title: Sunitinib and pancreatic neuroendocrine tumours. More assessment needed.
abstract: There is no standard first-line cytotoxic chemotherapy for patients with metastatic or inoperable well-differentiated pancreatic neuroendocrine tumours. All available regimens have significant toxicity. Sunitinib, a tyrosine kinase inhibitor, has been authorised for oral administration in this situation. Sunitinib has not been compared with cytotoxic regimens. Clinical evaluation is based on a double-blind randomised placebo-controlled trial that was halted prematurely after 171 patients had been treated for a median of about 10 months. During the trial, there were 9 deaths in the sunitinib group versus 21 deaths in the placebo group. The median progression-free survival time was statistically significantly longer with sunitinib than with placebo (11.4 versus 5.5 months), but the results are undermined by methodological issues. Adverse events classified as serious by the investigators (neutropenia, hypertension, palmoplantar erythrodysaesthesia, etc.) occurred in about 13% of patients in the sunitinib group versus 7% of patients in the placebo group. Two patients treated with sunitinib died of heart failure. More assessment of sunitinib is needed. The only available trial, a placebo-controlled study, failed to show whether the benefits outweigh the risks.
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011758:Pyrroles / Q000009:adverse effects / Q000627:therapeutic use*; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D004791:Enzyme Inhibitors; D007211:Indoles; D011758:Pyrroles; D011505:Protein-Tyrosine Kinases; D000077210:Sunitinib