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Ref Type Journal Article
PMID (31105270)
Authors O'Kane GM, Ezzat S, Joshua AM, Bourdeau I, Leibowitz-Amit R, Olney HJ, Krzyzanowska M, Reuther D, Chin S, Wang L, Brooks K, Hansen AR, Asa SL, Knox JJ
Title A phase 2 trial of sunitinib in patients with progressive paraganglioma or pheochromocytoma: the SNIPP trial.
Journal British journal of cancer
Vol 120
Issue 12
Date 2019 06
URL
Abstract Text Pheochromocytoma (PCC) and paraganglioma (PGL) are uncommon neoplasms with high morbidity in advanced stages. Effective systemic treatments are limited.A multisite phase 2 trial evaluated sunitinib in patients with progressive PCC/PGL. Patients received 50 mg orally for 4-6 weeks.Between May 2009 and May 2016, 25 patients were enroled. The median age was 50 years and 56% were male. Three patients (12%) received prior chemotherapy and 16 (64%) prior surgery. The DCR was 83% (95% CI: 61-95%) and median PFS 13.4 (95% CI: 5.3-24.6) months. Of 23 evaluable patients, 3 (13%) with germline mutations (SDHA, SDHB, RET) achieved a PR. The patient with mutated RET and MEN2A remains on treatment after 64 cycles. The median time on treatment was 12.4 (1-88.0) months. Grade 3 or 4 toxicities were as expected and manageable; fatigue (16%) and thrombocytopenia (16%) were most common. One patient with grade 3 hypertension and 2 with grade 3 cardiac events discontinued treatment.Although the primary endpoint of disease control was met, the overall response rate of sunitinib was low in unselected patients with progressive PCC/PGL. Patients with germline variants in RET or in the subunits of SDH may derive greatest benefit.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
Unknown unknown paraganglioma not applicable Sunitinib Phase II Actionable In a Phase II trial (SNIPP), Sutent (sunitinib) treatment in patients with paraganglioma (PGL, n=11) or pheochromocytoma (PCC, n=14) resulted in an overall response rate of 13% (3/23), including partial responses in one PGL patient and two PCC patients, a disease control rate of 83% (19/23), and median progression-free survival of 13.4 months (PMID: 31105270). 31105270
RET mutant pheochromocytoma predicted - sensitive Sunitinib Case Reports/Case Series Actionable In a Phase II trial (SNIPP), a patient with pheochromocytoma harboring a RET mutation achieved a partial response to treatment with Sutent (sunitinib), and demonstrated a 64% reduction in tumor volume and has remained on treatment for over 7 years (PMID: 31105270). 31105270
Unknown unknown pheochromocytoma not applicable Sunitinib Phase II Actionable In a Phase II trial (SNIPP), Sutent (sunitinib) treatment in patients with pheochromocytoma (PCC, n=14) or paraganglioma (PGL, n=11) resulted in an overall response rate of 13% (3/23), including partial responses in two PCC patients and one PGL patient, a disease control rate of 83% (19/23), and median progression-free survival of 13.4 months (PMID: 31105270). 31105270