9153 Safety and efficacy of sunitinib in patients with non-small cell lung cancer and irradiated brain metastases

An evidence-based review of the incidence of CNS bleeding with anti-VEGF therapy in non-small cell lung cancer patients with brain metastases

“…Patients with CNS metastases have generally also been excluded from ongoing trials of small molecule TKIs in NSCLC, again because of the perceived risk of cerebral hemorrhage during treatment [42,43]. Information on the safety profile of these agents in NSCLC is therefore based mainly on experience in patients who did not have brain metastases.…”

“…In a preliminary report of an open-label, phase II trial of singleagent sunitinib (50 mg/day) in 63 patients with refractory NSCLC, a fatal cerebral hemorrhage event was reported for 1 patient [42]. Another phase II study of 59 patients with NSCLC investigated sunitinib (starting dose 37.5 mg with continuous daily dosing in 4-week cycles) in patients who had received whole-brain radiotherapy for brain metastases and ≤2 prior systemic therapies [43]. In this study, 5 patients developed neurologic adverse events, including 2 grade 3 events (peripheral motor neuropathy and convulsion) and 1 grade 4 event (mental impairment), but there were no reports of intracranial hemorrhage [43].…”