Skip to main content
Erschienen in: Targeted Oncology 6/2020

17.10.2020 | Original Research Article

Sunitinib in Patients with Metastatic Colorectal Cancer (mCRC) with FLT-3 Amplification: Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) Study

verfasst von: Tareq Al Baghdadi, Elizabeth Garrett-Mayer, Susan Halabi, Pam K. Mangat, Patricia Rich, Eugene R. Ahn, Seungjean Chai, Andrew L. Rygiel, Olufunlayo Osayameh, Kaitlyn R. Antonelli, Samiha Islam, Suanna S. Bruinooge, Richard L. Schilsky

Erschienen in: Targeted Oncology | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

TAPUR is a pragmatic, phase II basket study evaluating the antitumor activity of commercially available targeted agents in patients with advanced cancers harboring genomic alterations known to be drug targets. Sunitinib is an oral multikinase inhibitor of FMS-like tyrosine kinase-3 (FLT-3), among other targets. Results from a cohort of patients with metastatic colorectal cancer (mCRC) with FLT-3 amplification treated with sunitinib are reported.

Objective

This study aimed to investigate whether patients with mCRC with FLT-3 amplification would be responsive to sunitinib, an oral multikinase inhibitor.

Methods

Eligible patients received a standard sunitinib dose of 50 mg orally for 4 weeks followed by 2 weeks off. Simon’s two-stage design was used with the primary study endpoint of objective response (OR) or stable disease (SD) at 16 weeks based on Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Secondary endpoints were progression-free survival, overall survival, and safety.

Results

Ten patients were enrolled from November 2016 to April 2018. All patients had mCRC with FLT-3 amplification. No ORs were observed. Although two patients had SD at 16 weeks, one died because of disease progression shortly thereafter and the cohort was closed. A single grade 3 adverse event of diarrhea was reported as possibly related to sunitinib.

Conclusions

Monotherapy with sunitinib does not have clinical activity in patients with mCRC with FLT-3 amplification and should not be prescribed for off-label use. Other treatments should be considered for these patients, including treatments offered in clinical trials.

