Pazopanib Hydrochloride in Treating Patients With Metastatic Kidney Cancer Who Have No Evidence of Disease After Surgery

Inclusion Criteria:

• Patient must be at least 18 years of age at the time of randomization

• Patient must have pathologically confirmed renal cell carcinoma with a clear cellcomponent; pure papillary and chromophobe histologies are excluded; there must bepathologic confirmation of metastatic disease in the resected metastasectomyspecimen

• Patient must have undergone nephrectomy or partial nephrectomy to remove primaryrenal cell carcinoma (at any time in the past)

• Patient must have undergone surgical resection to remove one or more sites ofmetastatic disease, with successful removal of all known sites 2-12 weeks prior torandomization. Any number of prior metastasectomies may have been performed in thepast, so long as the most recent procedure was within the 12 weeks of registration.The most recent procedure may be nephrectomy for a renal primary tumor

• Patients with synchronous disease at initial diagnosis must have metastatic (M1)disease (American Joint Committee on Cancer [AJCC] 7th edition T1-4N0-1M1)

• Positive surgical margins are permitted if the surgeon confirms complete resectionof gross metastatic disease, and post-operative scans are negative

• Patients presenting with metachronous disease may have distant metastases, regionallymph node or renal bed recurrence. Recurrences at a partial nephrectomy resectionsite are not eligible if it is the only site of disease

• Patient must have no evidence of disease on post-operative imaging:

• A computed tomography (CT) of the chest must be obtained within 4 weeks priorto randomization with or without contrast

• A CT of the abdomen/pelvis must be obtained within 4 weeks prior torandomization with intravenous (IV) contrast (oral contrast may be added at theradiologist's discretion); an magnetic resonance imaging (MRI) of theabdomen/pelvis with gadolinium may be substituted for the CT if the CT with IVcontrast is contra-indicated

• An MRI of the brain with and without gadolinium must be done within 8 weeksprior to randomization; a CT of the brain with and without IV contrast ispermitted if MRI is contra-indicated (i.e., pacemaker)

• Patient must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 at the time of randomization

• Absolute granulocyte count > 1,500/mcL (within 2 weeks prior to randomization)

• Platelets > 100,000/mcL (within 2 weeks prior to randomization)

• Total bilirubin < 1.5 x institutional upper limit of normal (ULN) (within 2 weeksprior to randomization)

• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) < 2.5 x upper limit of normal (ULN) (within 2 weeks prior to randomization)

• Calculated creatinine clearance (CrCl) > 30 mL/min (within 2 weeks prior torandomization)

• Subjects must have a urine protein/creatinine (UPC) ratio < 1; if UPC >= 1, then a 24-hour urine total protein must be obtained; subjects must have a 24-hour urineprotein value < 1 g to be eligible; use of urine dipstick for renal functionassessment is not acceptable (within 2 weeks prior to randomization)

• All females of childbearing potential must have a blood test or urine study within 2weeks prior to randomization to rule out pregnancy; a female of childbearingpotential is any woman, regardless of sexual orientation or whether they haveundergone tubal ligation, who meets the following criteria: 1) has not undergone ahysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausalfor at least 24 consecutive months (i.e., has had menses at any time in thepreceding 24 consecutive months)

• Women of childbearing potential and sexually active males must be strongly advisedto use an accepted and effective method of contraception or to abstain from sexualintercourse for the duration of their participation in the study; should a womanbecome pregnant while participating in this study, she should inform her treatingphysician immediately; if a man impregnates a woman while participating in thisstudy, he should inform his treating physician immediately

• Patient must be able to swallow pills and have no significant impairment ingastrointestinal absorption including history of gastric bypass surgery

• Patient must have a corrected QT (QTc) interval on electrocardiogram (ECG) =< 0.48seconds by Bazett's calculation (=< Common Terminology Criteria for Adverse Events [CTCAE] version [v.]4 grade 2) prior to randomization

• Patient must have a systolic blood pressure =< 140 mmHg and diastolic blood pressuremust be =< 90 mmHg, measured within 4 weeks prior to randomization; initiation oradjustment of anti-hypertensives prior to starting study treatment is allowed

• Patient must have no history of cerebrovascular accident (CVA) within 6 months ofrandomization

Exclusion Criteria:

• Patients presenting with tumors within the kidneys (multiple synchronous orsingle/multiple metachronous) are not eligible if there are no extrarenal sites ofdisease (i.e. potential multifocal primary disease)

• Patient must not have received any prior or concurrent systemic therapy for RCC.Adjuvant placebo administration is permitted

• Patient must have no active peptic ulcer disease

• Patient must have no active inflammatory bowel disease

• Patient must have no New York Heart Association (NYHA) class II or greatercongestive heart failure

• Patient must have no prior history or current clinically apparent central nervoussystem metastases

• Women must not be pregnant or breast-feeding due to the unknown effects of pazopanibon the developing fetus

• Patient must have no history of allergic reactions attributed to compounds ofsimilar chemical or biologic composition to pazopanib

• Patient must have no uncontrolled intercurrent illness including, but not limitedto, ongoing or active infection, symptomatic congestive heart failure, unstableangina pectoris, cardiac arrhythmia, or psychiatric illness/social situations thatwould limit compliance with study requirements

• Patient must not have serious or non-healing wound, ulcer, or bone fracture at thetime of randomization

• Patient must have no history of abdominal fistula, gastrointestinal perforation, orintra-abdominal abscess within 4 weeks prior to randomization

• Patient must have no history of myocardial infarction, hospital admission forunstable angina, cardiac angioplasty or stenting within 6 months of randomization

• Patient must have no history venous thrombosis within 12 weeks of randomization

• Patient cannot be taking strong cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) inhibitors such as:

• Antibiotics: clarithromycin, telithromycin, troleandomycin

• Human immunodeficiency virus (HIV) antiviral protease inhibitors: ritonavir,indinavir, saquinavir, nelfinavir, amprenavir, lopinavir

• Antifungals: itraconazole, ketoconazole, voriconazole, fluconazole

• Antidepressants: nefazodone

• Patient must not have history of hemoptysis in excess of 2.5 mL (1/2 teaspoon)within 8 weeks prior to randomization

• Patient must not be taking drugs known to prolong the QTc interval; such drugsshould be discontinued at least 5 half-lives prior to randomization

• Patients must not have any history of other cancer within 3 years from time ofrandomization with the exception of basal cell skin cancer, squamous cell skincancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast,or resected non-invasive (Ta) urothelial carcinoma