Sunitinib is a targeted therapy and is angiogenesis inhibitor (It doesn’t kill tumor cells directly but decreases its blood supply so tumor is unable to grow and decreases in size)
What sunitinib is used for?
- Treatment of gastrointestinal stromal tumor (GIST)
- Alveloar soft part sarcoma, solitary fibrous tumor
- Relapse refractory pheochromocytoma
Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.
How sunitinib is given?
- As a capsule taken by mouth.
- May be taken with or without food.
- The amount of sunitinib that the patient will receive depends on several factors, including their general health or other health problems, and the type of cancer or condition. Furthermore, the doctor decides the dose of the drug according to tolerance and fitness.
Sunitinib side effects
The following side effects are common (occurring in greater than 30%) among patients taking sunitinib:
- Fatigue
- Diarrhea
- Nausea and vomiting
- Heartburn
- Taste changes
- Hypertension (high blood pressure)
- Low blood counts (white and red blood cells and platelets may temporarily decrease). This can put the patient at increased risk for infection, anemia, and/or bleeding.
- Skin discoloration (possibly due to the drug color – yellow)
The following side effects are less common (occurring in 29-10%) among patients receiving sunitinib:
- Poor Appetite
- Headache
- Increased liver enzymes
- Weakness
- Constipation
- Abdominal pain
- Bleeding
- Fever
- Dry skin
- Swelling of ankles and feet
- Dizziness
- Increased amylase and lipase levels
- Shortness of breath
- Generalized aches and pains
- Rash
- Flatulence
- Hand foot syndrome (Palmar-plantar erythrodysesthesia or PPE) –skin rash, swelling, redness, pain, and/or peeling of the skin on the palms of hands and soles of feet.
- Dehydration
- Low potassium levels
- Increased bilirubin levels
- Hair color changes
- Cough
- Hypothyroid
- Hair loss
Rare (2-3%) but serious side effects may include problems with blood clots. It can lead to pulmonary embolus or stroke – potentially life-threatening conditions.
This list includes common and less common side effects for those taking sunitinib. Side effects that are very rare – occurring in less than about 10 percent of patients — are not listed here. However, patients should always inform their healthcare provider if they experience any unusual symptoms.
Sunitinib precautions
- Inform the healthcare professional if you are pregnant or may be pregnant prior to starting this treatment. Sunitinib belongs to pregnancy category D (may be hazardous to the fetus), so, women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.
- For both men and women: Use contraceptives, and do not conceive a child (get pregnant) while taking sunitinib. Barrier methods of contraception, such as condoms, are recommended.
- Do not breastfeed while taking sunitinib.
- To help treat/prevent mouth sores, use a soft toothbrush, and rinse three times a day with 1 teaspoon of baking soda mixed with 8 ounces of water. Use an electric razor and a soft toothbrush to minimize bleeding.
- To reduce nausea, take anti-nausea medications as prescribed by your doctor, and eat small, frequent meals.
- To prevent hand-foot syndrome, modify normal activities of daily living to reduce friction and heat exposure to hands and feet, for about a week after treatment.
- Keep palms of hands and soles of feet moist using emollients.
- Avoid sun exposure. Wear SPF 15 (or higher) sunblock and protective clothing.
Monitoring and testing while taking sunitinib
Patients will be checked regularly by their doctor while taking sunitinib, to monitor side effects and check their response to therapy. Periodic blood work will be obtained to monitor their complete blood count (CBC) and the function of other organs (such as your kidneys and liver) as well as their thyroid.
