Does sunitinib have a patient-specific dose without diminishing its antitumor effect on advanced pancreatic neuroendocrine neoplasms?

  • Satoshi Matsui
  • Atsushi KudoEmail author
  • Toshiro Ogura
  • Kosuke Ogawa
  • Hiroaki Ono
  • Yusuke Mitsunori
  • Daisuke Ban
  • Shinji Tanaka
  • Minoru Tanabe
Original Article – Clinical Oncology



Because it is unknown whether adjusting the dose of sunitinib can benefit patients with pancreatic neuroendocrine neoplasms (Pan-NENs), this retrospective study examined maximum tumor shrinkage rates and prognoses in patients with and without low doses of sunitinib administration.


Eighty-seven patients with metastatic and unresectable neoplasms, treated with sunitinib for > 1 month, were divided into a low-dose (LD) or high-dose (HD) group. The tumor response rates were investigated over time using computed tomography according to the response evaluation criteria in solid tumors criteria.


The LD and HD groups included 42 and 45 patients, respectively. There were no differences in baseline characteristics (tumor size, Ki-67 index, mitosis, and differentiation) between the two groups. Progressive disease (PD), stable disease (SD), and partial response (PR) were observed in 16.7, 54.8, and 28.6% of patients in the LD group, respectively, and in 13.3, 60, and 26.7% of patients in the HD group, respectively. There were no differences in tumor shrinkage rates between the two groups (p = 0.87). The 3-year progression-free survival rates for the LD and HD groups were 2.4% and 2.3%, respectively (p = 0.67), and the 3-year overall survival rates were 57.9% and 70.5%, respectively (p = 0.76). The occurrence of adverse events was similar between the two groups (61.9% vs. 60.0%, p > 0.95).


Dose reduction of sunitinib did not alter tumor shrinkage rates or prognoses for patients with advanced Pan-NENs.


Neuroendocrine tumor Sunitinib Low dose Liver metastasis Unresectable 



All pathological diagnoses were revised by Yuko Kinowaki at Department of human Pathology, Graduate school of Medicine, Tokyo Medical and Dental University.

Author contributions

Study concept and design: SM. Analysis and interpretation of data: SM, AK. Acquisition of data: SM, AK, TO, KO, HO, YM, DB. Drafting of the manuscript: SM, AK. Critical revision of the manuscript for important intellectual content: ST. Statistical analysis: SM. Obtained funding: AK. Administrative, technical, or material support; AK. Study supervision: MT.


This work was supported by Grant-in-Aid for Scientific Research (C) Grant Number 19K09041.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hepatobiliary-Pancreatic Surgery, Graduate School of MedicineTokyo Medical and Dental UniversityTokyoJapan
  2. 2.Department of Molecular OncologyTokyo Medical and Dental UniversityTokyoJapan

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