Novel angiogenesis inhibitor shrinks tumors in early NSCLC

Pazopanib reduced tumor volumes in 86% of patients with non-small cell lung cancer when used as a single agent, according to the results of a phase II study. Lead investigator Nasser Altorki, MD, stressed that the most important finding of his group’s work is that the drug can be given safely to patients with early-stage disease without altering their suitability for surgery.

“The most important finding is that you can give the drug safely to patients with early-stage disease, and it does not in any way alter their suitability for surgery. The final, remarkable, and unexpected result is that 30 out of 35 patients in the study had tumor shrinkage despite the short-term nature of the treatment,” said Dr. Altorki, who is from New York-Presbyterian/Weill Cornell Medical Center.

Dr. Altorki’s group enrolled 35 patients with stage 1a-1b (n=33) or stage 2a-2a NSCLC (n=2) who had received no cytotoxic, anti-angiogenic, or investigative therapy in the preceding six months. The primary endpoint was reduction in tumor volume after pazopanib treatment as measured by high-resolution CT. Subjects received pazopanib (800 mg) once daily for two to six weeks, followed by CT scan, surgical resection, and biopsy. After a median of 16 days of treatment, 30 patients (85.7%) achieved a reduction in tumor volume, reported Dr. Altorki, who is director of the division of thoracic surgery at his institution.

Changes in tumor volume were not consistently reflected by tumor changes according to the conventional RECIST criteria, he added. Baseline and post-treatment plasma samples were analyzed for levels of cytokines and angiogenic factors (C/AFs) that might predict clinical benefit. Interleukin-12 baseline levels best predicted tumor shrinkage (ESMO 2008 abstract 2250). “This is a phenomenally innovative study,” commented Jose Baselga, MD.

“This research could really facilitate the work of surgeons and might increase cure rates,” added Dr. Baselga, who is chief of medical oncology at the Vall d’Hebron University Hospital and Cntro Medico Teknon in Barcelona.