Sunitinib malate in solitary fibrous tumor (SFT)

Ann Oncol. 2012 Dec;23(12):3171-3179. doi: 10.1093/annonc/mds143. Epub 2012 Jun 17.

Abstract

Background: To report on sunitinib activity in a retrospective series of 35 solitary fibrous tumor (SFT) treated at a single institution.

Patients and methods: From April 2008, 35 patients with progressive advanced SFT (male/female: 20/15; mean age: 58 years; meningeal/extrameningeal: 6/29; locally advanced/metastatic: 15/20; prior chemotherapy: 25) were treated, on an individual use basis, with continuous-dosing sunitinib 37.5 mg/day. Platelet-derived growth factor receptor beta (PDGFRB) and vascular endothelial growth factor receptor 2 (VEGFR2) status were assessed by immunohistochemistry and, in a subgroup of patients, by real time PCR.

Results: Thirty-one patients were assessable for response by RECIST (one early death; three early interruptions). Best responses were 2 partial response (PR), 16 stable disease, 13 progressive disease. A <30% decrease in size was observed in three patients. Fourteen of 29 patients assessable by Choi criteria had a PR. Median progression-free survival by RECIST was 6 months (range 1-22). In two of six patients, resistance to sunitinib was overcome by increasing sunitinib to 50 mg/day. PDGFRB and/or VEGFR2 were positive in all cases and not predictive of response; a less aggressive morphology corresponded to an increased response rate (53% PR by Choi in the malignant SFT, 20% PR in the pleomorphic/dedifferentiated SFT).

Conclusions: Sunitinib is active in SFT. Response can be long-lasting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / therapeutic use
  • Antigens, CD34 / metabolism
  • Antineoplastic Agents / therapeutic use
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Indoles / therapeutic use*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Proto-Oncogene Proteins c-bcl-2 / metabolism
  • Pyrroles / therapeutic use*
  • Receptor, Platelet-Derived Growth Factor beta / metabolism
  • Retrospective Studies
  • Solitary Fibrous Tumors / drug therapy*
  • Solitary Fibrous Tumors / mortality*
  • Sunitinib
  • Treatment Outcome
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism

Substances

  • Angiogenesis Inhibitors
  • Antigens, CD34
  • Antineoplastic Agents
  • Indoles
  • Proto-Oncogene Proteins c-bcl-2
  • Pyrroles
  • Receptor, Platelet-Derived Growth Factor beta
  • Vascular Endothelial Growth Factor Receptor-2
  • Sunitinib