Uses

Sunitinib is a multi-targeted kinase inhibitor indicated for gastrointestinal stromal tumor (GIST) after imatinib failure, advanced renal cell carcinoma (RCC), adjuvant treatment of high-risk RCC following nephrectomy, and progressive well-differentiated pancreatic neuroendocrine tumors (pNET).

Do not use if

No absolute contraindications are listed in the FDA labeling. However, it should be used with extreme caution in patients with significant hepatic impairment, history of QT prolongation, or pre-existing cardiovascular disease.

Side effects

Common side effects include fatigue, diarrhea, nausea, mucositis, hand-foot syndrome, hypertension, myelosuppression, and skin discoloration. Serious adverse effects include hepatotoxicity, cardiovascular events, QT prolongation, hemorrhage, and thyroid dysfunction.

Warnings

Carries a boxed warning for potentially severe and fatal hepatotoxicity; liver function must be monitored throughout therapy. Monitor for cardiovascular events, hypertension, bleeding, and thyroid function. Embryo-fetal toxicity is a concern; effective contraception is required.

How it works

Sunitinib inhibits multiple receptor tyrosine kinases (RTKs) including PDGFR, VEGFR, KIT, FLT3, and RET. By blocking these receptors, it inhibits tumor cell proliferation, pathologic angiogenesis, and metastatic progression.

Storage

Store at room temperature (20–25°C). Dispense in a tight container.