FIRSTMAPPP
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.
Overview
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.
- 36 vs 19 out of 100 alive without the cancer growing at 12 months with Sunitinib 37.5 mg daily compared with Placebo; 17 more per 100.
- Roughly one extra person helped for every 6 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- 18 vs 3 out of 100 reached this endpoint with Sunitinib 37.5 mg daily compared with Placebo; 15 more per 100.
- Roughly one extra person helped for every 7 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- 13 vs 10 out of 100 reached this endpoint with Sunitinib 37.5 mg daily compared with Placebo; 3 more per 100.
- Roughly one extra person helped for every 33 treated. That is a rough figure taken from the two percentages, not a guarantee for any one person.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: 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. People in a different situation may not see the same effect.
- Only 78 people took part, so the numbers are less certain than in a large trial.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
78 enrolled.
14 of 39; 90% CI 23 to 50 · 7 of 39; 90% CI 11 to 31
SourceSimilar pages
not linked directly; found by shared links- TrialIMpactMF
Shares Small-molecule kinase inhibitors and the tag soc-trials.
- TrialSYMPATICO
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- TrialCOMFORT-II
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- TrialEXPLORER
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- TrialLAP07
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- TrialCLL12
Shares Small-molecule kinase inhibitors and the tag soc-trials.