# FIRSTMAPPP

Source: https://onco.cc/trials/firstmappp/  
OnCo record `firstmappp` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

FIRSTMAPPP was the first randomised trial ever completed in metastatic phaeochromocytoma and paraganglioma, rare hormone-producing tumours; the kinase inhibitor sunitinib kept 36 percent of patients free of progression at a year against 19 percent on placebo, giving the disease its first drug with randomised evidence.

## Summary

FIRSTMAPPP was an academic, double-blind, placebo-controlled phase 2 trial of the ENDOCAN-COMETE and ENSAT networks at 14 centres in four European countries, randomising 78 adults with progressive metastatic phaeochromocytoma or paraganglioma (a third with germline SDHx variants, two thirds previously treated) to sunitinib or placebo. The primary endpoint was progression-free survival at 12 months.

The primary endpoint was met: 14 of 39 patients on sunitinib (36 percent) were progression-free at 12 months against 7 of 39 on placebo (19 percent). Asthenia and hypertension were the common grade 3 or 4 adverse events; one drug-related death from rectal bleeding occurred. The corpus's metastatic phaeochromocytoma and paraganglioma page cites FIRSTMAPPP for sunitinib alongside belzutifan and cabozantinib.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-22
- Also known as: First International Randomized Study in Malignant Progressive Pheochromocytoma and Paraganglioma; IGR2010/1715
- Tags: soc-trials
- Registry id: NCT01371201
- Phase: 2
- Setting: Progressive metastatic phaeochromocytoma or paraganglioma in adults at 14 European centres: sunitinib 37.5 mg daily or placebo (double-blind), with progression-free survival at 12 months as the primary endpoint
- Sponsor: Gustave Roussy
- Enrolled: 78
- Result: Progression-free survival at 12 months 36 percent with sunitinib against 19 percent with placebo, meeting the primary endpoint of the first randomised trial in the disease.
- Outcomes: Progression-free survival at 12 months: Sunitinib 37.5 mg daily 36% vs Placebo 19%; Grade 3 or 4 asthenia: Sunitinib 37.5 mg daily 18% vs Placebo 3%; Grade 3 or 4 hypertension: Sunitinib 37.5 mg daily 13% vs Placebo 10%

## Sources

- ClinicalTrials.gov NCT01371201: https://clinicaltrials.gov/study/NCT01371201

## Connected records

- cancers: [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- drugs: [Sunitinib](https://onco.cc/drugs/sunitinib/)
- institutions: [Gustave Roussy](https://onco.cc/institutions/gustave-roussy/)
- key papers: [FIRSTMAPPP: sunitinib for metastatic progressive phaeochromocytomas and paragangliomas](https://onco.cc/key-papers/paper-firstmappp-sunitinib-metastatic-ppgl-baudin-lancet-2024/)

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