Saturday, February 2, 2013

New drug for sarcoma

Sarcoma is a type of aggressive cancer.   In my practice, uterine smooth muscle sarcoma (leiomyosarcoma) is one of the most difficult cancers to cure.   After the hysterectomy, patients are usually given Docetaxel + Gemcitabine chemotherapy.  Many patients then developed recurrence of cancer and be treated with Doxorubicin.  Since many of these patients have cancer recurrence again, oncologist dont have more effective treatment.

Recently, Pazopanib, a multitargeted tyrosine kinase inhibitor, seems to be a potential new drug for this aggressive uterine sarcoma.  van der Graaf randomized 369 patients into Pazopanib vs placebo.  The study showed median progression-free survival was 4·6 months (95% CI 3·7-4·8) for pazopanib compared with 1·6 months (0·9-1·8) for placebo (hazard ratio [HR]0·31, 95% CI 0·24-0·40; p<0·0001). Overall survival was 12·5 months (10·6-14·8) with pazopanib versus 10·7 months (8·7-12·8) with placebo (HR 0·86, 0·67-1·11; p=0·25). The most common adverse events were fatigue (60 in the placebo group [49%]vs 155 in the pazopanib group [65%]), diarrhoea (20 [16%]vs 138 [58%]), nausea (34 [28%]vs 129 [54%]), weight loss (25 [20%]vs 115 [48%]), and hypertension (8 [7%]vs 99 [41%]).

In english as I understood, Pazopanib gives 3 months of free cancer than placebo.  Unfortunately, there were no difference in cure rate between Pazopanib vs placebo.

Reference:
van der Graff WT, et al.  Pazopanib for metastatic soft-tissue sarcoma (PALETTE): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2012;379(9829):1879.
 

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