Safety, efficacy and prognostic analyses of sunitinib in the post-marketing surveillance study of Japanese patients with gastrointestinal stromal tumor.

Abstract

OBJECTIVE:

This study was conducted to expand the sunitinib safety database in Japanese imatinib-resistant/-intolerant gastrointestinal stromal tumor patients. Retrospective analyses investigated common adverse events as potential prognostic markers.

METHODS:

Four hundred and seventy patients who received sunitinib between June 2008 and November 2009 were analyzed for safety, progression-free survival and overall survival; 386 for objective response rate; 88% received sunitinib on Schedule 4/2 starting at 50 mg/day.

RESULTS:

No unexpected safety issues occurred. Grade ≥ 3 adverse events occurred in 70%, most commonly thrombocytopenia (33%), neutropenia (22%) and leukopenia (15%). Objective response rate was 20% (95% confidence interval 16-24). Median progression-free survival was 22.4 weeks (95% confidence interval, 21.7-24.0). The overall survival rate at 24 weeks was 91% (95% confidence interval, 88-94). Higher relative dose intensity (≥70 vs. <70%) during the first 6 weeks and better Eastern Cooperative Oncology Group performance status (0 vs. ≥1) were associated with longer progression-free survival (24.0 vs. 20.1 weeks; P = 0.011; and 24.1 vs. 16.9 weeks; P < 0.001) and higher 24-week overall survival rate (94 vs. 83%; P < 0.001; and 96 vs. 83%; P < 0.001). Increased progression-free survival and overall survival rates were associated with specific adverse events. Cox proportional hazard modeling adjusted for relative dose intensity and performance status established hand-foot syndrome (hazard ratio = 0.636; 95% confidence interval, 0.456-0.888) and leukopenia (hazard ratio = 0.683; 95% confidence interval, 0.492-0.948) occurring within 12 weeks were significantly correlated with increased progression-free survival.

CONCLUSION:

Sunitinib showed good efficacy and tolerable safety. Factors associated with greater efficacy were relative dose intensity, performance status and specific early adverse events.

• Authors: Yoshito Komatsu, Emiko Ohki, Naomi Ueno, Ai Yoshida, Yasuharu Toyoshima, Eiji Ueda, Hiroyuki Houzawa, Kanae Togo, Toshirou Nishida
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 45 Issue 11 Pg. 1016-22 (Nov 2015) ISSN: 1465-3621 [Electronic] England
• PMID: 26373318 (Publication Type: Clinical Trial, Phase IV, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press.

Chemical References

• Antineoplastic Agents
• Indoles
• Pyrroles
• Sunitinib

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Asian People (statistics & numerical data)
• Disease-Free Survival
• Female
• Gastrointestinal Neoplasms (drug therapy)
• Gastrointestinal Stromal Tumors (drug therapy)
• Hand-Foot Syndrome (epidemiology, etiology)
• Humans
• Incidence
• Indoles (administration & dosage, adverse effects, therapeutic use)
• Japan (epidemiology)
• Male
• Middle Aged
• Neutropenia (chemically induced, epidemiology)
• Prognosis
• Proportional Hazards Models
• Pyrroles (administration & dosage, adverse effects, therapeutic use)
• Severity of Illness Index
• Sunitinib
• Thrombocytopenia (chemically induced, epidemiology)
• Treatment Outcome