{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T04:06:25Z","timestamp":1783656385455,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Angiogenesis is critical in intrahepatic cholangiocarcinoma (ICC), a highly lethal cancer with limited treatment options. Sunitinib, a multi\u2010receptor tyrosine kinase inhibitor, has strong antiangiogenic and antitumor effects. We aimed to evaluate the efficacy and tolerability of sunitinib as a second\u2010line treatment in chemotherapy\u2010pretreated patients with advanced ICC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This open\u2010label, single\u2010arm, phase II trial was conducted across five French centres. Eligible patients were aged \u2265\u200918, had advanced ICC not suitable for curative surgery and had been pre\u2010treated with gemcitabine and\/or platinum. Patients received oral sunitinib at 37.5\u2009mg daily. The primary endpoint was overall survival (OS), with secondary endpoints including progression\u2010free survival (PFS), objective response rate (ORR), disease control rate (DCR) and safety. Tumour response was evaluated using RECIST v1.1, with exploratory analysis using Choi criteria. VEGF\u2010A, VEGF\u2010C and plasma sunitinib levels were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty\u2010three patients were included. Median OS was 9.6\u2009months (95% CI, 6.1\u201313.1), median PFS was 3.7\u2009months (95% CI, 3.1\u20136.4), the ORR was 14% and the DCR was 84%. Grade 3\u20134 cytopenias occurred in 25% of patients, hypertension in 21% and fatigue in 19%. Higher baseline levels of VEGF\u2010A and VEGF\u2010C correlated with longer OS. Patients with dose reductions maintained adequate drug exposure. Choi criteria, applied to 24 patients, predicted response duration better than RECIST v1.1. Baseline tumour density, assessed in 14 patients, showed a potential association with treatment responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sunitinib demonstrated efficacy and manageable toxicity as a second\u2010line treatment in patients with advanced ICC previously treated with chemotherapy, suggesting it may represent a viable therapeutic option for this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT01718327\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70196","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T13:55:28Z","timestamp":1752069328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Sunitinib as Second\u2010Line Treatment in Advanced Intrahepatic Cholangiocarcinoma: Results From the\n                    <scp>SUN<\/scp>\n                    \u2010\n                    <scp>CK GERCOR<\/scp>\n                    Phase\n                    <scp>II<\/scp>\n                    Trial"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9331-5148","authenticated-orcid":false,"given":"Louis","family":"Gros","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Paris Saint\u2010Joseph Hospital Group  Paris France"},{"name":"Department of Oncology Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne University  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3919-4135","authenticated-orcid":false,"given":"Mohamed","family":"Bouattour","sequence":"additional","affiliation":[{"name":"Department of Liver Cancer and Innovative Therapy Unit, H\u00f4pital Beaujon, Assistance Publique\u2010H\u00f4pitaux de Paris, AP\u2010HP. Nord, Clichy, France; Universit\u00e9 Paris Cit\u00e9, Centre de Recherche Sur L'Inflammation (CRI), INSERM, U1149, CNRS  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Dumont","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Saint\u2010Louis Hospital, Assistance Publique\u2010H\u00f4pitaux de Paris, AP\u2010HP. Nord, Paris, France; Universit\u00e9 Paris Cit\u00e9, Centre de Recherche Sur L'Inflammation (CRI), INSERM, U1149, CNRS  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"La\u00ebtitia","family":"Dahan","sequence":"additional","affiliation":[{"name":"Service Oncologie Digestive &amp; H\u00e9pato\u2010Gastroent\u00e9rologie CHU Timone, Assistance Publique\u2010H\u00f4pitaux de Marseille (APHM) &amp; Aix\u2010Marseille\u2010University (AMU)  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Malka","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institut Mutualiste Montsouris, Paris, France; Unit\u00e9 Dynamique des Cellules Tumorales, INSERM U1279, Universit\u00e9 Paris\u2010Saclay, Gustave Roussy, Villejuif, France; GERCOR  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemila\u00ef","family":"Tijeras\u2010Raballand","sequence":"additional","affiliation":[{"name":"OncoMEGA  Lamorlaye France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armand","family":"De Gramont","sequence":"additional","affiliation":[{"name":"AFR Oncology  Boulogne\u2010Billancourt France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7464-3939","authenticated-orcid":false,"given":"Maxime","family":"Ronot","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4pital Beaujon, Assistance Publique\u2010H\u00f4pitaux de Paris, AP\u2010HP. 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