Sunitinib
Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.
Overview
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.
1.Sunitinib slips into a pocket on its target.
- Route
- Oral
- Schedule
- 37.5 mg daily continuously (pNET)
- Monitoring
- Blood pressure, thyroid, cardiac function
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic sunitinib is available.
- Commercial insurance
- covered on label
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Plans require the generic.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- First-line advanced or metastatic RCC
- Notes
- GIST after imatinib: TA179 (2009). Pancreatic NETs: TA449 (2017). Generic since 2022.
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA169 · SMC advice: sunitinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2006 | Advanced RCC; GIST after imatinib |
| US | 2011 | Progressive pancreatic NETs |
| US | 2017 | Adjuvant RCC at high risk (S-TRAC), little used |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Diarrhoea | 59% | - |
| Nausea | 45% | - |
| Hypertension | 26% | 10% |
| Hand-foot syndrome | 23% | 6% |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topTrials recruiting now
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Notes
top- 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).
Latest papers
topQuery for this drug: (TITLE:"Sunitinib" OR ABSTRACT:"Sunitinib" OR TITLE:"Sutent" OR ABSTRACT:"Sutent") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Sunitinib, not a curated reading list.
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