Purpose: This phase II, open-label, multicenter study assessed the oral, multitargeted, tyrosine kinase inhibitor sunitinib in patients with advanced gastric or gastroesophageal junction adenocarcinoma who had received prior chemotherapy. Experimental design. Patients received sunitinib 50 mg/day on Schedule 4/2 (4 weeks on treatment, followed by 2 weeks off treatment). The primary endpoint was objective response rate; secondary endpoints included clinical benefit rate, duration of response, progression-free survival (PFS), overall survival (OS), pharmacokinetics, pharmacodynamics, safety and tolerability, and quality of life. Results: Of 78 patients enrolled, most had gastric adenocarcinoma (93.6%) and metastatic disease (93.6%). All were evaluable for safety and efficacy. Two patients (2.6%) had partial responses and 25 patients (32.1%) had a best response of stable disease for ≥6 weeks. Median PFS was 2.3 months (95% confidence interval [CI], 1.6-2.6 months) and median OS was 6.8 months (95% CI, 4.4-9.6 months). Grade ≥3 thrombocytopenia and neutropenia were reported in 34.6% and 29.4% of patients, respectively, and the most common non-hematologic adverse events were fatigue, anorexia, nausea, diarrhea, and stomatitis. Pharmacokinetics of sunitinib and its active metabolite were consistent with previous reports. There were no marked associations between baseline soluble protein levels, or changes from baseline, and measures of clinical outcome. Conclusions: The progression-delaying effect and manageable toxicity observed with sunitinib in this study suggest that although single-agent sunitinib has insufficient clinical value as second-line treatment for advanced gastric cancer, its role in combination with chemotherapy merits further study.
Bibliographical noteFunding Information:
Editorial assistance was provided by Jenni Macdougall of ACUMED® (Tytherington, UK) and was funded by Pfizer Inc. The authors also acknowledge data analysis from Charles Harmon (an employee of Atrium Inc., and a paid consultant to Pfizer Inc.) and Zhixiao Wang (Outcomes Research, Pfizer Oncology, New York, NY, USA), and input and review of the manuscript from Richard Chao, Darrel Cohen, and Kristen Letrent (Pfizer Oncology, La Jolla, CA, USA, and New York, NY, USA). This trial was sponsored by Pfizer Inc.
Conflict of interest Y-J Bang has received commercial research support, honoraria from speakers bureau, and compensation for consultation from Pfizer. Y-K Kang has received honoraria from speakers bureau from Pfizer. HC Chung has received research funding from Pfizer for the clinical trial. T Doi has received compensation for consultation for Pfizer’s Sutent GIST program. JM Tursi, MJ Lechuga, DR Lu, and A Ruiz-Garcia are employees of Pfizer. JM Tursi, MJ Lechuga, and DR Lu own stock in Pfizer. A Ruiz-Garcia owns restricted stocks in Pfizer. A Sobrero participated as chairman to advisory boards for Pfizer in 2009 and 2008. WK Kang, N Boku, JS Chen, Y Sun, L Shen, SK Qin, and WT Ng have nothing to disclose.
All Science Journal Classification (ASJC) codes
- Pharmacology (medical)