Inclusion Criteria:
- Histologically or cytologically confirmed thyroid cancer that is now advanced or
metastatic disease
- One of the following subtypes:
- Differentiated thyroid cancer
- Absence of sensitivity to therapeutic radioiodine
- Medullary thyroid cancer
- Anaplastic thyroid cancer
- Patients with confirmed differentiated thyroid cancer (DTC) must be thyroglobulin
antibody negative to be enrolled in the expanded/additional DTC cohort
- Zero, one or two prior therapeutic regimens (this includes cytotoxic plus
non-cytotoxic therapeutic regimens)
- Measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20 mm by
conventional techniques OR ≥ 10 mm by spiral computed tomography (CT) scan
- Objective evidence of tumor progression within the past 6 months, as assessed by the
following:
- Unequivocal progression of objectively measured disease on successive
appropriate imaging (e.g., CT scan); in cases of uncertainty of tumor
progression, the Principal Investigator of the study will be available to assist
in decisions
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 OR Karnofsky PS
60-100%
- Life expectancy > 3 months
- Leukocytes ≥ 3,000/mcL
- Absolute neutrophil count ≥ 1,500/mcL
- Platelets ≥ 100,000/mcL
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN) (direct bilirubin ≤ 1.5 times
ULN if patient has Gilbert syndrome)
- Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 2.5 times ULN
- Creatinine ≤ 1.5 times ULN
- Proteinuria ≤ 1+ on urinalysis
- No proteinuria > 1+ (< 30 mg/dL) on two consecutive dipstick or other urine
assessments taken at least 1 week apart
- International normalized ratio (INR) ≤ 1.2 times ULN
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception prior to and during study therapy
- Systolic blood pressure (BP) < 140 mm Hg and diastolic BP < 90 mm Hg
- Initiation or adjustment of BP medication is permitted prior to registration
provided the average of three BP readings at a visit prior to registration is <
140/90 mm Hg
- No sensitivity to therapeutic radioiodine (differentiated only)
- Able to understand and willing to sign a written informed consent document
- Willing to comply with the requirements of the study
- Willing to donate blood for correlative marker studies (only applicable to sites
within the United States)
- No admission for unstable angina, cardiac angioplasty, or stenting within the past 12
weeks
- At least 4 weeks since prior radiotherapy
- At least 4 weeks since prior major surgery
- No prior surgical procedure affecting absorption
- No requirement for IV alimentation
- No prior radiotherapy to ≥ 25% of bone marrow
- No concurrent octreotide
- Concurrent octreotide allowed provided tumor progression on this drug has been
demonstrated
- No other concurrent investigational agents
- No cytochrome (CYP) interactive medications prior to, during, and for at least 1-2
weeks after discontinuation from the study
- No concurrent antiretroviral therapy for human immunodeficiency virus (HIV)-positive
patients
- No concurrent medications or substances known to affect or with the potential to
affect the activity or pharmacokinetics of pazopanib hydrochloride
- No concurrent investigational or commercial agents or therapies other than those used
for this study with the intent to treat the patient's malignancy
- No concurrent therapeutic warfarin
- Low molecular weigh the paring and prophylactic low-dose warfarin allowed
- No more than 2 total prior cytotoxic or noncytotoxic therapeutic regimens
- Up to two total prior noncytotoxic or cytotoxic therapeutic regimens are allowed
provided therapy ceased > 21 days prior to registration
- No concurrent medications that are associated with a risk of QTc prolongation and/or
Torsades de Pointes
Exclusion Criteria:
- Thyroid lymphomas, sarcomas, or metastatic disease from other sites of origin to
thyroid
- Disease that is measurable by physical examination only
- Known active and/or untreated brain metastases and/or brain metastases requiring
ongoing therapy (e.g., corticosteroids)
- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to pazopanib hydrochloride or other agents used in the study
- QTc prolongation (defined as a QTc interval ≥ 4800 msecs) or other significant
electrocardiogram (ECG) abnormalities (e.g., frequent ventricular ectopy or evidence
of ongoing myocardial ischemia); NOTE: the Principal Investigator of the study should
be contacted in the event of uncertainty related patient eligibility based upon ECG
changes
- Any condition that impairs the ability to swallow and retain pazopanib hydrochloride,
including any of the following:
- Gastrointestinal tract disease resulting in an inability to take oral medication
- Active peptic ulcer disease
- Any of the following conditions:
- Serious or nonhealing wound, ulcer, or bone fracture
- History of abdominal fistula
- Gastrointestinal perforation
- Active diverticulitis
- Intra-abdominal abscess or gastrointestinal tract bleeding within the past 28
days prior to registration
- History of cerebrovascular accident (CVA) within the past 6 months
- History of myocardial infarction, cardiac arrhythmia within the past 12 weeks
- History of venous thrombosis within the past 12 weeks
- NYHA class III or IV heart failure
- History of bleeding disorder including hemophilia, disseminated intravascular
coagulation, or any other abnormality of coagulation potentially predisposing
patients to bleeding
- Poorly controlled depression or anxiety disorder, or recent (≤ 6 months)suicidal
ideation
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection or psychiatric illness/social situations that would or might reasonably be
expected to limit compliance with study requirements