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| Name | Class |
|---|---|
| Novartis | INDUSTRY |
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The area around a tumor ("pre-metastatic niche") may be an area to which cancer cells are attracted. The study doctor will take blood and tumor samples to look for certain features linked with response to treatment so that they can predict which future patients may benefit from this therapy. The purpose of this study is to see if the drug pazopanib can be used to reduce the amount of pre-metastatic niche in the patient's lymph nodes (a common site for prostate cancer to spread). Down the line, this may help to prevent prostate cancer from coming back after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo arm | Placebo Comparator | Participants receiving placebo |
|
| Pazopanib arm | Experimental | Participants receiving Pazopanib |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pazopanib | Drug | Pazopanib, 800 mg, orally daily for 28 days prior to radical prostatectomy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Vascular Endothelial Growth Factor Receptor 1 (VEGFR1)-Positive Clusters | Patients with high-risk, localized prostate cancer were treated with 28 days of Pazopanib or placebo, after which they underwent radical prostatectomy. During prostatectomy, benign pelvic lymph node tissue was collected and subsequently analyzed for the average number of VEGFR1-positive clusters in 8 distinct 40x microscopic fields as an indicator of pre-metastatic niche formation. | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Participants Experiencing Adverse Events | Adverse events were assessed using the Common Terminology for Adverse Events (CTCAE) version 4. Each event was assigned a grade (1-5), with lower grades indicating milder events. All adverse events were recorded, regardless of attribution to study treatment. For a full listing of Adverse Events, please see the Adverse Events section of the Results for this study. |
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Inclusion Criteria:
Men ≥ 18 years of age
Histological documentation of adenocarcinoma of the prostate, with available biopsy pathology. Biopsy material must be available for pathologic review.
All patients must meet one or more of the following disease features: clinical stage greater than or equal to T3; Primary Gleason score of 4 OR Gleason score of 8, 9 or 10; serum prostate-specific antigen (PSA) ≥ 20 ng/mL; Prostate MRI findings consistent with T3 disease; Any clinical stage and PSA (prostate-specific antigen) >10 and Gleason score 7; A Kattan nomogram predicted probability of being free from biochemical progression at 5 years after surgery of < 60%.
Patients must have a PSA (prostate-specific antigen) ≥ 2 ng/mL at the time of diagnosis of prostate cancer or later.
No prior radiation or chemotherapy for prostate cancer treatment.
Scheduled for radical prostatectomy surgery.
Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.
Patients may have been treated with up to 4 months of androgen deprivation therapy.
No clinical evidence of metastatic prostate cancer, or enlarged pelvic lymph nodes in the imaging studies.
Resected lymph nodes must be provided for all subjects for biomarker analysis immediately (same day) after surgery (radical prostatectomy).
Adequate organ system function as defined by study Protocol
Subjects must provide written informed consent within one month prior to performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up.
Exclusion Criteria:
Clinical evidence of metastatic prostate cancer.
Prior malignancy. No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 5 years.
Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding including, but not limited to: Active peptic ulcer disease Known intraluminal metastatic lesion/s with risk of bleeding Inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease), or other gastrointestinal conditions with increased risk of perforation History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 28 days prior to beginning study treatment.
Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product including, but not limited to:
Corrected QT interval (QTc) > 480 msecs Note: Correction method should be reported
History of any one or more of the following cardiovascular conditions within the past 6 months:
No evidence of preexisting uncontrolled hypertension. If the patient has a history of elevated blood pressure at baseline then they must have controlled hypertension documented and confirmed by 2 consecutive blood pressure readings taken within 1 hour. The baseline systolic blood pressure readings must be =<140 mm Hg, and the baseline diastolic blood pressure readings must be =<90 mm Hg.
Note: Initiation or adjustment of antihypertensive medication(s) is permitted prior to study entry. Following antihypertensive medication initiation or adjustment, blood pressure (BP) must be re-assessed three times at approximately 2-minute intervals. At least 24 hours must have elapsed between anti-hypertensive medication initiation or adjustment and Blood Pressure measurement. These three values should be averaged to obtain the mean diastolic blood pressure (DBP) and the mean systolic blood pressure (SBP). The mean SBP / DBP ratio must be <140/90 mm Hg (OR 150/90 mm Hg, if this criterion is approved by the Huntsman Cancer Institute (HCI) Data Safety and Monitoring Committee (DSMC) Chair or Co-chair) in order for a subject to be eligible for the study (see protocol for details on Blood Pressure control and re-assessment prior to study enrollment).
