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The current status and evolving role of sunitinib in non-small cell lung cancer

Mark A Socinski1

  • 1Multidisciplinary Thoracic Oncology Program, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina 27599-7305, USA. socinski@med.unc.edu

Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer
|June 27, 2008
PubMed

Insights

Sunitinib showed limited efficacy in previously treated non-small cell lung cancer (NSCLC) patients. Further trials are evaluating its use in combination therapy and as maintenance treatment for advanced NSCLC.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Sunitinib is a small molecule, multitargeted receptor kinase inhibitor.
  • It is approved for renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumors.
  • Its activity has been explored in other solid tumors, including non-small cell lung cancer (NSCLC).

Purpose of the Study:

  • To evaluate the efficacy and safety of sunitinib in previously treated non-small cell lung cancer (NSCLC) patients.
  • To explore different dosing schedules and their impact on outcomes.
  • To assess the potential role of sunitinib in combination therapies for NSCLC.

Main Methods:

  • Phase II trial involving previously treated NSCLC patients.
  • Two dosing schedules were investigated: 50 mg daily for 4/6 weeks and a continuous 37.5 mg daily schedule.
  • Efficacy was measured by response rate, stable disease rate, time to disease progression, and overall survival.
  • Toxicity profiles were monitored.

Main Results:

  • The initial trial (50 mg daily) showed an 11.1% response rate and 26.8% stable disease, with median progression-free survival of 12.0 weeks.
  • The subsequent trial (37.5 mg continuous) reported a 2.1% response rate and 19.X% stable disease, with median progression-free survival of 12.3 weeks.
  • Principal toxicities included fatigue, pain, nausea, and hypertension; hemorrhagic deaths were reported in the initial trial.
  • Toxicities were generally less frequent with the continuous dosing schedule.

Conclusions:

  • Sunitinib demonstrated limited single-agent activity in previously treated NSCLC patients.
  • The continuous dosing schedule appeared to have a more favorable toxicity profile.
  • Sunitinib is under investigation in combination regimens and as maintenance therapy for advanced NSCLC, with results eagerly awaited.

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