A trial of pazopanib before surgery for kidney cancer (PANTHER)

Cancer type:

Kidney cancer

Renal cell cancer

Status:

Results

Phase:

Phase 2

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).

This is usually followed by a biological therapy Open a glossary item such as pazopanib. This is a type of cancer growth blocker called a tyrosine kinase inhibitor (TKI for short).

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
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 (performance status )
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)
diarrhoea
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 (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.