General Information

Votrient (pazopanib) is a vascular epidermal growth factor receptor (VEGFR) tyrosine kinase inhibitor which acts at all three isoforms: VEGFR-1, VEGFR-2 and VEGFR-3. VEGF is a chemical signal produced by cells that stimulates the growth of new blood vessels. It is part of the system that restores the oxygen supply to tissues when blood circulation is inadequate. When VEGF is overexpressed, it can contribute to disease. Solid cancers need an adequete blood supply or they will not be able to grow. Hence, cancer that can express VEGF are able to grow and metastasize.

Votrient is specifically indicated for the treatment of patients with advanced renal cell carcinoma.

Votrient is supplied as a tablet designed for oral administration. The recommended initial dose is 800 mg orally once daily without food (at least 1 hour before or 2 hours after a meal). The dose of Votrient should not exceed 800 mg.

Votrient is specifically indicated for the treatment of advanced soft tissue sarcoma in patients who have received chemotherapy.

Votrient is supplied as a tablet designed for oral administration. The recommended initial dose is 800 mg orally once daily without food (at least 1 hour before or 2 hours after a meal). The dose of Votrient should not exceed 800 mg.

Clinical Results

RCC: The FDA approval of Votrient was based on the results of a randomized, double-blind, placebo-controlled, multicenter study in 435 subjects with locally advanced and/or metastatic RCC who had received either no prior therapy or one prior cytokine-based systemic therapy. The subjects were randomized to receive Votrient 800 mg once daily or placebo once daily. The primary objective progression-free survival (PFS); the secondary endpoints included overall survival (OS), overall response rate (RR), and duration of response. The median progression free survival for the overall population was 9.2 months in the Votrient arm versus 4.2 months in the placebo group (P<0.001). The median progression free survival for the treatment-naïve subgroup was 11.1 months versus 2.8 months and in the Cytokine pre-treated subgroup 7.4 months versus 4.2 months. In the Votrient arm, there was a 30% response rate (complete response + partial response) versus 3% in the placebo arm. The median duration of response was 58.7 weeks in the Votrient arm.

STS: The FDA Approval of Votrient was based on the results of a randomized, double-blind, placebo-controlled, multicenter trial named PALETTE. The study enrolled 369 subjects with soft tissue sarcoma (STS) who did not respond to previous chemotherapy treatment or who were ineligible for chemotherapy treatment. Subjects with adipocytic STS or gastrointestinal stromal tumors were excluded from the trial. Subjects were randomized 2:1 to be treated with Viotrent 800 mg per day or placebo. The primary efficacy endpoint was the rate of progression-free survival (PFS) and was assessed by independent radiological review. Secondary efficacy endpoints included overall survival (OS), overall response rate, and duration of response. The median duration of PFS among the Votrient arm was 4.6 months against 1.6 months in the placebo arm. The overall response rate in the treatment group was 4% for a duration of 9 months compared to 0% in the placebo group.

Side Effects

Adverse events associated with the use of Votrient for RCC may include, but are not limited to, the following:

• Diarrhea
• Hypertension
• Hair color change
• Nausea
• Fatigue
• Anorexia
• Vomiting

Adverse reactions associated with the use of Votrient for STS may include, but are not limited to, the following:

• fatigue
• diarrhea
• nausea
• decreased weight
• hypertension
• decreased appetite
• vomiting
• tumor pain
• hair color changes
• musculoskeletal pain
• headache
• dysgeusia
• dyspnea
• skin hypopigmentation

Mechanism of Action

Votrient (pazopanib) is a vascular epidermal growth factor receptor (VEGFR) tyrosine kinase inhibitor which acts at all three isoforms: VEGFR-1, VEGFR-2 and VEGFR-3. VEGF is a chemical signal produced by cells that stimulates the growth of new blood vessels. It is part of the system that restores the oxygen supply to tissues when blood circulation is inadequate. When VEGF is overexpressed, it can contribute to disease. Solid cancers need an adequete blood supply or they will not be able to grow. Hence, cancer that can express VEGF are able to grow and metastasize.