Clinical Trial registration

NCT02693535 (26 February 2016).
Anhänge
Nur mit Berechtigung zugänglich
Literatur
13.
Zurück zum Zitat Raymond E, Dahan L, Raoul J-L, Bang Y-J, Borbath I, Lombard-Bohas C, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011;364(6):501–13.CrossRef Raymond E, Dahan L, Raoul J-L, Bang Y-J, Borbath I, Lombard-Bohas C, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011;364(6):501–13.CrossRef
17.
Zurück zum Zitat Al Baghdadi T, Halabi S, Garrett-Mayer E, Mangat PK, Ahn ER, Sahai V, et al. Palbociclib in patients with pancreatic and biliary cancer with CDKN2A alterations: results from the targeted agent and profiling utilization registry study. JCO Precis Oncol. 2019;3:1–8. https://doi.org/10.1200/po.19.00124.CrossRef Al Baghdadi T, Halabi S, Garrett-Mayer E, Mangat PK, Ahn ER, Sahai V, et al. Palbociclib in patients with pancreatic and biliary cancer with CDKN2A alterations: results from the targeted agent and profiling utilization registry study. JCO Precis Oncol. 2019;3:1–8. https://​doi.​org/​10.​1200/​po.​19.​00124.CrossRef
22.
Zurück zum Zitat Carow CE, Levenstein M, Kaufmann SH, Chen J, Amin S, Rockwell P, et al. Expression of the hematopoietic growth factor receptor FLT3 (STK-1/Flk2) in human leukemias. Blood. 1996;87(3):1089–96.CrossRef Carow CE, Levenstein M, Kaufmann SH, Chen J, Amin S, Rockwell P, et al. Expression of the hematopoietic growth factor receptor FLT3 (STK-1/Flk2) in human leukemias. Blood. 1996;87(3):1089–96.CrossRef
26.
Zurück zum Zitat O’Farrell A-M, Foran JM, Fiedler W, Serve H, Paquette RL, Cooper MA, et al. An innovative phase i clinical study demonstrates inhibition of FLT3 phosphorylation by SU11248 in acute myeloid leukemia patients. Clin Cancer Res. 2003;9(15):5465–76.PubMed O’Farrell A-M, Foran JM, Fiedler W, Serve H, Paquette RL, Cooper MA, et al. An innovative phase i clinical study demonstrates inhibition of FLT3 phosphorylation by SU11248 in acute myeloid leukemia patients. Clin Cancer Res. 2003;9(15):5465–76.PubMed
27.
28.
Zurück zum Zitat Fiedler W, Kayser S, Kebenko M, Janning M, Krauter J, Schittenhelm M, et al. A phase I/II study of sunitinib and intensive chemotherapy in patients over 60 years of age with acute myeloid leukaemia and activating FLT3 mutations. Br J Haematol. 2015;169(5):694–700. https://doi.org/10.1111/bjh.13353.CrossRefPubMed Fiedler W, Kayser S, Kebenko M, Janning M, Krauter J, Schittenhelm M, et al. A phase I/II study of sunitinib and intensive chemotherapy in patients over 60 years of age with acute myeloid leukaemia and activating FLT3 mutations. Br J Haematol. 2015;169(5):694–700. https://​doi.​org/​10.​1111/​bjh.​13353.CrossRefPubMed
35.
Zurück zum Zitat Braxton DR, Zhang R, Morrissette JD, Loaiza-Bonilla A, Furth EE. Clinicopathogenomic analysis of mismatch repair proficient colorectal adenocarcinoma uncovers novel prognostic subgroups with differing patterns of genetic evolution. Int J Cancer. 2016;139(7):1546–56. https://doi.org/10.1002/ijc.30196.CrossRefPubMed Braxton DR, Zhang R, Morrissette JD, Loaiza-Bonilla A, Furth EE. Clinicopathogenomic analysis of mismatch repair proficient colorectal adenocarcinoma uncovers novel prognostic subgroups with differing patterns of genetic evolution. Int J Cancer. 2016;139(7):1546–56. https://​doi.​org/​10.​1002/​ijc.​30196.CrossRefPubMed
36.
Zurück zum Zitat Hasegawa H, Taniguchi H, Kato T, Fujii S, Ebi H, Shiozawa M et al. Prognostic and predictive impact on FMS-like tyrosine kinase 3 (FLT3) amplification in patients with metastatic colorectal cancer. Annals of Oncology. 2019;30(Supplement_5):v240. https://doi.org/10.1093/annonc/mdz246.113. Hasegawa H, Taniguchi H, Kato T, Fujii S, Ebi H, Shiozawa M et al. Prognostic and predictive impact on FMS-like tyrosine kinase 3 (FLT3) amplification in patients with metastatic colorectal cancer. Annals of Oncology. 2019;30(Supplement_5):v240. https://​doi.​org/​10.​1093/​annonc/​mdz246.​113.
41.
Zurück zum Zitat Perl AE, Martinelli G, Cortes JE, Neubauer A, Berman E, Paolini S, et al. Gilteritinib or chemotherapy for relapsed or refractory FLT3-mutated AML. N Engl J Med. 2019;381(18):1728–40.CrossRef Perl AE, Martinelli G, Cortes JE, Neubauer A, Berman E, Paolini S, et al. Gilteritinib or chemotherapy for relapsed or refractory FLT3-mutated AML. N Engl J Med. 2019;381(18):1728–40.CrossRef
Metadaten
Titel
Sunitinib in Patients with Metastatic Colorectal Cancer (mCRC) with FLT-3 Amplification: Results from the Targeted Agent and Profiling Utilization Registry (TAPUR) Study
verfasst von
Tareq Al Baghdadi
Elizabeth Garrett-Mayer
Susan Halabi
Pam K. Mangat
Patricia Rich
Eugene R. Ahn
Seungjean Chai
Andrew L. Rygiel
Olufunlayo Osayameh
Kaitlyn R. Antonelli
Samiha Islam
Suanna S. Bruinooge
Richard L. Schilsky
Publikationsdatum
17.10.2020
Verlag
Springer International Publishing
Erschienen in
Targeted Oncology / Ausgabe 6/2020
Print ISSN: 1776-2596
Elektronische ISSN: 1776-260X
DOI
https://doi.org/10.1007/s11523-020-00752-8

Weitere Artikel der Ausgabe 6/2020

Targeted Oncology 6/2020 Zur Ausgabe

Acknowledgement to Referees

Acknowledgement to Referees

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.