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IntroductionBrain metastases frequently cause significant morbidity in patients with non-small cell lung cancer (NSCLC). Sunitinib is a multitargeted inhibitor of tyrosine kinase receptors, including vascular endothelial growth factor receptors and platelet-derived growth factor receptors, which has single-agent antitumor activity in refractory NSCLC. This phase II study evaluated the antitumor activity and safety of sunitinib in patients with pretreated NSCLC and irradiated brain metastases.MethodsPatients received sunitinib 37.5 mg on a continuous daily dosing schedule. The primary end point was progression-free survival. Secondary end points included overall survival, patient-reported outcomes, and safety, including risk of intracranial hemorrhage (ICH) associated with focal neurological deficit.ResultsSixty-four patients received sunitinib (median age 61 years), most (83%) had received prior systemic therapy, 63% had adenocarcinoma, and 19% had squamous cell carcinoma; most (55%) were never-smokers. Median progression-free survival was 9.4 weeks (90% confidence interval [CI]: 7.5-13.1), and median overall survival was 25.1 weeks (95% CI: 13.4-35.5). The most common treatment-emergent (all-causality) nonhematologic toxicities (any grade) were fatigue (38%) and decreased appetite and constipation (both 25%). The most common grade 3/4 nonhematologic toxicities were dyspnea (9%) and fatigue (8%). Lymphopenia (20%) and neutropenia (13%) were the most common grade 3/4 hematologic abnormalities. Serious neurologic adverse events occurred in six patients (9%), and none were treatment-related. No cases of ICH were reported.ConclusionsSunitinib administration on a continuous daily dosing schedule in patients with NSCLC and brain metastases was safe and manageable, with no increased risk of ICH.

Original publication

DOI

10.1097/jto.0b013e318219a973

Type

Journal article

Journal

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

Publication Date

07/2011

Volume

6

Pages

1260 - 1266

Addresses

University of Turin, Orbassano, Turin, Italy. silvia.novello@unito.it

Keywords

Humans, Adenocarcinoma, Carcinoma, Large Cell, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Brain Neoplasms, Lung Neoplasms, Pyrroles, Indoles, Antineoplastic Agents, Neoplasm Staging, Treatment Outcome, Cranial Irradiation, Survival Rate, Follow-Up Studies, Adult, Aged, Middle Aged, Female, Male, Chemoradiotherapy, Sunitinib