Research Papers:

Sunitinib as salvage treatment including potent anti-tumor activity in carcinomatous ulcers for patients with multidrug-resistant metastatic breast cancer

Bing Sun, Xin Zhao, Lijuan Ding, Xiangying Meng, Santai Song and Shikai Wu _

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Oncotarget. 2016; 7:57894-57902. https://doi.org/10.18632/oncotarget.11082

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Bing Sun1,*, Xin Zhao2,*, Lijuan Ding1, Xiangying Meng1, Santai Song2, Shikai Wu1,2

1Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China

2Department of Radiotherapy, Department of Breast Cancer, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, 100071, China

*These authors contributed equally to this work

Correspondence to:

Shikai Wu, email: [email protected]

Keywords: breast cancer, multidrug resistance, sunitinib, salvage treatment

Received: January 15, 2016     Accepted: July 18, 2016     Published: August 05, 2016


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.

Materials and 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.

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