Abstract
To improve the efficacy of radiotherapy (RTx), there is a growing interest in combining RTx with drugs that inhibit angiogenesis, i.e., the process of neo-vessel formation out of preexisting capillaries. A frequently used drug to inhibit angiogenesis is sunitinib (Sutent, SU11248), a receptor tyrosine kinase inhibitor that is currently FDA approved for the treatment of several cancer types. The current review presents an overview of the preclinical studies and clinical trials that combined sunitinib with RTx. We discuss the findings from preclinical and clinical observations with a focus on dose scheduling and commonly reported toxicities. In addition, the effects of combination therapy on tumor response and patient survival are described. Finally, the lessons learned from preclinical and clinical studies are summarized and opportunities and pitfalls for future clinical trials are presented.
https://www.ncbi.nlm.nih.gov/pmc/articl ... po=32.3864
Angiogenesis Springer Combining radiotherapy with sunitinib: lessons (to be) learned
Re: Angiogenesis Springer Combining radiotherapy with sunitinib: lessons (to be) learned
In reading thru the article I believe there was concern of the useage of the 37.5 mg was sometimes toxic when combined with RT AND that the timing of the 2, taking sutent then RT or visa versa was found to create a different outcome for the patient .
"Another important lesson to be learned concerns the proper scheduling of both treatment modalities. Sunitinib treatment is often applied several weeks before RTx. This might be beneficial since sunitinib treatment has been shown to induce transient vascular normalization in preclinical models, resulting in improved tumor oxygenation [20, 21, 69]. However, evidence for such a response in patients should be addressed by future trials, for example with perfusion measurements using DCE-MRI [70–72] or by hypoxia imaging techniques such as FMISO PET [73, 74]. On the other hand, in the preclinical models, vascular normalization occurs rapidly after the start of treatment and lasts for only a few days. This suggests that even when vascular normalization occurs in the clinical setting, the window of opportunity has already passed when sunitinib treatment is given for several weeks prior to RTx. This is supported by a study of Lewin et al. [63] where DCE-MRI and FAZA-PET/CT analyses showed decreased tumor perfusion and increased tumor hypoxia after 2 weeks of sunitinib."
"Another important lesson to be learned concerns the proper scheduling of both treatment modalities. Sunitinib treatment is often applied several weeks before RTx. This might be beneficial since sunitinib treatment has been shown to induce transient vascular normalization in preclinical models, resulting in improved tumor oxygenation [20, 21, 69]. However, evidence for such a response in patients should be addressed by future trials, for example with perfusion measurements using DCE-MRI [70–72] or by hypoxia imaging techniques such as FMISO PET [73, 74]. On the other hand, in the preclinical models, vascular normalization occurs rapidly after the start of treatment and lasts for only a few days. This suggests that even when vascular normalization occurs in the clinical setting, the window of opportunity has already passed when sunitinib treatment is given for several weeks prior to RTx. This is supported by a study of Lewin et al. [63] where DCE-MRI and FAZA-PET/CT analyses showed decreased tumor perfusion and increased tumor hypoxia after 2 weeks of sunitinib."
Debbie
Re: Angiogenesis Springer Combining radiotherapy with sunitinib: lessons (to be) learned
After our over 3cm ablation in July of 2015, we began Sunitinib in October. November 22 we discontinue Sutent and our CT showed an alarming increase of our lung tumors and then in January an adrenal tumor appeared.
Our liver ablation
http://www.cureasps.org/forum/viewtopic ... =120#p8342
We had also just ablated a brain tumor of over 1cm in April 2015
http://www.cureasps.org/forum/viewtopic ... =105#p8041
Our liver ablation
http://www.cureasps.org/forum/viewtopic ... =120#p8342
We had also just ablated a brain tumor of over 1cm in April 2015
http://www.cureasps.org/forum/viewtopic ... =105#p8041
Debbie