Pilot Study of Pazopanib With Low Fat Meal (PALM) in Advanced Renal Cell Carcinoma

Inclusion Criteria:

Adult (>18 years of age) with unresectable locally advanced or metastatic renal cell carcinoma with a clear cell component.
Subjects must have measurable disease per RECIST 1.1 criteria.
Subjects must not have had prior pazopanib therapy.
Subjects must have an ECOG (Eastern Cooperative Oncology Group scoring system used to quantify general well-being and activities of daily life; scores range from 0 to 5 where 0 represents perfect health and 5 represents death.) performance status of less than or equal to 2.
Up to 3 lines of prior VEGF (vascular endothelial growth factor) or VEGFR (vascular endothelial growth factor receptor) targeted therapy are permitted. Any prior therapy should have been completed ≥ 2 weeks prior to start of study therapy.
Subjects may have received any number of the following therapies: cytokine therapy (e.g. high dose interleukin-2) or checkpoint inhibitor therapy (e.g. anti-PD1/PDL1, anti-CTLA4) or mTOR inhibitor therapy (e.g. everolimus, temsirolimus).
Adequate organ and marrow function (Absolute neutrophil count > 1000/mm3, platelets > 100,000/mm3, aspartate aminotransferase/ alanine aminotransferase/ total bilirubin < 1.5 X ULN (upper limit of normal). Patients with Gilbert's disease are exempt.
Subject must be willing and able to take pazopanib with a low-fat meal every day as specified in the protocol.
Subjects must be willing and able to come off any PPI(proton pump inhibitor)/other strong CYP3A4 inhibitors or inducers/simvastatin.
Ability to understand and the willingness to sign a written informed consent.
All subjects, including those who are surgically sterilized, must be willing to use an effective method of contraception.

Exclusion Criteria:

Any concurrent health condition that in the view of the treating physician would pose excessive risk to the patient if enrolled in the study.
Subjects with a history of hemoptysis, cerebral hemorrhage, clinically significant GI hemorrhage, myocardial infarction within the past 6 months.
Patients at significant risk for GI (gastrointestinal) perforation or fistula.
Pregnant or nursing mothers.
Untreated CNS (central nervous system) metastasis. If treated CNS metastasis/es, treatment of CNS disease (surgery or radiation) must have been completed at least 30 days prior to registration. Patients could still be on steroids.
Subjects with known history of Cirrhosis, HIV, Hepatitis B or C.
Averaged QTc baseline in 3 ECGs (electrocardiograms) at least 5 minutes apart of ≥450 ms.
Congestive Heart Failure (NYHA Class III/IV) or LVEF (left ventricular ejection fraction) <50% at baseline.
Uncontrolled hypertension (HTN) despite medical management (blood pressure (BP) ≥ 160/100.