Inclusion Criteria:
- Histologically or cytologically confirmed malignant pleural mesothelioma:
- Measurable disease
- No progressive disease inside or outside of any prior radiation field
- No symptomatic, untreated, or uncontrolled CNS metastases
- Patients with CNS metastases treated with whole brain radiation (WBRT) may be
enrolled after completion of WBRT
- Patients may begin study therapy as early as the next day after completion
of WBRT
- ECOG performance status 0-2
- Life expectancy >= 12 weeks
- ANC >=1,500/mm^3
- Platelet count >= 100,000/mm^3
- WBC >= 3,000/mm^3
- Bilirubin =< 1.5 times upper limit of normal (ULN)
- AST and ALT =< 2.5 times ULN
- Alkaline phosphatase =< 2.5 times ULN
- Creatinine =< 1.5 times ULN or creatinine clearance >= 50 mL/min
- Proteinuria =< 1+ on 2 consecutive dipsticks taken >= 1 week apart
- No condition that impairs ability to swallow and retain study drug tablets including,
but not limited to, any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral medication
- Requirement for IV alimentation
- Prior surgical procedures affecting absorption
- Active peptic ulcer disease
- No other primary malignancy except for carcinoma in situ of the cervix or
nonmelanomatous skin cancer, unless that prior malignancy was diagnosed and
definitively treated ≥ 5 years ago with no subsequent evidence of recurrence
- Patients with a history of low-grade (Gleason score =< 6) localized prostate cancer
are eligible even if diagnosed within the past 5 years
- No history of allergic reactions attributed to compounds of similar chemical or
biological composition to pazopanib hydrochloride or other agents used in the study
- None of the following concurrent severe and/or uncontrolled medical conditions:
- Serious or nonhealing wound, ulcer, or bone fracture
- Abdominal fistula, diverticulosis, gastrointestinal perforation, or
intra-abdominal abscess within the past 28 days
- Poorly controlled diabetes
- Interstitial pneumonia
- Extensive and symptomatic interstitial fibrosis of the lung
- No cardiovascular illness or complication, including any of the following:
- Any history of cerebrovascular accident within the past 6 months
- History of myocardial infarction (prior electrocardiographic evidence of
myocardial injury)
- History of cardiac arrhythmia (prior electrocardiographic evidence of abnormal
heart rhythm)
- Admission for unstable angina
- Cardiac angioplasty or stenting within the past 12 months
- NYHA class III-IV heart failure
- Asymptomatic NYHA class II heart failure allowed
- QTc prolongation (defined as a QTc interval ≥ 500 msecs) or other significant
electrocardiogram abnormalities
- Venous thrombosis within the past 12 weeks
- No ancillary therapy considered investigational within the past 4 weeks
- No symptomatic, untreated, or uncontrolled seizure disorder
- No uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection or psychiatric illness/social situations that would limit study compliance
- No significant traumatic injury within the past 4 weeks
- No more than 1 prior systemic therapy for malignant pleural mesothelioma
- No major surgery (i.e., laparotomy) or open biopsy within the past 4 weeks
- Insertion of a vascular access device is not considered major or minor surgery
- No minor surgery within the past 2 weeks
- Insertion of a vascular access device is not considered major or minor surgery
- Prior palliative radiotherapy allowed
- No prior palliative radiotherapy to the chest except for a maximum of 3
fractions of radiotherapy for superior vena cava syndrome
- No concurrent therapeutic warfarin
- Low molecular-weight heparin or prophylactic low-dose warfarin allowed
- No other concurrent chemotherapy, immunotherapy, hormonal therapy, or radiotherapy
- No concurrent medications that act through the CYP450 system
- No concurrent combination antiretroviral therapy for HIV-positive patients
- PT/INR/PTT =< 1.2 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective nonhormonal contraception
- No uncontrolled infection
- No uncontrolled blood pressure (BP) (defined as systolic BP > 140 mm Hg and/or
diastolic BP > 90 mm Hg in spite of adequate anti-hypertensive therapy)
- No other severe underlying disease that, in the judgment of the investigator, would
limit study compliance