Efficacy and safety of surufatinib in the treatment of advanced solid tumors: a systematic evaluation and meta‑analysis

Abstract

Previous retrospective studies have suggested that surufatinib is effective for treating advanced solid tumors; however, the efficacy and safety of this drug needs to be investigated further via high-quality evidence or randomized controlled trials. In the present study, a meta-analysis was carried out to evaluate the safety and effectiveness of surufatinib for patients with advanced solid tumors. Systematic, electronic literature searches were conducted using PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov. The disease control rate (DCR) of surufatinib in solid tumors was 86% [effect size (ES), 0.86; 95% confidence interval (CI), 0.82-0.90; I 2 =34%; P=0.208] and the objective response rate was 16% (ES, 0.16; 95% CI, 0.12-0.21; I 2 =48%; P=0.103), while the progressive disease rate was only 9% (ES, 0.09; 95% CI, 0.05-0.15; I 2 =68%, P=0.014). Surufatinib showed different degrees of adverse reactions during the treatment of solid tumors. Among these adverse events, the incidence of increased levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were 24% (ES, 0.24; 95% CI, 0.18-0.30; I 2 =45.1%; P=0.141) and 33% (ES, 0.33; 95%CI, 0.28-0.38; I 2 =63.9%; P=0.040), respectively. In the placebo-controlled trial, the relative risks (RRs) of elevated AST and ALT were 1.04 (95% CI, 0.54-2.02; I 2 =73.3%; P=0.053) and 0.84 (95% CI, 0.57-1.23; I 2 =0%; P=0.886), respectively. Overall, surufatinib was characterized by a high DCR and a low disease progression rate, thus indicating that it could exert a good therapeutic effect on solid tumors. Additionally, surufatinib showed a lower RR for adverse effects compared with other treatment modalities.

Clinical Evaluation of the Pancreatic Cancer Microenvironment: Opportunities and Challenges

“…Anti-angiogenic therapy with the VEGF-targeting antibody bevacizumab has not shown clinical benefit, with or without concomitant chemotherapy [193,194]. Recent clinical trials found that multi-tyrosine kinase inhibitors have been efficacious in treating a variety of other neoplasms [195], including pancreatic neuroendocrine tumors [196], which, in contrast to PDAC, are notably hypervascular [197]. One such drug, surufatinib, impairs angiogenesis by targeting VEGFR while simultaneously blocking FGFR1 (a mechanism of resistance to anti-VEGF therapy) and CSF-1R, thereby decreasing the recruitment of tumor-associated macrophages [198].…”