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Study Of Sunitinib In Patients With Recurrent Paraganglioma/Pheochromocytoma (SNIPP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00843037
Recruitment Status : Active, not recruiting
First Posted : February 13, 2009
Last Update Posted : November 30, 2021
Information provided by (Responsible Party):
University Health Network, Toronto

Brief Summary:
This is an open-label phase II study of an investigational drug, sunitinib malate in patients with advanced malignant paraganglioma or phaeochromocytoma cancer. Paragangliomas (PGs) are tumours that arise from the para-sympathetic system in the head and neck and sympathetic system in the thorax and abdomen. Paragangliomas that secrete hormones (catecholamines) from the adrenal glands are called pheochromocytomas (PCs). In this study, patients whose disease has advanced or spread despite prior standard therapy, will receive sunitinib for 4-weeks followed by a 2-week rest period, for up to 12 months, in the absence of disease progression. Sunitinib is an investigational drug, which has been shown to shrink tumours in several tumour models. The study will evaluate the efficacy as well as the toxicity profile of sunitinib when used as an alternative treatment for patients with PG/PC tumours.

Condition or disease Intervention/treatment Phase
Paraganglioma Pheochromocytoma Drug: Sunitinib Phase 2

Detailed Description:

This study will be a single arm, open-label, phase II trial of sunitinib in patients with metastatic or locally advanced malignant paraganglioma or phaeochromocytoma. Oral sunitinib (50 mg) will be administered to all patients daily for the first four weeks of a six week study cycle, followed by a 2-week rest. Patients will be assessed for response to study treatment using MRI/CT scans as well as bio-chemical tests, and will receive the study treatment for up to 12 months or until disease progression.

Primary study outcomes include:

To assess the efficacy (response rate) of sunitinib given orally daily for 4 out of every 6 weeks in patients with advanced or metastatic paraganglioma/ pheochromocytoma.

To assess the toxicity of sunitinib in patients with advanced or metastatic paraganglioma/ pheochromocytoma.

To document effects of sunitinib on markers of biochemical activity of advanced or metastatic paraganglioma/ pheochromocytoma.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 25 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Investigator Initiated Phase II Study Of Sunitinib In Patients With Recurrent Paraganglioma/Pheochromocytoma
Actual Study Start Date : February 2009
Estimated Primary Completion Date : May 2022
Estimated Study Completion Date : May 2022

Arm Intervention/treatment
Experimental: Open label - Sunitinib
Sunitinib, 50mg daily, once daily for 4 weeks followed by a 2-week break
Drug: Sunitinib
50 mg oral dose daily for 4 weeks, 2 week rest period (repeating 6 week cycles)
Other Name: Sunitinib malate (suntinib; SU11248, SU011248, Sutent®)

Primary Outcome Measures :
  1. Clinical benefit rate (CBR) which is defined as either a partial response (PR) complete response (CR) or stable disease (SD) for ≥ 12 weeks measured using Response Evaluation Criteria in Solid Tumors (RECIST) criteria. [ Time Frame: Every 12 weeks (2 cycles) ]

Secondary Outcome Measures :
  1. Biochemical response of > 20% drop in; 24-hour urinary metanephrines, catecholamines or serum chromogranin A, sustained for > 12-week period [ Time Frame: Patient specific based on disease progression ]
  2. Overall survival [ Time Frame: Patient specific based on disease progression ]
  3. Time to progression [ Time Frame: Patient specific based on disease progression ]
  4. Overall response rate (PR) + (CR) [ Time Frame: Patient specific based on disease progression ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Histologically or cytologically confirmed diagnosis of malignant paraganglioma or pheochromocytoma and either evidence of metastases or unresectability.
  • Evidence of recent disease progression (radiological, biochemical, symptomatic).
  • Measurable disease defined as that which can be measured in at least one dimension with a minimum size of 10 mm by CT scan.
  • ECOG 0-2.
  • Life expectancy of greater than 24 weeks.
  • Age > 18 years.
  • Patients must have normal organ and marrow function.
  • Patients must have PT/INR/PTT within 1.2 X the upper limit
  • Patients may have had prior radiation therapy. A minimum of 28 days must have elapsed between the end of radiotherapy and registration onto the study.
  • Previous Surgery: Previous major surgery is permitted provided that it has been at least 28 days prior to patient registration
  • Laboratory Requirements Parameter Limit granulocytes (AGC) > 1.5 x 109/L platelets > 100 x 109/L bilirubin < 1.5XULN AST and ALT < 2.5 x ULN Amylase <1.5XULN Lipase <1.5XULN Calcium < 3 mmol/L creatinine < 2.0XULN

