GW786034 in Patients With Non Small Cell Lung Cancer 3rd Line

Inclusion Criteria:

Required Characteristics 3.1. Subjects must provide written informed consent prior to performance of study-specific procedures or assessments, and must be willing to comply with treatment and follow up. Procedures conducted as part of the subject's routine clinical management (e.g., blood count, imaging study) and obtained prior to signing of informed consent may be utilized for screening or baseline purposes provided these procedures are conducted as specified in the protocol.

Note: It is not necessary that informed consent be obtained within the protocol-specified screening window.

3.11 ≥18 years of age.

3.12 ≥2 prior systemic therapies for Non Small Cell Lung Cancer.

3.13 Histologic or cytologic diagnosis of stage IV Non Small Cell Lung cancer

. 3.14 Measurable disease. For patients having only lesions measuring ≥1 cm to ≤2 cm per RECIST criteria must use spiral CT imaging for both pre- and post-treatment tumor assessments.

3.15 Laboratory values obtained ≤14 days prior to registration: Hematologic Absolute neutrophil count (ANC) 1.5 X 109/L Hemoglobin1 9 g/dL (5.6 mmol/L) Platelets 100 X 109/L Prothrombin time (PT) or international normalized ratio (INR) 1.2 X upper limit of normal (ULN) Partial thromboplastin time (PTT) 1.2 X ULN Hepatic2 Total bilirubin 1.5 X ULN AST and ALT 2.5 X ULN Renal Serum creatinine 1.5 mg/dL (133 µmol/L)

Or, if greater than 1.5 mg/dL:

Calculated creatinine clearance 50 mL/min

Urine Protein to Creatinine Ratio (UPC)3 \< 1

1. Subjects may not have had a transfusion within 7 days of screening assessment.
2. Concomitant elevations in bilirubin and AST/ALT above 1.0 x ULN are not permitted
3. If UPC \>/= 1, then a 24-hour urine protein must be assessed. Subjects must have a 24-hour urine protein value \<1g to be eligible.

   3.16 ECOG Performance Score 0, or 1.

   3.17 Negative pregnancy test done ≤ 7 days prior to registration, for women of childbearing potential only.

   A female is eligible to enter and participate in this study if she is of: Non-childbearing potential (i.e., physiologically incapable of becoming pregnant), including any female who has had:
   * A hysterectomy
   * A bilateral oophorectomy (ovariectomy)
   * A bilateral tubal ligation
   * Is post-menopausal

   Subjects not using hormone replacement therapy (HRT) must have experienced total cessation of menses for ≥ 1 year and be greater than 45 years in age, OR, in questionable cases, have a follicle stimulating hormone (FSH) value \>40 mIU/mL and an estradiol value \< 40pg/mL (\<140 pmol/L).

   Subjects using HRT must have experienced total cessation of menses for \>= 1 year and be greater than 45 years of age OR have had documented evidence of menopause based on FSH and estradiol concentrations prior to initiation of HRT

   Childbearing potential, including any female who has had a negative serum pregnancy test within 1 week prior to the first dose of study treatment, preferably as close to the first dose as possible, and agrees to use adequate contraception. GSK acceptable contraceptive methods, when used consistently and in accordance with both the product label and the instructions of the physician, are as follow:
   * An intrauterine device with a documented failure rate of less than 1% per year.
   * Vasectomized partner who is sterile prior to the female subject's entry and is the sole sexual partner for that female.
   * Complete abstinence from sexual intercourse for 14 days before exposure to investigational product, through the dosing period, and for at least 21 days after the last dose of investigational product.
   * Double-barrier contraception (condom with spermicidal jelly, foam suppository, or film; diaphragm with spermicide; or male condom and diaphragm with spermicide).
   * Oral contraceptives
   * Female subjects who are lactating should discontinue nursing prior to the first dose of study drug and should refrain from nursing throughout the treatment period and for 14 days following the last dose of study drug

   3.18 Ability and willingness to provide informed consent.

   3.19 Life expectancy ≥12 weeks.

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   Exclusion Criteria:

   3.21 Any of the following as this regimen may be harmful to a developing fetus or nursing child.

   • Pregnant women
   * Nursing women
   * Men or women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception.

