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Background: Pazopanib is an oral,multikinase inhibitor of VEGFR-1,-2,-3,PDGFR-α and-β,and c-Kit.Preclinical and clinical studies support VEGF(R)and PDGF(R)as targets for AEOC treatment.This study evaluated the efficacy,safety,and tolerability of pazopanib maintenance therapy in patients who have not progressed after first-line chemotherapy for AEOC.Methods: Patients with histologically confirmed AEOC,FIGO Ⅱ-Ⅳ,and no evidence of progression after surgery and ≥ 5 cycles of platinum-taxane chemotherapy were randomized 1:1 to receive 800 mg pazopanib once daily or placebo for up to 24 months.Primary endpoint was progression-free survival(PFS)by RECIST.Secondary endpoints included overall survival,PFS by GCIG criteria,safety,and quality of life.Results: Most of the 940 randomized patients had stage Ⅲ/Ⅳ disease(91%)at initial diagnosis,and no residual disease after surgery(58%).The median time from diagnosis to randomization was 7.1 months in the placebo arm and 7.0 months in the pazopanib arm.The median follow-up was 24 months.Patients in the pazopanib arm had a prolonged PFS vs placebo(HR = 0.766; 95%CI: 0.64-0.91; p = 0.0021; medians 17.9 vs 12.3 months,respectively).Sensitivity and subgroup analyses of PFS,and analysis of PFS by GCIG criteria,were consistent with the primary analysis.The first interim analysis for OS(only 189 OS events = 20.1%of population)showed no difference between arms.Pazopanib mean exposure was shorter vs placebo(8.9 vs 11.7 months).Pazopanib treatment was associated with a higher incidence of adverse events(AEs)and serious AEs(26%vs 11%)vs placebo.The most common AEs were hypertension,diarrhea,nausea,headache,fatigue,and neutropenia.Fatal SAEs were reported in three patients on pazopanib and one patient on placebo.Conclusions: Pazopanib maintenance therapy provided a statistically significant and clinically meaningful PFS benefit in patients with AEOC; OS data are not mature.The safety profile of pazopanib in this setting was consistent with its established profile.