Treatment Name: Sunitinib (Sutent®)
How does sunitinib work?
Sunitinib is designed to slow the growth of cancer cells by inhibiting several mechanisms that the cell uses to grow and survive. Sunitinib is in a class of medications called Tyrosine Kinase Inhibitors (TKIs).
Goals of therapy:
Sunitinib is taken to shrink tumors and decrease symptoms of renal cell carcinoma (RCC). Sunitinib is not commonly given with the goal of cure.
- Usual starting dose: 50 mg oral capsule by mouth once daily for 4 weeks, followed by a 2 week break
Sunitinib is taken by mouth once daily on days 1 through 28 of each 6-week cycle. In other words, sunitinib is taken continuously for 4 weeks followed by a 2-week break each cycle.
In some cases, sunitinib may be given as 50 mg daily for 2 weeks followed by a 1-week break. It may also be given as 37.5 mg daily continuously, without any breaks. These are considered off-label alternative dosing schedules for sunitinib.
Sunitinib is usually taken at home. Typically, each 6 week cycle with sunitinib is repeated until the drug no longer works or unacceptable toxicity is experienced.
In clinical studies, the most commonly reported side effects with sunitinib are shown here. Side effects sometimes have percentage ranges [example 42 – 78%] because they differed between in clinical studies:
- Low white blood cells (42 - 78%)
- Fatigue (28 - 54%)
- Anemia [low red blood cells] (26 - 79%)
- Increased bleeding risk [low platelets] (21 - 68%)
- Diarrhea (20 - 61%)
- Upset stomach (16 - 31%)
- High blood pressure (16 - 30%)
- Rash and blistering on soles of hands and feet (15 - 29%)
- Nausea (13 - 52%)
- Mouth sores (13 - 30%)
- Decreased appetite (12 - 34%)
- Vomiting (10 - 31%)
- Altered sense of taste (9 - 46%)
- Pain in arms and legs (6 - 18%)
- Skin rash (3 - 24%)
Roughly 8 - 19% of patients discontinue sunitinib due to unacceptable side effects.
How often is monitoring needed?
Labs (blood tests) may be checked before treatment and periodically during treatment, most commonly before a new cycle is started. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), urinalysis, and thyroid stimulating hormone (TSH)
How often is imaging needed?
Imaging may be checked before treatment, after cycles 1-4, then after every other cycle until the end of treatment. Imaging may include: computerized tomography (CT) scans, magnetic resonance imaging (MRI), and bone scans
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue sunitinib as planned, or delay or switch therapy
- Sunitinib can possibly impair your body’s ability to heal wounds. Talk to your oncologist about any planned surgeries and let your surgeon know that you are taking sunitinib
- Skin changes such as rash, dry skin, cracking, and blisters. The medication in sunitinib is yellow and can also cause you skin and hair to look yellow or lighter in color
- If blisters or rash on the palms of your hands and soles of your feet occur use a non-alcoholic moisturizer to help prevent this from reccurring
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for renal cell carcinoma. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Sunitinib (Sutent®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Sunitinib (Sutent®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Sunitinib (Sutent®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Sunitinib (Sutent®)