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From: Steve on 3 Aug 2008 01:45
http://www.ncbi.nlm.nih.gov/pubmed/18612155?ordinalpos=37&itool=EntrezSystem
2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

J Clin Oncol. 2008 Jul 10;26(20):3403-10. Links

Activity of sunitinib in patients with advanced neuroendocrine tumors.

Kulke MH, Lenz HJ, Meropol NJ, Posey J, Ryan DP, Picus J, Bergsland E,
Stuart K, Tye L, Huang X, Li JZ, Baum CM, Fuchs CS.
Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA.

PURPOSE: Standard cytotoxic chemotherapy has limited efficacy in metastatic
neuroendocrine tumor patients. Neuroendocrine tumors express vascular
endothelial growth factor (VEGF) and its receptor (VEGFR). Sunitinib malate,
an oral tyrosine kinase inhibitor, has activity against VEGFRs as well as
platelet-derived growth factor receptors, stem-cell factor receptor, glial
cell line-derived neurotrophic factor, and FMS-like tyrosine kinase-3. We
evaluated the efficacy of sunitinib in a two-cohort, phase II study of
advanced carcinoid and pancreatic neuroendocrine tumor patients. PATIENTS
AND METHODS: Patients were treated with repeated 6-week cycles of oral
sunitinib (50 mg/d for 4 weeks, followed by 2 weeks off treatment). Patients
were observed for response, survival, and adverse events. Patient-reported
outcomes were assessed. RESULTS: Among 109 enrolled patients, 107 received
sunitinib (carcinoid, n = 41; pancreatic endocrine tumor, n = 66). Overall
objective response rate (ORR) in pancreatic endocrine tumor patients was
16.7% (11 of 66 patients), and 68% (45 of 66 patients) had stable disease
(SD). Among carcinoid patients, ORR was 2.4% (one of 41 patients), and 83%
(34 of 41 patients) had SD. Median time to tumor progression was 7.7 months
in pancreatic neuroendocrine tumor patients and 10.2 months in carcinoid
patients. One-year survival rate was 81.1% in pancreatic neuroendocrine
tumor patients and 83.4% in carcinoid patients. No significant differences
from baseline in patient-reported quality of life or fatigue were observed
during treatment. CONCLUSION: Sunitinib has antitumor activity in pancreatic
neuroendocrine tumors; its activity against carcinoid tumors could not be
definitively determined in this nonrandomized study. Randomized trials of
sunitinib in patients with neuroendocrine tumors are warranted.


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