Sunitinib Plus Paclitaxel in Patients with Advanced Esophageal Cancer: A Phase II Study from the Hoosier Oncology Groupe

The combination of sunitinb (37.5 mg orally daily) + paclitaxel (90 mg/m2 intravenously on days 1, 8, 15 every 4 weeks) was examined in patients with advanced esophageal or gastroesophageal junction cancer, and progression-free survival (PFS) was compared to that of historical controls. The end points included response rate, overall survival, and toxicities. Twenty-eight patients were enrolled at six centers. Median age was 59.5 years. The 24-week PFS rate was 25% (90% confidence interval [CI], 12–42%). Three (11%) of 23 evaluable patients had a response (1 complete response and 2 partial response) (90% CI, 3–25%). Median overall survival was 228 days (90% CI, 140–283 days). Grade 3/4 toxicities included leukopenia/neutropenia (25%), anemia (18%), fatigue (11%), and hemorrhage (11%). There were four grade 5 toxicities including upper gastrointestinal hemorrhage (n = 2), gastrointestinal/esophageal fistula (n = 1), and unexplained death (n = 1). In our study, we found that sunitinib + paclitaxel in patients with advanced esophageal or gastroesophageal junction cancer had a 24-week PFS no better than the PFS of historical controls. The combination also had a high rate of serious toxicities and will not be pursued.