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Phase II study of sunitinib in Japanese patients with unresectable or metastatic, well-differentiated pancreatic neuroendocrine tumor.

AbstractBACKGROUND:
Pancreatic neuroendocrine tumors (NETs) are rare but are frequently diagnosed at advanced stages and require systemic therapy.
PATIENTS AND METHODS:
This multicenter, open-label, phase II study evaluated sunitinib in Japanese patients with well-differentiated pancreatic NET. Patients received sunitinib 37.5 mg/day on a continuous daily dosing (CDD) schedule. The primary endpoint was clinical benefit rate (CBR; percentage of complete responses [CRs] plus partial responses [PRs] plus stable disease [SD] ≥ 24 weeks). Secondary endpoints included objective response rate (ORR), tumor shrinkage, progression-free survival (PFS) probability, safety, pharmacokinetics, and biomarkers.
RESULTS:
Twelve patients received treatment. The CBR was 75 % (95 % confidence interval [CI], 43-94) and included 6 patients with a PR and 3 with SD. The ORR was 50 % (95 % CI, 21-79). PFS probability was 91 % (95 % CI, 54-99) at 6 months and 71 % (95 % CI, 34-90) at 12 months. Commonly reported treatment-emergent (all-causality), any-grade adverse events included diarrhea (n=10), hand-foot syndrome and hypertension (both n=8), fatigue and headache (both n=7), and neutropenia (n=6). No deaths on study were reported; one death due to disease progression occurred >28 days after end of treatment. Sunitinib on a CDD schedule resulted in sustained drug concentrations without accumulation across cycles. Tumor responses in all 12 patients did not appear to correlate with decreases in chromogranin A levels.
CONCLUSIONS:
Sunitinib 37.5 mg/day on a CDD schedule demonstrated antitumor activity in Japanese patients with unresectable, well-differentiated pancreatic NET. Commonly reported adverse events were consistent with the known safety profile of sunitinib.
AuthorsTetsuhide Ito, Takuji Okusaka, Toshirou Nishida, Kenji Yamao, Hisato Igarashi, Chigusa Morizane, Shunsuke Kondo, Nobumasa Mizuno, Kazuo Hara, Akira Sawaki, Satoshi Hashigaki, Nobuyuki Kimura, Mami Murakami, Emiko Ohki, Richard C Chao, Masayuki Imamura
JournalInvestigational new drugs (Invest New Drugs) Vol. 31 Issue 5 Pg. 1265-74 (Oct 2013) ISSN: 1573-0646 [Electronic] United States
PMID23269537 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Angiogenesis Inhibitors
  • Biomarkers, Tumor
  • Chromogranin A
  • Gastrins
  • Indoles
  • Pyrroles
  • Sunitinib
Topics
  • Adult
  • Aged
  • Angiogenesis Inhibitors (blood, pharmacokinetics, therapeutic use)
  • Asian People
  • Biomarkers, Tumor (blood)
  • Chromogranin A (blood)
  • Female
  • Gastrins (blood)
  • Humans
  • Indoles (blood, pharmacokinetics, therapeutic use)
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neuroendocrine Tumors (blood, drug therapy, pathology)
  • Pancreatic Neoplasms (blood, drug therapy, pathology)
  • Pyrroles (blood, pharmacokinetics, therapeutic use)
  • Sunitinib
  • Treatment Outcome

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