title: Sunitinib as salvage treatment including potent anti-tumor activity in carcinomatous ulcers for patients with multidrug-resistant metastatic breast cancer.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of single-agent sunitinib as salvage treatment in Chinese patients with multidrug-resistant metastatic breast cancer (MBC).
  
  
  RESULTS
  37 patients were enrolled with median age of 48 years. 17 had hormone receptor (HR)-positive tumors, 7 had HER2-positive tumors, and 10 had triple-negative tumors. Among 32 evaluable patients with follow-up, 6 (18.8%) achieved partial response, 14 (43.8%) achieved stable disease, and 11 (34.4%) exhibited tumor shrinkage. The response rate in 9 patients with carcinomatous ulcers was 77.8%. The median progression free survival (PFS) was 8.6 weeks. Patients with a better response had improved overall survival and PFS relative to patients with a worse response (p = 0.007, p < 0.001). Compared with HR-negative tumor, HR-positive tumor had significantly better response to sunitinib (p = 0.035). The most frequent non-hematologic adverse events were fatigue (82.8%) and hypertension (34.5%). Grade 3/4 hematologic toxicity included neutropenia (82.8%) and thrombocytopenia (79.3%). There was no correlation between the clinical response and IHC findings.
  
  
  METHODS
  Patients with MBC who were resistant to multiple salvage regimens (≥ 3 previous chemotherapy lines) were enrolled to receive sunitinib monotherapy. Dosage adjustment was allowed depending on adverse events. 14 patients underwent immunohistochemistry (IHC) testing for VEGF, PDGFR, EGFR and c-KIT.
  
  
  CONCLUSIONS
  Sunitinib salvage treatment provided modest antitumor effect to patients with refractory multidrug-resistant MBC, especially to those with troublesome carcinomatous ulcers. The treatment-related adverse events of sunitinib were manageable through dosage adjustment.
authors: Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Bing
authors: B
authors: Sun
authors: Department of Radiotherapy, Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Xin
authors: X
authors: Zhao
authors: Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Lijuan
authors: L
authors: Ding
authors: Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Xiangying
authors: X
authors: Meng
authors: Department of Radiotherapy, Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Santai
authors: S
authors: Song
authors: Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.|Department of Radiotherapy, Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China.
authors: Shikai
authors: S
authors: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D002277:Carcinoma / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D018432:Drug Resistance, Multiple; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007211:Indoles / Q000494:pharmacology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011758:Pyrroles / Q000494:pharmacology*; D016879:Salvage Therapy / Q000379:methods*; D000077210:Sunitinib; D016896:Treatment Outcome; D014456:Ulcer / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: breast cancer; multidrug resistance; salvage treatment; sunitinib