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Learning experiences with sunitinib continuous daily dosing in patients with pancreatic neuroendocrine tumours
Abstract:
Molecular strategies to improve outcomes for patients with pancreatic neuroendocrine tumours (nets) have focused on targeting vascular endothelial growth factor, platelet-derived growth factor, and mtor (the mammalian target of rapamycin). This approach has led to the regulatory approval of two molecularly targeted agents for advanced pancreatic nets: sunitinib, a multi-targeted tyrosine kinase inhibitor, and everolimus, an mtor inhibitor. Initial experience with sunitinib in advanced pancreatic net was gained from the phase iii registration trial, which used a continuous daily dosing (cdd) schedule instead of daily drug administration for 4 consecutive weeks every 6 weeks (schedule 4/2), the approved schedule for advanced renal cell carcinoma (rcc) and gastrointestinal stromal tumour (gist). Clinical experience gained with schedule 4/2 in rcc and gist shows that, using a therapy management approach, patients can start and be maintained on the recommended dose and schedule, thus optimizing treatment outcomes. Here, we discuss challenges that can potentially be faced by physicians who use sunitinib on the cdd schedule, and we use clinical data and real-life clinical experience to present therapy management approaches that support cdd in advanced pancreatic net.
Insights
Sunitinib offers a new treatment option for advanced pancreatic neuroendocrine tumors (pNETs). This review discusses challenges and management strategies for using sunitinib on a continuous daily dosing schedule to optimize patient outcomes.
Area of Science:
- Oncology
- Pharmacology
- Gastroenterology
Background:
- Pancreatic neuroendocrine tumors (pNETs) are rare neoplasms.
- Targeted therapies like sunitinib and everolimus have emerged for advanced pNETs.
- Sunitinib is approved for advanced pNETs, with initial trials using a continuous daily dosing (cdd) schedule.
Purpose of the Study:
- To discuss challenges in using sunitinib on a cdd schedule for advanced pancreatic neuroendocrine tumors.
- To present therapy management approaches supporting the cdd schedule for sunitinib in advanced pNETs.
Main Methods:
- Review of clinical data and real-life clinical experience with sunitinib.
- Analysis of challenges faced by physicians using sunitinib on a cdd schedule.
- Development of therapy management strategies for cdd sunitinib in advanced pNETs.
Main Results:
- Sunitinib is an approved molecularly targeted agent for advanced pancreatic neuroendocrine tumors.
- The continuous daily dosing (cdd) schedule for sunitinib was used in initial trials for advanced pancreatic neuroendocrine tumors.
- Clinical experience suggests that therapy management approaches can optimize outcomes with the cdd schedule.
Conclusions:
- Physicians may face challenges when using sunitinib on a cdd schedule for advanced pancreatic neuroendocrine tumors.
- Effective therapy management strategies are crucial for supporting the cdd schedule of sunitinib.
- Optimizing treatment outcomes in advanced pancreatic neuroendocrine tumors can be achieved through careful management of sunitinib therapy.
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