History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
Major surgery or trauma within 28 days prior to first dose of investigational product and/or presence of any non-healing wound, fracture, or ulcer (procedures such as catheter placement not considered to be major surgery).
Evidence of active bleeding or bleeding diathesis.
Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage Note: Lesions infiltrating major pulmonary vessels (contiguous tumour and vessels) are excluded; however, the presence of a tumor that is touching, but not infiltrating (abutting) the vessels is acceptable (CT (computed tomography) with contrast is strongly recommended to evaluate such lesions).
Recent hemoptysis (=> ½ teaspoon of red blood within 8 weeks before first dose of study drug).
Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to study procedures.
Unable or unwilling to discontinue use of prohibited medications listed in the protocol for at least 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of study drug and for the duration of the study.
Treatment with any of the following anti-cancer therapies:
Administration of any non-oncologic investigational drug within 30 days or 5 half lives whichever is longer prior to receiving the first
Any ongoing toxicity from prior hormonal therapy that is >Grade 1 and/or that is progressing in severity.
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| Name | Affiliation | Role |
|---|---|---|
| Neeraj Agarwal, MD | Huntsman Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Huntsman Cancer Institute | Salt Lake City | Utah | 84112 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30575560 | Derived | Maughan BL, Pal SK, Gill D, Boucher K, Martin C, Salgia M, Nussenzveig R, Liu T, Hawks JL, Batten J, Nachaegari G, Stephenson R, Lowrance W, Jones J, Dechet C, Agarwal N. Modulation of Premetastatic Niche by the Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor Pazopanib in Localized High-Risk Prostate Cancer Followed by Radical Prostatectomy: A Phase II Randomized Trial. Oncologist. 2018 Dec;23(12):1413-e151. doi: 10.1634/theoncologist.2018-0652. Epub 2018 Nov 1. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo Arm | Participants receiving placebo Placebo: Placebo tablet orally, daily for 28 days prior to radical prostatectomy. |
| FG001 | Pazopanib Arm | Participants receiving Pazopanib Pazopanib: Pazopanib, 800 mg, orally daily for 28 days prior to radical prostatectomy. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 22, 2018 |
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| Placebo | Other | Placebo tablet orally, daily for 28 days prior to radical prostatectomy. |
|
| From first dose of study treatment to one month post-prostatectomy (approximately 2 months) |
| Biochemical Recurrence Progression Free Survival Rate | Following prostatectomy, patients' Prostate Specific Antigen (PSA) lab values were collected for up to two years. Biochemical recurrence was defined as the first PSA lab value of greater than or equal to 0.2 ng/mL following prostatectomy. Biochemical recurrence progression free survival rate was defined as the percent chance of 1 year survival with no biochemical recurrence. | 2 years |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo Arm | Participants receiving placebo Placebo: Placebo tablet orally, daily for 28 days prior to radical prostatectomy. |
| BG001 | Pazopanib Arm | Participants receiving Pazopanib Pazopanib: Pazopanib, 800 mg, orally daily for 28 days prior to radical prostatectomy. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Vascular Endothelial Growth Factor Receptor 1 (VEGFR1)-Positive Clusters | Patients with high-risk, localized prostate cancer were treated with 28 days of Pazopanib or placebo, after which they underwent radical prostatectomy. During prostatectomy, benign pelvic lymph node tissue was collected and subsequently analyzed for the average number of VEGFR1-positive clusters in 8 distinct 40x microscopic fields as an indicator of pre-metastatic niche formation. | The tissue of one patient on the Pazopanib arm and two patients on the Placebo arm was not able to be analyzed. Another patient on the Pazopanib arm had surgery delayed by a few weeks following stopping study medication and was determined to be unevaluable, resulting in 13 patients analyzed on each arm. | Posted | Mean | Standard Deviation | VEGFR1+ clusters per hpf | 1 month |
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| Secondary | Participants Experiencing Adverse Events | Adverse events were assessed using the Common Terminology for Adverse Events (CTCAE) version 4. Each event was assigned a grade (1-5), with lower grades indicating milder events. All adverse events were recorded, regardless of attribution to study treatment. For a full listing of Adverse Events, please see the Adverse Events section of the Results for this study. | Posted | Count of Participants | Participants | From first dose of study treatment to one month post-prostatectomy (approximately 2 months) |
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| Secondary | Biochemical Recurrence Progression Free Survival Rate | Following prostatectomy, patients' Prostate Specific Antigen (PSA) lab values were collected for up to two years. Biochemical recurrence was defined as the first PSA lab value of greater than or equal to 0.2 ng/mL following prostatectomy. Biochemical recurrence progression free survival rate was defined as the percent chance of 1 year survival with no biochemical recurrence. | Two patients on the Pazopanib arm were not evaluable, one due to prostatectomy not being completed, and one due to prostatectomy being delayed outside of protocol windows. | Posted | Number | 95% Confidence Interval | percent chance of survival | 2 years |
|
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Adverse events were collected for approximately 2 months (from first dose of study medication to 1 month post-prostatectomy).
