Sunitinib Active in Platinum-Refractory Thymic Carcinoma
In a phase II study reported in The Lancet Oncology, Thomas et al found that sunitinib (Sutent) was active in patients with platinum-refractory thymic carcinoma.
Study Details
In the open-label study, 23 evaluable patients with thymic carcinoma and 16 with thymoma who had disease progression after at least one previous platinum regimen were treated between May 2012 and October 2013 with sunitinib 50 mg in 6-week cycles consisting of 4 weeks on/2 weeks off treatment until tumor progression or unacceptable toxicity. The primary endpoint was investigator-assessed best tumor response.
Response Rates
Median follow-up on trial was 17 months. Among the 23 patients with thymic carcinoma, 6 (26%, 95% confidence interval [CI] = 10.2%–48.4%) had a partial response, 15 (65%) had stable disease, and 2 (9%) had disease progression. Median time to response for the six patients with partial response was 5.6 months (range = 2.7–13.8 months), and median duration of response was 16.4 months (range = 1.4–16.4 months). Of the 16 patients with thymoma, 1 (6%, 95% CI = 0.2%–30.2%) had a partial response, 12 (75%) had stable disease, and 3 (19%) had disease progression.
Toxicity
The most common grade 3 or 4 treatment-related adverse events were lymphocytopenia (20%), fatigue (20%), and oral mucositis (20%). Decreased left-ventricular ejection fraction was observed in 13% of patients (grade 3 in 8%). One patient died of an adverse event considered possibly related to treatment (cardiac arrest).
The investigators concluded: “Sunitinib is active in previously treated patients with thymic carcinoma. Further studies are needed to identify potential biomarkers of activity.”
Giuseppe Giaccone, MD, of Georgetown Lombardi Comprehensive Cancer Center, is the corresponding author for The Lancet Oncology article.
The study was funded by the National Cancer Institute. The study authors reported no potential conflicts of interest.
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