Phase II trial of pazopanib before surgery in early stage lung cancer

An innovative trial has shown pazopanib, a new oral angiogenesis inhibitor, to demonstrate interesting activity in difficult to treat non-small-cell lung cancer. 30 out of 35 patients treated with preoperative pazopanib for a minimum of two weeks saw their tumour size shrink by up to 85% in the phase II trial announced at the 33^rd European Society for Medical Oncology meerting in Stockholm.

“This is a positive result that will be explored further,” said Prof. Nasser Altorki from Weil Medical College of Cornell University in New York. “To my knowledge, no other results on the effect of angiogenesis inhibitors in early stage operable lung cancer have been published. The results presented here with pazopanib indicate a highly active drug in this setting and further development in lung cancer is underway to fully understand the value of this drug in this disease.” He added that the research was novel due to 4 key features: First its use of pre-surgery therapy for early stage lung cancer, second its use of targeted monotherapy, third its use of innovative imaging techniques to measure exact tumour volume as a 3D object rather than just x and y measurements, and fourth the collection of tissue and blood samples before and after treatment.

Pazopanib is a tyrosine kinase inhibitor which jams the mechanism by which the protein instigates tumour growth.

Speaking at the same press conference ESMO president Jose Baselga commented: “Lung cancer is a disease where innovative new trial design is rare so I am especially pleased with this research. The reduced toxicity of such targeted drugs increases the length of time they can be used and thus the effectiveness.”

Prof. Altorki finished by saying that there would be more trials as soon as possible, aimed at using the drug in an adjuvant setting as well, but that they were very hard to recruit for and this novel type of trial needed to move more into the medical mainstream.

Speaking from the surgeon’s point of view, Prof Irving Taylor, President of the European Society of Surgical Oncology, noted that such neo-adjuvant therapy to downsize a tumour, making it operable when previously not, was extremely important.

Watch Professor Nasser Altorki talk about his research