Department of Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Department of Molecular Oncology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
J Cancer Res Clin Oncol. 2019 Aug;145(8):2097-2104. doi: 10.1007/s00432-019-02947-7. Epub 2019 May 30.
Because it is unknown whether adjusting the dose of sunitinib can benefit patients with pancreatic neuroendocrine neoplasms (Pan-NENs), this retrospective study examined maximum tumor shrinkage rates and prognoses in patients with and without low doses of sunitinib administration.
Eighty-seven patients with metastatic and unresectable neoplasms, treated with sunitinib for > 1 month, were divided into a low-dose (LD) or high-dose (HD) group. The tumor response rates were investigated over time using computed tomography according to the response evaluation criteria in solid tumors criteria.
The LD and HD groups included 42 and 45 patients, respectively. There were no differences in baseline characteristics (tumor size, Ki-67 index, mitosis, and differentiation) between the two groups. Progressive disease (PD), stable disease (SD), and partial response (PR) were observed in 16.7, 54.8, and 28.6% of patients in the LD group, respectively, and in 13.3, 60, and 26.7% of patients in the HD group, respectively. There were no differences in tumor shrinkage rates between the two groups (p = 0.87). The 3-year progression-free survival rates for the LD and HD groups were 2.4% and 2.3%, respectively (p = 0.67), and the 3-year overall survival rates were 57.9% and 70.5%, respectively (p = 0.76). The occurrence of adverse events was similar between the two groups (61.9% vs. 60.0%, p > 0.95).
Dose reduction of sunitinib did not alter tumor shrinkage rates or prognoses for patients with advanced Pan-NENs.
由于尚不清楚调整舒尼替尼剂量是否能使胰腺神经内分泌肿瘤（Pan-NENs）患者获益，本回顾性研究旨在检查低剂量舒尼替尼治疗与未接受低剂量舒尼替尼治疗患者的最大肿瘤退缩率和预后。
87 例转移性和不可切除的神经内分泌肿瘤患者接受舒尼替尼治疗>1 个月，将其分为低剂量（LD）组或高剂量（HD）组。根据实体瘤反应评价标准，采用 CT 定期评估肿瘤反应率。
LD 组和 HD 组分别包括 42 例和 45 例患者。两组患者的基线特征（肿瘤大小、Ki-67 指数、有丝分裂和分化）无差异。LD 组分别有 16.7%、54.8%和 28.6%的患者出现疾病进展（PD）、稳定疾病（SD）和部分缓解（PR），HD 组分别有 13.3%、60%和 26.7%的患者出现 PD、SD 和 PR。两组患者的肿瘤退缩率无差异（p=0.87）。LD 组和 HD 组的 3 年无进展生存率分别为 2.4%和 2.3%（p=0.67），3 年总生存率分别为 57.9%和 70.5%（p=0.76）。两组患者不良事件的发生情况相似（61.9% vs. 60.0%，p>0.95）。
对于晚期 Pan-NENs 患者，减少舒尼替尼的剂量并未改变肿瘤退缩率和预后。
