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Reuters Health Information (2007-10-25): Sunitinib shows promise against advanced hepatocellular carcinoma

Drug & Device Development

Sunitinib shows promise against advanced hepatocellular carcinoma

Last Updated: 2007-10-25 13:34:37 -0400 (Reuters Health)

NEW YORK (Reuters Health) - New research reported at a cancer conference suggests that sunitinib, a receptor tyrosine kinase inhibitor approved for use in kidney and stomach cancers, may also be a useful treatment for advanced hepatocellular carcinoma (HCC), a disease with a poor prognosis.

"We have tested a novel agent that targets multiple pathways of cancer cells," lead author Dr. Andrew X. Zhu, from Massachusetts General Hospital in Boston, told Reuters Health. "Sunitinib has overlapping (effects) but a different spectrum of target inhibition compared with other agents tested in HCC, i.e. sorafenib."

Dr. Zhu presented his teams findings Tuesday at the AACR-NCI-EORTC International Conference in San Francisco. The results provide "preliminary evidence that single agent sunitinib has modest antitumor activity in HCC, which was what we were hoping to achieve," he added.

In a phase II, single-arm study, the researchers assessed the efficacy, safety, and changes in angiogenic markers in 30 patients treated with sunitinib.

Ten patients showed stabilization of their malignancy for 3 months or longer and one patient had a partial remission. The overall progression-free survival period was 4 months.

Sunitinib was generally well tolerated, but between 3% and 20% of patients experienced a grade 3 or 4 toxicity, the report indicates.

Hepatocellular carcinoma is known to be difficult to treat due to extensive vascular support. In this regard, the investigators found that levels of VEGFR2, a key angiogenic factor, fell in most patients and a 38% reduction in tumor vessel permeability was noted as well. Furthermore, a change in the ratio of circulating endothelial cells and progenitor cells suggested that sunitinib was, in fact, targeting relevant angiogenesis pathways.

"We are testing more targeted agents in advanced HCC and hopefully more of these agents (will) prove to be beneficial to patients suffering from this devastating cancer. Until the right study is performed and the data available, we should not use these agents off clinical trials in clinical practice," Dr. Zhu emphasized.

He added that in a future study it will be important to compare the efficacy and tolerability of sunitinib with that of sorafenib.

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