Exclusion Criteria:

  • History of other malignancies.
  • Patients with known brain metastases.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to sunitinib.
  • Patients receiving concurrent treatment with other anti-cancer therapy given for paraganglioma or pheochromocytoma or other therapy or other investigational anticancer agents.
  • Patients who have received prior treatment with any other antiangiogenic agent or multi-targeted tyrosine kinase inhibitors are ineligible.
  • Patients with any of the following cardiovascular findings are to be excluded:
  • QTc prolongation or other significant ECG abnormalities.
  • Current or history of Class III or IV heart failure as defined by the NYHA functional classification system
  • Patients with prior anthracycline exposure, previous central thoracic radiation that included heart in radiation port, or a history of NYHA Class II cardiac function.
  • Poorly controlled hypertension
  • Myocardial infarction, cardiac arrhythmia, stable/unstable angina, symptomatic congestive heart failure, or coronary/peripheral artery bypass graft or stenting within 12 months prior to study entry
  • History of venous thrombosis or pulmonary embolism in the past 3 months
  • History of cerebrovascular accident (CVA) or transient ischemic attack within 12 months prior to study entry
  • Patients who require use of therapeutic doses of coumarin-derivative anticoagulants such as warfarin
  • Patients with bowel obstruction or any condition that impairs their ability to swallow and retain sunitinib tablets.
  • Use of agents with proarrhythmic potential is not permitted during the study.
  • Must be able to stop prohibited selected CYP3A4 inhibitors/inducers prior to starting sunitinib
  • Patients with pre-existing hypothyroidism prior to enrolment are ineligible unless they are euthyroid on medication.
  • Pregnant or lactating women, positive pregnancy test, women of childbearing potential who do not agree to use adequate contraception prior to study entry and for the duration of study participation.
  • Known HIV-positive patients on combination antiretroviral therapy
  • Greater than +1 proteinuria on urinary dipstick if also >1g urinary protein/24hrs

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00843037

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Canada, Alberta
Tom Baker Cancer Centre
Calgary, Alberta, Canada, T2N 4N2
Canada, Ontario
University Health Network, Princess Margaret Cancer Centre
Toronto, Ontario, Canada, M5G 2M9
Canada, Quebec
Hôpital Notre-Dame du CHUM
Montreal, Quebec, Canada, H2L 4M1
University Medical Centre Groningen
Groningen, Netherlands
Sponsors and Collaborators
University Health Network, Toronto
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Principal Investigator: Jennifer Knox, MD, FRCPC University Health Network--Princess Margaret Cancer Centre
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Responsible Party: University Health Network, Toronto Identifier: NCT00843037    
Other Study ID Numbers: SNIPP
First Posted: February 13, 2009    Key Record Dates
Last Update Posted: November 30, 2021
Last Verified: November 2021
Keywords provided by University Health Network, Toronto:
Metastatic or locally advanced malignant paraganglioma
Metastatic or locally advanced malignant pheochromocytoma
Additional relevant MeSH terms:
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Carotid Body Tumor
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Paraganglioma, Extra-Adrenal
Antineoplastic Agents
Angiogenesis Inhibitors
Angiogenesis Modulating Agents
Growth Substances
Physiological Effects of Drugs
Growth Inhibitors
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action