Literature DB >> 21306237

Sunitinib malate for the treatment of pancreatic neuroendocrine tumors.

Eric Raymond1, Laetitia Dahan, Jean-Luc Raoul, Yung-Jue Bang, Ivan Borbath, Catherine Lombard-Bohas, Juan Valle, Peter Metrakos, Denis Smith, Aaron Vinik, Jen-Shi Chen, Dieter Hörsch, Pascal Hammel, Bertram Wiedenmann, Eric Van Cutsem, Shem Patyna, Dongrui Ray Lu, Carolyn Blanckmeister, Richard Chao, Philippe Ruszniewski.   

Abstract

BACKGROUND: The multitargeted tyrosine kinase inhibitor sunitinib has shown activity against pancreatic neuroendocrine tumors in preclinical models and phase 1 and 2 trials.
METHODS: We conducted a multinational, randomized, double-blind, placebo-controlled phase 3 trial of sunitinib in patients with advanced, well-differentiated pancreatic neuroendocrine tumors. All patients had Response Evaluation Criteria in Solid Tumors-defined disease progression documented within 12 months before baseline. A total of 171 patients were randomly assigned (in a 1:1 ratio) to receive best supportive care with either sunitinib at a dose of 37.5 mg per day or placebo. The primary end point was progression-free survival; secondary end points included the objective response rate, overall survival, and safety.
RESULTS: The study was discontinued early, after the independent data and safety monitoring committee observed more serious adverse events and deaths in the placebo group as well as a difference in progression-free survival favoring sunitinib. Median progression-free survival was 11.4 months in the sunitinib group as compared with 5.5 months in the placebo group (hazard ratio for progression or death, 0.42; 95% confidence interval [CI], 0.26 to 0.66; P<0.001). A Cox proportional-hazards analysis of progression-free survival according to baseline characteristics favored sunitinib in all subgroups studied. The objective response rate was 9.3% in the sunitinib group versus 0% in the placebo group. At the data cutoff point, 9 deaths were reported in the sunitinib group (10%) versus 21 deaths in the placebo group (25%) (hazard ratio for death, 0.41; 95% CI, 0.19 to 0.89; P=0.02). The most frequent adverse events in the sunitinib group were diarrhea, nausea, vomiting, asthenia, and fatigue.
CONCLUSIONS: Continuous daily administration of sunitinib at a dose of 37.5 mg improved progression-free survival, overall survival, and the objective response rate as compared with placebo among patients with advanced pancreatic neuroendocrine tumors. (Funded by Pfizer; ClinicalTrials.gov number, NCT00428597.).

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Year:  2011        PMID: 21306237     DOI: 10.1056/NEJMoa1003825

Source DB:  PubMed          Journal:  N Engl J Med        ISSN: 0028-4793            Impact factor:   91.245


  728 in total

Review 1.  Sunitinib in pancreatic neuroendocrine tumors.

Authors:  Eric Raymond; Pascal Hammel; Chantal Dreyer; Christian Maatescu; Olivia Hentic; Philippe Ruszniewski; Sandrine Faivre
Journal:  Target Oncol       Date:  2012-06-02       Impact factor: 4.493

Review 2.  Clinical pathways for pancreatic neuroendocrine tumors.

Authors:  Angela Alistar; Max Sung; Michelle Kim; Randall F Holcombe
Journal:  J Gastrointest Cancer       Date:  2012-12

3.  First-Line sunitinib in patients with renal cell carcinoma (RCC) in von Hippel-Lindau (VHL) disease: clinical outcome and patterns of radiological response.

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Review 4.  Escalated-dose somatostatin analogues for antiproliferative effect in GEPNETS: a systematic review.

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Journal:  Endocrine       Date:  2017-07-19       Impact factor: 3.633

5.  Treatment-related changes in neuroendocrine tumors as assessed by textural features derived from 68Ga-DOTATOC PET/MRI with simultaneous acquisition of apparent diffusion coefficient.

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6.  The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours.

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Review 7.  Management of aggressive pituitary adenomas and pituitary carcinomas.

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Review 8.  Management of pulmonary neuroendocrine tumors.

Authors:  Robert A Ramirez; Aman Chauhan; Juan Gimenez; Katharine E H Thomas; Ioni Kokodis; Brianne A Voros
Journal:  Rev Endocr Metab Disord       Date:  2017-12       Impact factor: 6.514

Review 9.  Application and Dosimetric Requirements for Gallium-68-labeled Somatostatin Analogues in Targeted Radionuclide Therapy for Gastroenteropancreatic Neuroendocrine Tumors.

Authors:  David Taïeb; Philippe Garrigue; Manuel Bardiès; Ahmad Esmaeel Abdullah; Karel Pacak
Journal:  PET Clin       Date:  2015-07-08

10.  Alopecia in patients treated with molecularly targeted anticancer therapies.

Authors:  V R Belum; K Marulanda; C Ensslin; L Gorcey; T Parikh; S Wu; K J Busam; P A Gerber; M E Lacouture
Journal:  Ann Oncol       Date:  2015-09-19       Impact factor: 32.976

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