Phase II trial of concurrent sunitinib and image-guided radiotherapy for oligometastases

Charles C L Tong, Eric C. Ko, Max W. Sung, Jamie A. Cesaretti, Richard G. Stock, Stuart Packer, Kevin Forsythe, Eric M. Genden, Myron Schwartz, K. H Vincent Lau, Matthew Galsky, Junko Ozao-Choy, Shu hsia Chen, Johnny Kao

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Abstract

Background: Preclinical data suggest that sunitinib enhances the efficacy of radiotherapy. We tested the combination of sunitinib and hypofractionated image-guided radiotherapy (IGRT) in a cohort of patients with historically incurable distant metastases. Methods: Twenty five patients with oligometastases, defined as 1-5 sites of active disease on whole body imaging, were enrolled in a phase II trial from 2/08 to 9/10. The most common tumor types treated were head and neck, liver, lung, kidney and prostate cancers. Patients were treated with the recommended phase II dose of 37.5 mg daily sunitinib (days 1-28) and IGRT 50 Gy (days 8-12 and 15-19). Maintenance sunitinib was used in 33% of patients. Median follow up was 17.5 months (range, 0.7 to 37.4 months). Results: The 18-month local control, distant control, progression-free survival (PFS) and overall survival (OS) were 75%, 52%, 56% and 71%, respectively. At last follow-up, 11 (44%) patients were alive without evidence of disease, 7 (28%) were alive with distant metastases, 3 (12%) were dead from distant metastases, 3 (12%) were dead from comorbid illness, and 1 (4%) was dead from treatment-related toxicities. The incidence of acute grade ≥ 3 toxicities was 28%, most commonly myelosuppression, bleeding and abnormal liver function tests. Conclusions: Concurrent sunitinib and IGRT achieves major clinical responses in a subset of patients with oligometastases. Trial Registration: ClinicalTrials.gov NCT00463060.

Original languageEnglish (US)
Article numbere36979
JournalPLoS One
Volume7
Issue number6
DOIs
StatePublished - Jun 27 2012
Externally publishedYes

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Image-Guided Radiotherapy
Radiotherapy
radiotherapy
metastasis
Liver
Toxicity
Neoplasm Metastasis
kidney neoplasms
toxicity
Whole Body Imaging
liver neoplasms
Kidney Neoplasms
Liver Function Tests
liver function
prostatic neoplasms
lung neoplasms
Liver Neoplasms
Head and Neck Neoplasms
Tumors
active sites

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Tong, C. C. L., Ko, E. C., Sung, M. W., Cesaretti, J. A., Stock, R. G., Packer, S., ... Kao, J. (2012). Phase II trial of concurrent sunitinib and image-guided radiotherapy for oligometastases. PLoS One, 7(6), [e36979]. https://doi.org/10.1371/journal.pone.0036979

Phase II trial of concurrent sunitinib and image-guided radiotherapy for oligometastases. / Tong, Charles C L; Ko, Eric C.; Sung, Max W.; Cesaretti, Jamie A.; Stock, Richard G.; Packer, Stuart; Forsythe, Kevin; Genden, Eric M.; Schwartz, Myron; Lau, K. H Vincent; Galsky, Matthew; Ozao-Choy, Junko; Chen, Shu hsia; Kao, Johnny.

In: PLoS One, Vol. 7, No. 6, e36979, 27.06.2012.

Research output: Contribution to journalArticle

Tong, CCL, Ko, EC, Sung, MW, Cesaretti, JA, Stock, RG, Packer, S, Forsythe, K, Genden, EM, Schwartz, M, Lau, KHV, Galsky, M, Ozao-Choy, J, Chen, SH & Kao, J 2012, 'Phase II trial of concurrent sunitinib and image-guided radiotherapy for oligometastases', PLoS One, vol. 7, no. 6, e36979. https://doi.org/10.1371/journal.pone.0036979
Tong, Charles C L ; Ko, Eric C. ; Sung, Max W. ; Cesaretti, Jamie A. ; Stock, Richard G. ; Packer, Stuart ; Forsythe, Kevin ; Genden, Eric M. ; Schwartz, Myron ; Lau, K. H Vincent ; Galsky, Matthew ; Ozao-Choy, Junko ; Chen, Shu hsia ; Kao, Johnny. / Phase II trial of concurrent sunitinib and image-guided radiotherapy for oligometastases. In: PLoS One. 2012 ; Vol. 7, No. 6.
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abstract = "Background: Preclinical data suggest that sunitinib enhances the efficacy of radiotherapy. We tested the combination of sunitinib and hypofractionated image-guided radiotherapy (IGRT) in a cohort of patients with historically incurable distant metastases. Methods: Twenty five patients with oligometastases, defined as 1-5 sites of active disease on whole body imaging, were enrolled in a phase II trial from 2/08 to 9/10. The most common tumor types treated were head and neck, liver, lung, kidney and prostate cancers. Patients were treated with the recommended phase II dose of 37.5 mg daily sunitinib (days 1-28) and IGRT 50 Gy (days 8-12 and 15-19). Maintenance sunitinib was used in 33{\%} of patients. Median follow up was 17.5 months (range, 0.7 to 37.4 months). Results: The 18-month local control, distant control, progression-free survival (PFS) and overall survival (OS) were 75{\%}, 52{\%}, 56{\%} and 71{\%}, respectively. At last follow-up, 11 (44{\%}) patients were alive without evidence of disease, 7 (28{\%}) were alive with distant metastases, 3 (12{\%}) were dead from distant metastases, 3 (12{\%}) were dead from comorbid illness, and 1 (4{\%}) was dead from treatment-related toxicities. The incidence of acute grade ≥ 3 toxicities was 28{\%}, most commonly myelosuppression, bleeding and abnormal liver function tests. Conclusions: Concurrent sunitinib and IGRT achieves major clinical responses in a subset of patients with oligometastases. Trial Registration: ClinicalTrials.gov NCT00463060.",
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AU - Packer, Stuart

AU - Forsythe, Kevin

AU - Genden, Eric M.

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AU - Lau, K. H Vincent

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AU - Ozao-Choy, Junko

AU - Chen, Shu hsia

AU - Kao, Johnny

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