelial carcinoma who have failed to respond to platinum-based chemotherapy, daily pazopanib is not an effective alternative to weekly paclitaxel, according to the phase II trial results reported by Jones et al, of the University of Liverpool, UK, in the Journal of Clinical Oncology. In fact, the study was stopped early due to futility.

A total of 140 patients took part in this randomized trial comparing daily oral pazopanib with weekly paclitaxel (days 1, 8, and 15 every 28 days) in the second-line setting. Median overall survival for patients treated with paclitaxel was 8.0 months, and for those treated with pazopanib, it was 4.7 months. The authors reported a trend toward superior overall survival with paclitaxel. In addition, the use of pazopanib was associated with more treatment discontinuation for toxicity than the use of paclitaxel (23.1% vs 7.8%).

Although two prior single-arm trials had yielded mixed results regarding the activity of pazopanib in this patient population, the investigators noted that their study findings should resolve this question in urothelial cancer. “Single-agent pazopanib should not be further pursued in unselected patients,” concluded corresponding author of the study Thomas Powles, MD, MRCP, of Barts Cancer Institute, Queen Mary University of London, and colleagues.