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Placebo Arm | Participants receiving placebo Placebo: Placebo tablet orally, daily for 28 days prior to radical prostatectomy. | 0 | 15 | 0 | 15 | 15 | 15 |
| EG001 | Pazopanib Arm | Participants receiving Pazopanib Pazopanib: Pazopanib, 800 mg, orally daily for 28 days prior to radical prostatectomy. | 0 | 15 | 0 | 15 | 15 | 15 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Agitation | Psychiatric disorders | CTCAE (4.0) | Systematic Assessment |
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| Alanine aminotransferase increased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Alopecia | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Anemia | Blood and lymphatic system disorders | CTCAE (4.0) | Systematic Assessment |
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| Anorexia | Metabolism and nutrition disorders | CTCAE (4.0) | Systematic Assessment |
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| Anxiety | Psychiatric disorders | CTCAE (4.0) | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Bladder spasm | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Bloating | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Blood bilirubin increased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Bruising | Injury, poisoning and procedural complications | CTCAE (4.0) | Systematic Assessment |
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| Burn | Injury, poisoning and procedural complications | CTCAE (4.0) | Systematic Assessment |
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| Irregular heartbeat | Cardiac disorders | CTCAE (4.0) | Systematic Assessment |
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| Chills | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Creatinine increased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | CTCAE (4.0) | Systematic Assessment |
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| Depression | Psychiatric disorders | CTCAE (4.0) | Systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| Dry mouth | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Dry skin | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Erectile dysfunction | Reproductive system and breast disorders | CTCAE (4.0) | Systematic Assessment |
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| Eye disorders - Other | Eye disorders | CTCAE (4.0) | Systematic Assessment |
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| Fatigue | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Fever | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Flank pain | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Flu like symptoms | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Flushing | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Gastroesophageal reflux disease | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Loose stool | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Generalized discomfort | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Generalized muscle weakness | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Genital edema | Reproductive system and breast disorders | CTCAE (4.0) | Systematic Assessment |
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| Headache | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| Hematoma | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Hematuria | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Hemoglobin increased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Hoarseness | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Hot flashes | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | CTCAE (4.0) | Systematic Assessment |
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| Hypertension | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Hypotension | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Hypoxia | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Insomnia | Psychiatric disorders | CTCAE (4.0) | Systematic Assessment |
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| Localized edema | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Oral dysesthesia | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Oral pain | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Pain | General disorders | CTCAE (4.0) | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Pelvic pain | Reproductive system and breast disorders | CTCAE (4.0) | Systematic Assessment |
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| Perineal pain | Reproductive system and breast disorders | CTCAE (4.0) | Systematic Assessment |
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| Peripheral sensory neuropathy | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| Phlebitis | Vascular disorders | CTCAE (4.0) | Systematic Assessment |
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| Platelet count decreased | Investigations | CTCAE (4.0) | Systematic Assessment |
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| Productive cough | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Proteinuria | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Rash maculo-papular | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Rectal pain | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Renal and urinary disorders - Other | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Skin and subcutaneous tissue disorders - Other | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Hair color change | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Skin atrophy | Skin and subcutaneous tissue disorders | CTCAE (4.0) | Systematic Assessment |
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| Sore throat | Respiratory, thoracic and mediastinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Stomach pain | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Tinnitus | Ear and labyrinth disorders | CTCAE (4.0) | Systematic Assessment |
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| Tremor | Nervous system disorders | CTCAE (4.0) | Systematic Assessment |
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| Urinary frequency | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Urinary incontinence | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Urinary tract pain | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Urinary urgency | Renal and urinary disorders | CTCAE (4.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | CTCAE (4.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Josiah Lyn Hawks | Huntsman Cancer Institute / University of Utah | 801-585-0601 | Josiah.Hawks@hci.utah.edu |
| May 2, 2018 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| C516667 | pazopanib |
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| >=65 years |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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