E P Hui1, B B Y Ma, A D King, F Mo, S L Chan, M K M Kam, H H Loong, A T Ahuja, B C Y Zee, A T C Chan. 1. Department of Clinical Oncology, Prince of Wales Hospital, Sir YK Pao Center for Cancer, Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, The Chinese University of Hong Kong, Hong Kong SAR, China.
Abstract
BACKGROUND: We aimed to evaluate the safety and efficacy of single-agent sunitinib in nasopharyngeal carcinoma (NPC). METHODS: Eligible patients had progressive disease after prior platinum-based chemotherapy. Sunitinib was given as continuous once-daily dosing of 37.5 mg in 4-week cycles until progression. RESULTS: Thirteen patients were enrolled. Recruitment was stopped after two patients died of hemorrhagic events. All patients had previously received curative radiotherapy (RT) to nasopharynx/neck (including nine patients who had chemoradiotherapy). Patients received a median of three cycles of sunitinib. One patient was still on sunitinib with stable disease after 24 cycles. Hemorrhagic events occurred in nine patients (64%), including epistaxis in six, hemoptyses in three and hematemesis in two patients. Prior RT to thorax was significantly associated with hemoptyses (P = 0.03). Two patients with local tumor invasion into the carotid sheath developed fatal epistaxis/hematemesis within the first cycle of sunitinib, likely due to internal carotid blowout after tumor shrinkage. CONCLUSIONS: Sunitinib demonstrated modest clinical activity in heavily pretreated NPC patients. However, the high incidence of hemorrhage from the upper aerodigestive tract in NPC patients who received prior high-dose RT to the region is of concern. Direct vascular invasion by tumors appeared to increase the risk of serious bleeding.
BACKGROUND: We aimed to evaluate the safety and efficacy of single-agent sunitinib in nasopharyngeal carcinoma (NPC). METHODS: Eligible patients had progressive disease after prior platinum-based chemotherapy. Sunitinib was given as continuous once-daily dosing of 37.5 mg in 4-week cycles until progression. RESULTS: Thirteen patients were enrolled. Recruitment was stopped after two patients died of hemorrhagic events. All patients had previously received curative radiotherapy (RT) to nasopharynx/neck (including nine patients who had chemoradiotherapy). Patients received a median of three cycles of sunitinib. One patient was still on sunitinib with stable disease after 24 cycles. Hemorrhagic events occurred in nine patients (64%), including epistaxis in six, hemoptyses in three and hematemesis in two patients. Prior RT to thorax was significantly associated with hemoptyses (P = 0.03). Two patients with local tumor invasion into the carotid sheath developed fatal epistaxis/hematemesis within the first cycle of sunitinib, likely due to internal carotid blowout after tumor shrinkage. CONCLUSIONS:Sunitinib demonstrated modest clinical activity in heavily pretreated NPCpatients. However, the high incidence of hemorrhage from the upper aerodigestive tract in NPCpatients who received prior high-dose RT to the region is of concern. Direct vascular invasion by tumors appeared to increase the risk of serious bleeding.
Authors: Philip Wong; Peter Houghton; David G Kirsch; Steven E Finkelstein; Arta M Monjazeb; Meng Xu-Welliver; Adam P Dicker; Mansoor Ahmed; Bhadrasain Vikram; Beverly A Teicher; C Norman Coleman; Mitchell Machtay; Walter J Curran; Dian Wang Journal: J Natl Cancer Inst Date: 2014-10-18 Impact factor: 13.506
Authors: Kenneth C W Wong; Edwin P Hui; Kwok-Wai Lo; Wai Kei Jacky Lam; David Johnson; Lili Li; Qian Tao; Kwan Chee Allen Chan; Ka-Fai To; Ann D King; Brigette B Y Ma; Anthony T C Chan Journal: Nat Rev Clin Oncol Date: 2021-06-30 Impact factor: 66.675
Authors: B B Y Ma; B C Goh; W T Lim; E P Hui; E H Tan; G de Lima Lopes; K W Lo; L Li; H Loong; N R Foster; C Erlichman; A D King; M K M Kam; S F Leung; K C Chan; A T C Chan Journal: Invest New Drugs Date: 2015-06-19 Impact factor: 3.651