Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial of pazopanib before surgery for kidney cancer (PANTHER)
This trial looked at pazopanib before surgery for kidney cancer that had spread elsewhere in the body. It was for people:
- with a type of kidney cancer called clear cell kidney cancer
- who hadn’t had treatment for advanced kidney cancer
More about this trial
If possible, it is usual to have surgery to remove the kidney (a nephrectomy).
TKIs block tyrosine kinase, which is a chemical messenger that sends messages telling cells to divide and grow. Blocking the effect of tyrosine kinase might stop cancer cells growing.
When this trial was done, doctors didn’t know if having surgery to remove the kidney helped people with advanced cancer in the long term. It delays starting treatment for cancer that has spread to other parts of the body. So in this trial, the researchers wanted to find out if there was a benefit to starting pazopanib before surgery.
The aims of the trial were to find out:
- if having pazopanib before surgery helps people with advanced clear cell kidney cancer
- what the complications of surgery could be after having pazopanib
Summary of results
The trial team found having pazopanib before surgery was safe and might be a useful treatment for some people with advanced kidney cancer.
104 people took part in this study. The average age was 64. The plan was that people would have:
- pazopanib for 12 to 14 weeks before surgery
- pazopanib after surgery for as long as treatment was helping and the side effects weren’t too bad
The trial team checked the results for 100 people before surgery. They looked at how well treatment worked and found:
- in 13 people the cancer got a bit smaller (a partial response)
- in 71 people the cancer stayed the same (stable disease)
- in 16 people the cancer got worse
Of the 104 people in the trial, 63 had surgery. For those who didn’t, the 3 most common reasons were:
- their cancer had got worse
- they decided not to have an operation
- they were not well enough to have surgery
Having pazopanib before surgery seemed to increase length of time it took for wounds to heal after surgery.
The trial team looked at risk scores for 101 people. These included factors such as:
- how well people were (
- the amount of time between diagnosis and treatment
- certain blood test results
Doctors used this information to try and work out how well people would do (their outcome). Of the people who took part:
- 83 were in the intermediate risk group
- 18 were in the poor risk group
The study team found that having pazopanib before surgery helped people with intermediate risk cancer but those in the poor risk group had poor outcomes.
The trial team looked at how long before the cancer started to grow again after surgery. This is called progression free survival. This was on average just over 7 months.
They also looked at how long people lived after surgery. This is called overall survival. This was on average just under 23 months.
The more serious side effects of pazopanib included:
- tiredness (fatigue)
- high blood pressure
- sore, red skin on the palms of the hands and soles of the feet (hand-foot syndrome)
The trial team concluded that having pazopanib before surgery was safe and possible. It helped some people with intermediate risk factors and most of them were able to have surgery as planned.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Prof Thomas Powles
Experimental Cancer Medicine Centre (ECMC)
Queen Mary University of London