Tolerability and pharmacokinetic profile of a sunitinib powder formulation in pediatric patients with refractory solid tumors: A Children's Oncology Group study

Steven G. DuBois, Suzanne Shusterman, Joel M. Reid, Ashish M. Ingle, Charlotte H. Ahern, Sylvain Baruchel, Julia Glade-Bender, Percy Ivy, Peter C. Adamson, Susan M. Blaney

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Purpose: Sunitinib is an oral tyrosine kinase inhibitor of VEGF, PDGF, c-KIT, and flt-3 receptors. A pediatric phase I study of sunitinib capsules identified the maximum tolerated dose as 15 mg/m 2/day. This study was conducted to evaluate sunitinib given as a powder formulation. Methods: Sunitinib 15 mg/m 2 was administered orally daily for 4 weeks on/2 weeks off to patients <21 years old with refractory solid tumors. Sunitinib capsules were opened, and the powder sprinkled onto applesauce or yogurt. Plasma levels of sunitinib and an active metabolite, SU12662, were measured, and pharmacokinetic parameters were estimated. Results: 12 patients, median age 13 (range 4-21) years, were treated. The most common first-cycle toxicities were leucopenia (n = 6), fatigue (n = 5), neutropenia (n = 4), and hypertension (n = 4). Three patients had dose-limiting toxicities (DLTs) in cycle 1 (dizziness/back pain, hand-foot syndrome, and intratumoral hemorrhage/hypoxia). A median peak plasma sunitinib concentration of 21 (range 6-36) ng/ml was reached at a median of 4 (range 4-8) h after the first dose. The median exposure (AUC 0-48) was 585 (range 196-1,059) h ng/l. The median half-life was 23 (range 13-36) h. The median trough concentration measured before day 14 dosing was 32 (range 12-58) ng/ml. Conclusions: The pharmacokinetic profile of sunitinib appears similar between a powder formulation and published data using capsules. The powder formulation allows patients unable to swallow capsules to receive sunitinib.

Original languageEnglish (US)
Pages (from-to)1021-1027
Number of pages7
JournalCancer chemotherapy and pharmacology
Volume69
Issue number4
DOIs
StatePublished - Apr 1 2012

Keywords

  • Formulation
  • Pediatric
  • Pharmacokinetics
  • Sunitinib

ASJC Scopus subject areas

  • Oncology
  • Toxicology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

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