Researchers from several U.S. and Spanish medical centers have reported that single-agent daily Sutent® (sunitinib) was associated with a 25% disease control rate in patients with previously treated advanced non–small cell lung cancer (NSCLC). The details of this study appeared in the November 4, 2009 issue of the British Journal of Cancer.[1]
Sutent is an oral kinase inhibitor of fms-like tyrosine kinase 3 (Flt3), Kit, vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF) receptors. It produces anticancer effects through these targeted mechanisms that include anti-angiogenesis, as well as direct killing of the cancer cell. Sutent is approved for the treatment of advanced renal cell cancer, as well as for the treatment of gastrointestinal stromal tumors after disease progression on, or intolerance to, Gleevec® (imatinib).
A previous international multicenter trial reported that Sutent has significant single-agent activity in previously-treated advanced NSCLC. This Phase II clinical trial included 63 patients who had failed platinum-based therapy. Patients received 50 mg of Sutent daily for four weeks, followed by two weeks off. The partial response rate was 11%, and 29% had stable disease for at least eight weeks. Side effects included fatigue, nausea, shortness of breath, vomiting, anorexia, and diarrhea. Two patients died of pulmonary hemorrhage, and one patient died of cerebral hemorrhage.
The current study evaluated a continuous dosing of Sutent in 47 patients with advanced NSCLC who had failed other therapies. The partial response rate was 2%, with 23.4% having stable disease for at least eight weeks. Five patients had stable disease for more than six months. Median progression-free survival was 12 weeks, and median overall survival was 37 weeks. The one-year probability of survival was 38%. The toxicity profile appeared to be less than in the previous study.
Comments: Single-agent daily Sutent appears to be well tolerated and palliative for a significant fraction of patients with advanced, refractory NSCLC.
Reference:
[1] Novello S, Seagliotti GV, Rosell R, et al. Phase II study of continuous daily sunitinib dosing in patients with previously treated advanced non-small cell lung cancer. British Journal of Cancer. 2009;101:1543-1548.
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