Onco Wiki / Regimen

Sunitinib monotherapy (metastatic non-MIBG-avid pheochromocytoma/paraganglioma; FIRSTMAPPP)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.

Source YAML: complete record

ComponentsDRUG-SUNITINIB
IDREG-SUNITINIB-PHEO
TypeRegimen
Statusreviewed 2026-07-11 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-FIRSTMAPPP-BAUDIN-2024 SRC-NCCN-NET-2025

Notes

FIRSTMAPPP (Baudin et al, for the FIRSTMAPPP investigators; Lancet 2024;403(10431):1061-1070; PMID 38402886) is the only randomized, placebo-controlled trial of a systemic agent in metastatic/progressive PPGL and is the primary evidence basis for sunitinib as the default 1L systemic option in MIBG-non-avid metastatic disease, ahead of cabozantinib (REG-CABOZANTINIB-PHEO), whose PPGL evidence rests on smaller single-arm/retrospective data per NCCN. Primary endpoint met: 12-month progression-free survival 36% (90% CI 23-50) with sunitinib vs 19% (90% CI 11-31) with placebo -- see SRC-FIRSTMAPPP-BAUDIN-2024 for full detail (figures independently verified via PubMed during this authoring session; the file under review had cited this trial as "2023" with unverified/null DOI-PMID -- corrected here to the PubMed-confirmed 2024 Lancet publication with real identifiers). Dosing (37.5 mg continuous) mirrors the dose already documented on DRUG-SUNITINIB for pNET, which matches the FIRSTMAPPP protocol dose. STUB pending clinical co-lead signoff (CHARTER §6.1, dev-mode-exempted).

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