In the first-line setting, targeted therapy and SSAs were associated with longer PFS than chemotherapy, with surufatinib and lanreotide showing favorable disease control. SDHx pathogenic variant status did not show a clear association with response to TKIs or temozolomide, underscoring the need for validation in larger cohorts.

P1/2, N=29, Suspended, University of Florida | Trial completion date: Jun 2026 --> Jun 2027 | Trial primary completion date: Dec 2025 --> Dec 2026

P2, N=66, Recruiting, Shandong Tumor Hospital

P2/3, N=502, Recruiting, Hutchmed | Trial completion date: Aug 2027 --> May 2028 | Trial primary completion date: Aug 2027 --> May 2028

P4, N=350, Recruiting, Shanghai Zhongshan Hospital | Not yet recruiting --> Recruiting

P2, N=36, Recruiting, Sun Yat-sen University | Trial completion date: Nov 2025 --> Dec 2027 | Trial primary completion date: Nov 2024 --> Dec 2027

P2, N=35, Not yet recruiting, Second Affiliated Hospital, School of Medicine, Zhejiang University

P4, N=350, Not yet recruiting, Shanghai Zhongshan Hospital

Exploratory analysis indicates that responders show significantly higher tumor PD-L1 expression than non-responders do, with median tumor proportion scores of 8% and 2%, respectively. The study is registered at ClinicalTrials.gov (NCT05236699).

Increasing evidence suggests that a subset of CCA patients can benefit from multiple tyrosine kinase inhibitors (mTKIs) such as surufatinib...Furthermore, cancer-associated fibroblasts (CAFs) were identified as the major source of IGF1 in CCA microenvironment, essential for IGF1R-driven tumor progression.In summary, the PTPN9-IGF1R axis plays a pivotal role in modulating mTKI sensitivity and tumor progression in CCA. This axis serves as a promising biomarker for identifying potential mTKI beneficiaries and represents a potential therapeutic target to enhance mTKI efficacy and overcome resistance.

From August 2019 to October 2020, he received long-acting octreotide and transarterial chemoembolization (TACE), achieving stable disease...In September 2022, oral surufatinib was initiated but paused in September 2023 due to adverse effects...This case demonstrates that everolimus can induce SSTR re-expression in advanced, SSTR-negative pNETs, offering new therapeutic possibilities. The "induction plus re-evaluation" approach could guide personalized treatment strategies in late-stage pNETs, although further studies are needed to validate this approach.

Surufatinib plus paclitaxel showed promising efficacy and manageable safety as second-line treatment for advanced gastric cancer, especially in patients who had failed prior immunotherapy.