Enter your Email address:
Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
You currently have no recent searches
Strosberg, Jonathan MD; Campos, Tiffany; Kvols, Larry MD
H. Lee Moffitt Cancer Center, Tampa, FL.
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) frequently metastasize to the liver. Hepatic artery embolization is an important therapeutic modality in patients with liver-predominant metastases. NETs are highly vascular and are known to express both VEGF and VEGFR. We hypothesize that administration of sunitinib malate, a VEGFR inhibitor, following hepatic artery embolizaiton will delay tumor revascularization and extend progression-free survival.
Patients with differentiated GEP-NETs metastasized to the liver underwent a series of selective arterial embolizations followed by sunitinib (one week after each embolization, and continued until disease progression or up to a maximum of 8 cycles). Radiographic response rates were assessed by RECIST criteria.
Fourteen patients have been enrolled to date. Primary tumor sites include the small-intestine (11), rectum (2), and pancreas (1). The initial starting dose of sunitinib was 50 mg, however all five patients enrolled at this dose required dose reductions. Consequently, the starting dose was reduced to 37.5 mg resulting in improved tolerance. Nine patients (64%) had a partial radiographic response (PR), four patients (28%) had stable disease (SD) and one patient (7%) had progressive disease (PD) as best response. At a median follow-up of 8 months, progression-free survival (PFS) is 79%. Seven grade 3 toxicity events were reported in six patients. Serum VEGF levels increased byan average of 107 pg/ml (88%) after embolizations.
Hepatic artery embolization is a highly active treatment option for patients with metastatic GEP-NETs. Embolization stimulates release of VEGF into the circulation. Sunitinib can be safely administered following hepatic artery embolization at a dose of 37.5 mg. Longer follow-up is needed to assess whether this strategy results in prolonged time to tumor progression.
© 2010 Lippincott Williams & Wilkins, Inc.
Colleague's E-mail is Invalid
Your Name: (optional)
Separate multiple e-mails with a (;).
Thought you might appreciate this item(s) I saw at Pancreas.
Send a copy to your email
Your message has been successfully sent to your colleague.
Some error has occurred while processing your request. Please try after some time.
An Existing Folder
A New Folder
The item(s) has been successfully added to "".
Login with your LWW Journals username and password.
Username or Email:
Enter and submit the email address you registered with. An email with instructions to reset your password will be sent to that address.
Link to reset your password has been sent to specified email address.
What does "Remember me" mean?
By checking this box, you'll stay logged in until you logout. You'll get easier access to your articles, collections,
media, and all your other content, even if you close your browser or shut down your
To protect your most sensitive data and activities (like changing your password),
we'll ask you to re-enter your password when you access these services.
What if I'm on a computer that I share with others?
If you're using a public computer or you share this computer with others, we recommend
that you uncheck the "Remember me" box.
Save my selection
Article Level Metrics