Evaluation of Acute Locoregional Toxicity in Patients with Breast Cancer Treated with Adjuvant Radiotherapy in Combination with Pazopanib

Abstract

Purpose. The purpose of this study was to analyze acute locoregional toxicity in patients with breast cancer receiving concurrent pazopanib and RT. Materials and Methods. Patients with breast cancer who received pazopanib in combination with radiation were identified and matched (2 : 1) to patients with breast cancer who did not receive pazopanib by use of chemotherapy, radiation field design, and radiation dose. Toxicity was scored by the Common Terminology Criteria for Adverse Events and statistical analysis was performed. Results. Grade 1 or 2 radiation dermatitis was seen in 100% and 84% of pazopanib and RT patients and matched controls respectively (P = NS). None of the patients receiving pazopanib and RT experienced ≥ grade 3 toxicity within the irradiated volume; three (16%) matched patients experienced a grade 3 skin reaction (P = 0.05). Interestingly, grade 1 or 2 hyperpigmentation was seen in 17% of pazopanib and RT patients and 60% of matched controls (P = 0.005). Conclusion. The addition of concurrent pazopanib and RT when treating the intact breast, chest wall, and associated nodal regions in breast cancer seems to be safe and well tolerated.

Combined high dose radiation and pazopanib in metastatic renal cell carcinoma: a phase I dose escalation trial

“…We hypothesized that the combination of pazopanib and SBRT could increase response rates. The safety of the combination of pazopanib with conventional radiotherapy has already been investigated [ 25 , 26 ]. However, there are only limited retrospective cases reported on SBRT and pazopanib [ 27 ].…”

Radiotherapy and Vascular Endothelial Growth Factor Receptor-Tyrosine Kinase Inhibitors in Renal Cancer

“…Only 1 case report observed a complete response of gastric metastases from renal cancer treated with pazopanib and RT (30 Gy in 10 fractions) [42]. Other studies investigated the RT-pazopanib combination in soft tissue sarcoma [43], breast cancer [40], and in 1 case of radiation recall dermatitis [44]. …”

“…The inhibiting effect of pazopanib on VEGF should improve, as other compounds do, vessel quality, enhancing tumor oxygenation, thus resulting in increased radiation efficacy [40]. …”

Advances in the targeted therapy of liposarcoma

“…Similarly, the combination of radiotherapy with sorafenib might provide clinical benefits in patients with hepatocellular carcinoma (HCC), 140 metastatic RCC, 141 as well as gastrointestinal 142 and other malignancies. Furthermore, the strategy of combining pazopanib with radiotherapy has also been reported recently in cervical cancer (CC) 143 and breast cancer, 144 all of which demonstrate potential benefits to some extent. Although the included entities cannot be compared with STSs, for which irradiation is limited due to the large tumor size and critical anatomic sites such as major vessels and nerves or vital organs, the results of the study provided an application prospect for the combination of radiotherapy and TKIs in LPS.…”