Safety and efficacy of sunitinib in patients with advanced hepatocellular carcinoma: an open-label, multicentre, phase II study

Sandrine Faivre, Eric Raymond, Eveline Boucher, Jean Douillard, Ho Y. Lim, Jun S. Kim, Magaly Zappa, Silvana Lanzalone, Xun Lin, Samuel DePrimo, Charles Harmon, Ana Ruiz-Garcia, Maria J. Lechuga, Ann Lii Cheng

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235 Citations (Scopus)

Abstract

Background: Hepatocellular carcinoma (HCC) tumour spread is partly dependent on neoangiogenesis. In this open-label, multicentre, phase II trial done in Europe and Asia, sunitinib, a multitargeted tyrosine-kinase inhibitor with anti-angiogenic properties, was assessed in patients with advanced unresectable HCC. Methods: Between February and July, 2006, eligible patients were enrolled and treated with repeated cycles of oral sunitinib (50 mg/day for 4 weeks, followed by 2 weeks off treatment). The primary endpoint of this Simon two-stage phase II trial was objective response rate according to Response Evaluation Criteria in Solid Tumours (RECIST) criteria, with an expected response rate of 15%. This trial is registered with ClinicalTrials.gov, number NCT00247676. Findings: Of 37 patients enrolled, one (2·7%) patient experienced a confirmed partial response, giving an overall objective response rate of 2·7% (95% CI 0·1-14·2); on the basis of this, the trial did not proceed to the second stage. 13 (35%) of 37 patients achieved stable disease for over 3 months. Commonly observed grade 3 and 4 adverse events included thrombocytopenia (14 of 37; 37·8%), neutropenia (nine of 37; 24·3%), asthenia (five of 37; 13·5%), hand-foot syndrome (four of 37; 10·8%), and anaemia (four of 37; 10·8%). There were four deaths among the 37 patients (10·8%) that were possibly related to treatment. Interpretation: Sunitinib showed pronounced toxicities at a dose of 50 mg/day in patients with unresectable HCC. The response rate was low, and the study did not meet the primary endpoint based on RECIST criteria. Funding: Pfizer Oncology.

Original languageEnglish
Pages (from-to)794-800
Number of pages7
JournalThe Lancet Oncology
Volume10
Issue number8
DOIs
Publication statusPublished - 2009 Aug
Externally publishedYes

ASJC Scopus subject areas

  • Oncology

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    Faivre, S., Raymond, E., Boucher, E., Douillard, J., Lim, H. Y., Kim, J. S., Zappa, M., Lanzalone, S., Lin, X., DePrimo, S., Harmon, C., Ruiz-Garcia, A., Lechuga, M. J., & Cheng, A. L. (2009). Safety and efficacy of sunitinib in patients with advanced hepatocellular carcinoma: an open-label, multicentre, phase II study. The Lancet Oncology, 10(8), 794-800. https://doi.org/10.1016/S1470-2045(09)70171-8