Secondary Polycythemia in a Sarcoma Patient: A Commentary about Cediranib

Cediranib, a potent inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, platelet-derived growth factor subunit B, and the c-Kit receptor tyrosine kinase, has shown antitumour activity as an antiangiogenic agent in preclinical models. Initial clinical trials with cediranib in a variety of tumour types, including glioblastoma multiforme, non-small-cell lung cancer, renal cell cancer, colorectal cancer, and prostate cancer, showed activity comparable to that for other vascular endothelial growth factor (vegf) inhibitors, but with significant toxicities, resulting in abandonment of the drug’s development in 2011. However, recent dramatic results in the icon6 trial of cediranib in relapsed platinum-sensitive ovarian cancer (which demonstrated a 7.4-month improvement in overall survival) and significant activity in phase ii studies in a rare soft-tissue sarcoma, alveolar soft part sarcoma (asps), could result in the drug’s revival1,2. As of October 2017, eleven clinical trials were accruing, and fifty-six clinical trials using cediranib as single agent or in combination with other small molecules or chemotherapy had been completed. Here, we report a case of secondary polycythemia in a patient treated with cediranib for asps. Informed consent for publication was provided by the patient.