{"entity":{"id":"paper-firstmappp-sunitinib-metastatic-ppgl-baudin-lancet-2024","kind":"paper","name":"FIRSTMAPPP: sunitinib for metastatic progressive phaeochromocytomas and paragangliomas","aka":[],"tldr":"In the first randomised trial in these rare tumours, sunitinib kept 36 percent of patients free of progression at one year against 19 percent on placebo.","summary":"Academic, multicentre, double-blind, placebo-controlled phase 2 trial at 14 European centres: 78 adults with progressive metastatic phaeochromocytoma or paraganglioma were randomised to sunitinib 37.5 mg daily or placebo. The primary endpoint was progression-free survival at 12 months.\n\n14 of 39 sunitinib patients (36 percent) and 7 of 39 placebo patients (19 percent) were progression-free at 12 months, meeting the primary endpoint. Grade 3 or 4 asthenia (18 against 3 percent) and hypertension (13 against 10 percent) were the common toxicities; one death from rectal bleeding was drug-related.","asOf":"2026-09-22","links":[{"label":"Lancet 2024","url":"https://doi.org/10.1016/S0140-6736(23)02554-0"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/38402886/"}],"tags":[],"related":[],"cancers":["metastatic-ppgl","pheochromocytoma-paraganglioma"],"sections":[],"technologies":[],"targets":[],"drugs":["sunitinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["firstmappp"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2024,"doi":"10.1016/S0140-6736(23)02554-0","pmid":"38402886","authors":"Baudin E, Goichot B, Berruti A, et al.","paperType":"rct","findings":["Progression-free survival at 12 months 36 percent (90% CI 23 to 50) with sunitinib versus 19 percent (11 to 31) with placebo.","Grade 3 or 4 asthenia 18 versus 3 percent; hypertension 13 versus 10 percent; one drug-related death."],"whatItMeans":"Sunitinib has the highest level of evidence of any drug for progressive metastatic phaeochromocytoma and paraganglioma, alongside the later approval of belzutifan.","caveats":["Small phase 2 with a single-arm-style primary endpoint; the placebo arm validated the design rather than providing a formal superiority test."],"changedPractice":true,"participants":78},"route":"/key-papers/paper-firstmappp-sunitinib-metastatic-ppgl-baudin-lancet-2024/","neighbours":{"cancer":[{"id":"metastatic-ppgl","kind":"cancer","name":"Metastatic pheochromocytoma and paraganglioma","route":"/cancers/metastatic-ppgl/"},{"id":"pheochromocytoma-paraganglioma","kind":"cancer","name":"Pheochromocytoma and paraganglioma (PPGL)","route":"/cancers/pheochromocytoma-paraganglioma/"}],"drug":[{"id":"sunitinib","kind":"drug","name":"Sunitinib","route":"/drugs/sunitinib/"}],"trial":[{"id":"firstmappp","kind":"trial","name":"FIRSTMAPPP","route":"/trials/firstmappp/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}