The use of sunitinib in renal cell carcinoma: where are we now?

Sunitinib malate (Sutent (TM)) is an inhibitor of multiple protein tyrosine kinases that shows antitumor and antiangiogenic activities. In a randomized Phase III trial of treatment-naive patients with metastatic renal cell carcinoma (mRCC), patients treated with sunitinib showed a significant improvement in progression-free survival compared with those treated with IFN-alpha. Sunitinib also exhibited antitumor activity in unselected RCC patients, including those with who were refractory to treatment, had non-clear cell histology brain metastases, or an Eastern Cooperative Oncology Group performance status > 1. Typical side effects of sunitinib malate are fatigue, asthenia, diarrhea, skin rash, stomatitis, hand-foot skin syndrome, hypothyroidism and hematological abnormalities. Hypertension, other toxicities may serve as biomarkers for improved clinical outcomes in sunitinib treatment. Currently, sunitinib remains the gold standard of care in the treatment of mRCC.