# Sunitinib

Source: https://nuclide.cc/drugs/sunitinib/  
Nuclide record `sunitinib` (Agent). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.

## Summary

Sunitinib is an oral inhibitor of VEGFR1-3, PDGFR, KIT, FLT3 and RET that blocks tumour blood-vessel growth and, in GIST, the KIT driver itself. It is approved for advanced renal cell carcinoma and imatinib-resistant GIST (2006), progressive pancreatic neuroendocrine tumours (2011, 37.5 mg daily continuously) and, little used, as adjuvant therapy in high-risk RCC (S-TRAC, 2017). The pancreatic NET phase 3 (Raymond 2011) showed PFS of 11.4 versus 5.5 months and was stopped early for benefit. In kidney cancer it has been largely displaced by immunotherapy combinations and is the control arm they beat in CheckMate 214, KEYNOTE-426, CheckMate 9ER and CLEAR, while it is still standard second line in GIST. Fatigue, diarrhoea, hand-foot syndrome, hypertension and hypothyroidism are common. For a newcomer, sunitinib defined first-line kidney cancer treatment before immunotherapy.

## Fields

- Kind: Agent
- Status: approved
- Last checked: 2026-09-07
- Brand: Sutent
- Modality: Small-molecule multi-kinase inhibitor (VEGFR, PDGFR, KIT)
- Mechanism: Oral inhibitor of VEGFR1-3, PDGFR, KIT, FLT3, RET.
- Approvals: US 2006: Advanced RCC; GIST after imatinib; US 2011: Progressive pancreatic NETs; US 2017: Adjuvant RCC at high risk (S-TRAC), little used
- Dosing: Oral; 37.5 mg daily continuously (pNET)
- Toxicity (grade 3+): Hypertension 10%; Hand-foot syndrome 6%

## Notes

- In kidney cancer: Motzer 2007 showed PFS 11 versus 5 months against interferon alfa and OS 26.4 versus 21.8 months, and sunitinib then served as the control arm of CheckMate 214, KEYNOTE-426, CheckMate 9ER and CLEAR; it is now mainly used in favourable-risk disease, where immunotherapy doublets show no OS gain, and in GIST, and has been generic since 2021. Resistance runs through alternative angiogenic pathways (FGF, MET, AXL).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Sunitinib
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Sunitinib

## Connected records

- indications: [Grade 3 well-differentiated neuroendocrine tumour](https://nuclide.cc/indications/grade-3-net/), [Meningioma](https://nuclide.cc/indications/meningioma/), [Metastatic pheochromocytoma and paraganglioma](https://nuclide.cc/indications/metastatic-ppgl/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://nuclide.cc/indications/multiple-endocrine-neoplasia/), [Neuroendocrine tumours](https://nuclide.cc/indications/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://nuclide.cc/indications/pancreatic-net/), [Pheochromocytoma and paraganglioma (PPGL)](https://nuclide.cc/indications/pheochromocytoma-paraganglioma/), [Renal cell carcinoma](https://nuclide.cc/indications/rcc/)
- companies: [Pfizer (incl. Seagen)](https://nuclide.cc/companies/pfizer/)
- terms: [SDH deficiency (SDHB immunohistochemistry loss)](https://nuclide.cc/terms/sdh-deficiency/)

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