   3.22 Any abnormal serum calcium, magnesium, and potassium levels

   3.23 Clinically significant hemoptysis, cerebral hemorrhage, or gastrointestinal hemorrhage in the past 6 months

   3.24 Any patient currently on an antiarrhythmics or other medications that are know to prolong the QT interval.

   3.25 Uncontrolled infection.

   3.26 Poorly controlled hypertension \[defined as systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥ 90mmHg\].

   Note: Initiation or adjustment of antihypertensive medication(s) is permitted prior to study entry. BP must be re-assessed on two occasions that are separated by a minimum of 1 hour; on each of these occasions, the mean (of 3 readings) SBP / DBP values from each BP assessment must be \<140/90 mmHg in order for a subject to be eligible for the study

   3.27 Any condition (e.g., gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation, prior surgical procedures, affecting absorption, or active peptic ulcer disease) that impairs their ability to swallow and retain pazopanib tablets.
   * Malabsorption syndrome
   * Major resection of the stomach or small bowel. 3.28 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.

   3.29 Known endobronchial lesions and or lesions infiltrating major pulmonary vessels.

   3.30 Cavitary lesions deemed to be at increased risk of bleeding.

   3.31 Any other severe underlying diseases that are, in the judgment of the investigator, inappropriate for entry into this study.

   3.32 Second 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 previously with no subsequent evidence of recurrence. Patients with a history of low-grade (Gleason score ≤6) localized prostate cancer will be eligible even if diagnosed \<5 years prior to registration.

   3.33 Any ancillary therapy considered investigational (utilized for a non-FDA approved indication and in the context of a research investigation) ≤4 weeks prior to registration.

   3.34 Other concurrent chemotherapy, immunotherapy, radiotherapy.

   3.35a. History of allergic reactions attributed to compounds of similar chemical or biologic composition to pazopanib or other agents used in the study.

   b. Medications that act through the CYP450 system. Some medications that act through the cytochrome P450 system are specifically prohibited in patients receiving pazopanib. Certain other agents should be used with caution. (A list of medications that are specifically prohibited or that should be used with caution during this trial of pazopanib will be provided with the full study protocol as Appendix 1. A list of selected agents that could affect pazopanib will be listed in Appendix I. ) c. Any of the following concurrent severe and/or uncontrolled medical conditions:

   • Serious or non-healing wound, ulcer, or bone fracture

   • History of abdominal fistula, diverticulosis, gastrointestinal perforation, or intra-abdominal abscess ≤28 days prior to registration
   * Any history of cerebrovascular accident (CVA) ≤6 months prior to registration
   * History of any one or more of the following cardiovascular conditions within the past 6 months:
   * Cardiac angioplasty or stenting
   * Myocardial infarction
   * Unstable angina
   * Coronary artery bypass graft surgery
   * Symptomatic peripheral vascular disease
   * Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA)
   * History of venous thrombosis ≤12 weeks prior to registration.
   * Class III or IV heart failure as defined by the NYHA functional classification system .History of Class II heart failure and is asymptomatic on treatment may be considered eligible.
   * Poorly controlled diabetes.
   * Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung.
   * QTc prolongation (defined as a QTc interval ) \> 480 msecs using Bazett's formula) or other significant ECG abnormalities d. Symptomatic, untreated, or uncontrolled CNS metastases or seizure disorder. Patients with CNS metastases treated with whole brain radiation (WBRT)or gamma knife may be enrolled after completion of WBRT or gamma knife. Patients may begin chemotherapy as early as the next day after completion of WBRT or gamma knife.

     e. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection or psychiatric illness/social situations that would limit compliance with study requirements.

     f. HIV-positive patients on combination antiretroviral therapy because of the potential for pharmacokinetic interactions with pazopanib. In addition, these patients are at increased risk of lethal infections when treated with marrow suppressive therapy

     g. Any of the following prior therapies:
   * Major surgery (i.e., laparotomy), open biopsy, or significant traumatic injury ≤4 weeks prior to registration. Minor surgery ≤4 weeks prior to registration. Insertion of a vascular access device is not considered major or minor surgery in this regard.
   * Treatment with any of the following anti-cancer therapies:
   * radiation therapy, surgery or tumor embolization within 14 days prior to the first dose of Pazopanib OR
   * chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days or five half-lives of a drug (whichever is longer) prior to the first dose of pazopanib

   Patients with progressive disease inside of the radiation field are not eligible.

   3.36 History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.

   Note: Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible

   3.37 Evidence of active bleeding or bleeding diathesis.

   3.38 Hemoptysis within 6 weeks of first dose of study drug.

   3.39 Unable or unwilling to discontinue use of prohibited medications 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.

   3.40 Any ongoing toxicity from prior anti-cancer therapy that is \>Grade 1 and/or that is progressing in severity, except alopecia.

   3.41 Other Eligibility Criteria Considerations To assess any potential impact on subject eligibility with regard to safety, the investigator must refer to the following document(s) for detailed information regarding warnings, precautions, contraindications, adverse events, and other significant data pertaining to the investigational product(s) being used in this study: Clinical Investigator's Brochure for pazopanib.\[Investigator Brochure\]

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