The use of sunitinib for pancreatic neuroendocrine tumours and metastatic paraganglioma in Weston Park Hospital, Sheffield


Year:

Session type:

Timothy Simmons1, Jonathan Wadsley1
1Weston Park Hospital, Sheffield, UK

Background

Pancreatic neuroendocrine tumours (PNETs) are rare neoplasms of the pancreas. In 2011, Raymond et al published the results of a phase three study of sunitinib at 37.5mg per day for the treatment of PNETs, reporting low toxicity and a survival advantage.

We report our experience of using Sunitinib for PNETs in its first year of use at this major UK cancer centre. Two cases of metastatic paraganglioma have been treated recently with the same regimen, and have been included in this analysis.

Method

All patients treated with sunitinib for this indication at Weston Park were identified. The medical notes were then reviewed to assess the safety and efficacy of Sunitinib.

Results

Notes for nine patients were reviewed. Seven neuroendocrine pancreatic cancer and two metastatic paragangliomas. 5 Male, 4 female, mean age 53 (36 to 63). At the time of analysis, 8/9 were alive.

Efficacy: Sunitinib continues in 4/9 patients, all of whom have had a symptomatic response and there has been a radiological response in two. Where sunitinib has been discontinued, 2 had progressed at the first re-staging scan, one had stable disease after the first scan but progressed at six months. Of the two patients with paraganglioma, one died of pneumonia (not neutropenic) prior to re-staging, and one responded, but sunitinib was stopped due to an aortic aneurism.

Tolerability: Dose reductions made for 3 patients, 2 for thrombocytopenia and one for non-neutropenic infection. Grade 1 hypertension, dermatalogical and GI toxicities were also reported. No treatment was stopped due to toxicity.

Conclusion

Sunitinib, appears to be well tolerated and in this limited case series, and has a response rate comparable to trials. It was well tolerated with few grade 3-4 toxicities, and no deaths attributable to treatment. With only one death as yet, median survival has not been reached.