Sunitinib for the treatment of metastatic paraganglioma and vasoactive intestinal polypeptide-producing tumor (VIPoma)

Pancreas. 2013 Mar;42(2):348-52. doi: 10.1097/MPA.0b013e31825c53fa.

Abstract

Objectives: Gastroenteropancreatic neuroendocrine tumors (NETs) are rare tumors of the endocrine and nervous systems. Whereas early surgical resection can significantly reduce tumor mass, there are few data available concerning the control of hormonal secretion and associated symptoms. Studies have shown that the tyrosine kinase inhibitor sunitinib significantly prolongs progression-free survival in patients with pancreatic NETs. Here, we present 2 case reports of sunitinib in patients with different types of NETs.

Methods: The patients were a 12-year-old boy with metastatic vasoactive intestinal polypeptide-producing tumor (VIPoma) and a 70-year-old woman with metastatic paraganglioma/NET. Both were treated in an outpatient clinical setting. Sunitinib was titrated to 37.5 mg on a continuous daily dosing schedule in the patient with VIPoma, and the dose was 50 mg/d (4 weeks on, 2 weeks off) in the patient with the paraganglioma/NET.

Results: The patient with the paraganglioma/NET had a confirmed complete radiographic response and the patient with VIPoma had a confirmed partial response (Response Evaluation Criteria in Solid Tumors). In both patients, improvements were observed in biochemical tumor markers, clinical responses, and quality of life.

Conclusions: In these patients, sunitinib reduced biochemical markers and stabilized or reduced tumor bulk and may therefore be a potential therapeutic option for these tumor types.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Neoplasms / blood
  • Abdominal Neoplasms / drug therapy*
  • Abdominal Neoplasms / enzymology
  • Abdominal Neoplasms / pathology
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Biomarkers, Tumor / blood
  • Child
  • Drug Administration Schedule
  • Female
  • Humans
  • Indoles / administration & dosage*
  • Liver Neoplasms / blood
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / enzymology
  • Liver Neoplasms / secondary
  • Lung Neoplasms / blood
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / enzymology
  • Lung Neoplasms / secondary
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Male
  • Pancreatic Neoplasms / blood
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / enzymology
  • Pancreatic Neoplasms / pathology
  • Paraganglioma / blood
  • Paraganglioma / drug therapy*
  • Paraganglioma / enzymology
  • Paraganglioma / secondary
  • Protein Kinase Inhibitors / administration & dosage*
  • Pyrroles / administration & dosage*
  • Sunitinib
  • Time Factors
  • Treatment Outcome
  • Vipoma / blood
  • Vipoma / drug therapy*
  • Vipoma / enzymology
  • Vipoma / secondary

Substances

  • Antineoplastic Agents
  • Biomarkers, Tumor
  • Indoles
  • Protein Kinase Inhibitors
  • Pyrroles
  • Sunitinib