Abstract
Sunitinib, a molecular-targeted therapy, is a potential new treatment strategy for malignant pheochromocytoma. However, because of the rarity of malignant pheochromocytoma and the consequent limited number of patients available for clinical study, there is no good evidence of the efficacy of sunitinib for malignant pheochromocytoma. The present report describes our experience with sunitinib for refractory malignant pheochromocytoma. Two patients were treated with sunitinib at a standard dose (50 mg daily; 4 weeks on, 2 weeks off) after cyclophosphamide/vinblastine/dacarbazine chemotherapy, because vascular endothelial growth factor (VEGF)-positive cells were partly observed by immunohistochemical staining. Both patients were assessed as having stable disease according to the Response Evaluation Criteria in Solid Tumors 1.1. The duration of overall survival from the time sunitinib was initiated was 13 and 8 months, respectively, and the progression-free survival was 5 and 4 months, respectively. Adverse events were evaluated according to the Common Terminology Criteria for adverse events of the US Department of Health and Human Services version 4.0. One patient experienced hypothyroidism (Grade 2) and thrombocytopenia (Grade 2). The other patient experienced anorexia (Grade 3) and general malaise (Grade 3). In conclusion, sunitinib was effective in the treatment of malignant pheochromocytoma when VEGF-positive cells were observed in the tumor specimens.
References
Parenti G, Zampetti B, Rapizzi E, Ercolino T, Giache V, Mannelli M (2012) Updated and new perspectives on diagnosis, prognosis, and therapy of malignant pheochromocytoma/paraganglioma. J Oncol 2012:872713
Chrisoulidou A, Kaltsas G, Ilias I, Grossman AB (2007) The diagnosis and management of malignant phaeochromocytoma and paraganglioma. Endocr Relat Cancer 14:569–585
Huang H, Abraham J, Hung E et al (2008) Treatment of malignant pheochromocytoma/paraganglioma with cyclophosphamide, vincristine, and dacarbazine: recommendation from a 22-year follow-up of 18 patients. Cancer 113:2020–2028
Nemoto K, Miura T, Shioji G, Tsuboi N (2012) Sunitinib treatment for refractory malignant pheochromocytoma. Neuro Endocrinol Lett 33:260–264
Ayala-Ramirez M, Chougnet CN, Habra MA et al (2012) Treatment with sunitinib for patients with progressive metastatic pheochromocytomas and sympathetic paragangliomas. J Clin Endocrinol Metab 97:4040–4050
Park KS, Lee JL, Ahn H et al (2009) Sunitinib, a novel therapy for anthracycline- and cisplatin-refractory malignant pheochromocytoma. Jpn J Clin Oncol 39:327–331
Sun FK, He HC, Su TW et al (2012) Multi-targeted tyrosine kinase inhibitor sunitinib: a novel strategy for sporadic malignant pheochromocytoma. Chin Med J (Engl) 125:2231–2234
Grogan RH, Mitmaker EJ, Duh QY (2011) Changing paradigms in the treatment of malignant pheochromocytoma. Cancer Control 18:104–112
Ye L, Santarpia L, Gagel RF (2010) The evolving field of tyrosine kinase inhibitors in the treatment of endocrine tumors. Endocr Rev 31:578–599
Oh DY, Kim TW, Park YS et al (2012) Phase 2 study of everolimus monotherapy in patients with nonfunctioning neuroendocrine tumors or pheochromocytomas/paragangliomas. Cancer 118:6162–6170
Conflict of interest
There are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hata, J., Haga, N., Ishibashi, K. et al. Sunitinib for refractory malignant pheochromocytoma: two case reports. Int Urol Nephrol 46, 1309–1312 (2014). https://doi.org/10.1007/s11255-014-0663-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-014-0663-8