Sunitinib is a chemotherapeutic medicine prescribed for kidney cancer treatment. Its common brand names include Sutent and Sunicine. It is available as oral tablets of strengths: 12.5mg, 25mg, and 50mg.

FDA Approval History:

For Gastrointestinal Stromal Tumors: Jan 26, 2006

For Advanced Renal Cell Carcinoma: Jan 26, 2006

For Pancreatic Cancer: May 20, 2011

Uses

Sunitinib is an oral, small-molecule, multi-targeted receptor tyrosine kinase inhibitor and chemotherapeutic drug indicated:

• After disease progression on or intolerance to imatinib mesylate in patients with Gastrointestinal Stromal Tumor (GIST).
• To patients with Advanced Renal Cell Carcinoma (RCC).
• For adjuvant treatment to adult patients with Renal Cell Carcinoma (RCC) who are at high risk of recurrent RCC following nephrectomy.
• To patients with progressive, well-differentiated Pancreatic Neuroendocrine Tumors with unresectable locally advanced or metastatic disease.

Working

Sunitinib is a targeted therapy drug that belongs to the class of receptor tyrosine kinase inhibitors. It works in the following manner.

• STEP-1
  Receptor Tyrosine Kinase: These are the high-affinity cell surface receptors that are a part of protein tyrosine kinases. Receptor tyrosine kinase plays a vital role in the regulation of cell growth, differentiation, and survival.
• STEP-2
  Sunitinib Enters: Sunitinib inhibits various receptor tyrosine kinases, some of which facilitate tumor growth, pathologic angiogenesis, and metastatic progression of cancer.
• STEP-3
  Cell Death: Due to the effect of Sunitinib, it becomes tough for cells to undergo division and other survival processes. This ultimately leads to cell death.

Side Effects

Side effects of drugs may occur because the formulations are new to your body mechanisms. Therefore, your doctor may prescribe an over-the-counter regimen to be taken if side effects appear. Below are some of such common & rare adverse effects.

Common side effects

• Bleeding gums
• Fever
• Cracked lips
• Nervousness
• Dizziness
• Headache
• Fainting
• Difficulty in breathing
• Unusual weight loss
• Irregular heartbeat
• Coughing up blood
• Chest tightness

Rare side effects

• Seizures
• Abdominal pain
• Skin rash
• Skin darkening
• Vomiting
• Changes in vision
• Tiredness
• Numbness in the leg

Side effects of unknown incidence

• Blistering of the skin
• Joint stiffness
• Cough
• Muscle cramps
• Itching
• Difficulty in urination
• Sore throat
• Pale skin
• Mouth sores
• Ulcers
• Increased thirst
• Skin lesions
• Tooth loosening

Warnings and Precautions

• Pregnancy
  In pregnant women, Sunitinib can cause serious harm after administration. Due to this, patients are advised to use effective contraception during therapy. Though no proven studies of this drug in pregnant females are available.
• Nursing
  As per clinical trials in rats, Sunitinib may get excreted via breast milk. However, it is unknown whether the primary metabolite of this drug gets excreted in human breast milk. To avoid unfavorable events, doctors advise to not breastfeed.
• Adrenal Function
  In some non-clinical studies, adrenal toxicity was diagnosed in certain patients. Physicians may monitor the adrenal function of patients who administer Sunitinib.
• Hepatotoxicity
  Experts link hepatotoxicity with the use of this medicine. Thus, the signs of liver failure (nausea, vomiting, abdominal pain, etc) must not be ignored during the therapy.
• Hypertension
  Patients taking Sunitinib are prone to conditions like hypertension. If symptoms of the disease occur, antihypertensive drugs may be prescribed. Regular monitoring of such signs is thus required.

Interactions

Interactions between two medicines or medicines and diseases may cause unfavorable events. This is the only reason why your doctor asks for the list of drugs you already take. To avoid predictable interactions, dose changes may be initiated.

Interaction with drugs: Drugs such as apalutamide, hydroxychloroquine, efavirenz, bedaquiline, ribociclib, cabozantinib, fingolimod, osimertinib, siponimod, teriflunomide, and ziprasidone may affect the functioning of Sunitinib. Dose changes are necessary in cases where severe interactions are predicted.

Interaction with diseases: Certain diseases may affect how this drug works. In fact, drug-disease interaction may lead to serious complications. Below are the conditions that the experts think may interact with Sunitinib:

• Hemorrhagic events
• QT prolongation
• Liver disease
• Thyroid abnormality
• Adrenal toxicity
• Lung toxicity
• Hypertension
• Cardiovascular events
• Hypoglycemia
• Dermatologic toxicities
• Proteinuria

Interaction with alcohol & food: Consumption of grapefruit and foods made using it must be avoided. That’s because this drug can severely interact with grapefruit. Experts claim that it can significantly increase the levels of Sunitinib in the patient’s body.

Overdose

Sunitinib’s recommended dose is given below. This drug is indicated for oral administration once daily with or without food.

• Advanced RCC (Renal Cell Carcinoma): 50 mg on a schedule of 4 weeks on treatment followed by 2 weeks off.
• GIST (Gastrointestinal Stromal Tumor): 50 mg on a schedule of 4 weeks on treatment followed by 2 weeks off for nine 6-week cycles.
• PNET (Pancreatic Neuroendocrine Tumors): 37.5 mg continuously without a scheduled off-treatment period.

If overdose symptoms (fainting, shortness of breath, etc) occur, it is important to seek a doctor’s attention. Reach out to your nearest medical center, clinic, or hospital. Medical practitioners may give supportive care since no proven treatment for overdose on Sunitinib is available.

NOTE: We do not encourage you to consider this article as a substitute for any medical therapy or advice. This medicine must not be sold without a valid prescription by an oncologist.