Sunitinib can be used to treat a type of kidney cancer called renal cell carcinoma (RCC), gastrointestinal stromal tumors (GISTs), as well as a rare type of pancreatic cancer called neuroendocrine tumors.

WHAT IS SUNITINIB?

Sunitinib is a type of treatment called a multikinase inhibitor. Kinases are important proteins for the body that regulate the way cells grow and divide.

HOW DOES SUNITINIB WORK?

Sunitinib acts by blocking signals within the cancer cells that make them grow and divide. Blocking the signals causes them to die.

Sunitinib can also halt the development of new blood vessels inside cancer cells. This reduces the supply of oxygen and nutrients, making the tumor shrink or stop growing. Drugs that interfere with the growth of blood vessels this way are called angiogenesis inhibitors or anti-angiogenics.

WHEN IS SUNITINIB USED?

Sunitinib is used to treat several types of cancer.

Kidney cancer

Sunitinib is used to treat people with kidney cancer that has spread to other parts of the body (advanced or metastatic renal-cell cancer).

Gastrointestinal stromal tumors (GISTs)

Sunitinib is also used in people with GISTs that can't be removed by surgery or have spread (advanced or metastatic) and cannot receive imatinib any longer.

Pancreatic tumors

Sunitinib is also used to treat people with pancreactic neuroendocrine tumors (pancreatic NETs) that cannot be surgically removed or have spread beyond the pancreas.

WHAT DOES SUNITINIB LOOK LIKE?

Sunitinib is caramel- or orange-colored capsule. It is given in four different dose sizes: 12.5 mg, 25 mg, 37.5 mg, and 50 mg.

HOW IS SUNITINIB TAKEN?

Sunitinib is taken with a glass of water, on an empty or a full stomach. It should not be taken with grapefruit or grapefruit juice.

Your doctor what dose you need. When given to treat kidney cancer or GIST, the normal dose size is 50 mg once a day for four weeks followed by two weeks off the drug. Together this makes for a six-week treatment length.

When given to treat pancreatic NETs, sunitinib is normally given in a dose of 37.5 mg once a day.

Your doctor what dose you need.

POSSIBLE SIDE EFFECTS OF SUNITINIB

TIREDNESS (FATIGUE)

Tiredness is a common side effect, especially toward the end of treatment and for a few weeks after the treatment has finished. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks. If you feel drowsy, don't drive or operate heavy machinery.

HAND/FOOT SKIN REACTION

You may notice reddening on the palms of your hands of the soles of your feet. At times, the hands and feet become painful and inflamed. You may also have changes in sensation, such as numbness or tingling. Tell your specialist if this happens.

Sometimes, if the pain does not go away or if blistering occurs, your doctor may need to lower the dose of sunitinib or interrupt the treatment. Occasionally, people may need to stop the treatment entirely.

SORENESS OF THE MOUTH AND MOUTH ULCERS

Your mouth may become sore or dry or you may develop small ulcers during your treatment. Some find that sucking on ice can help. Drinking lots of fluids and regularly brushing your teeth gently using a soft-bristled toothbrush can help lower the risk of this happening. Tell your doctor or nurse if you have any of these problems, as they can prescribe a mouthwash and drugs to prevent infection in the mouth.

EFFECTS ON THE HAIR AND SKIN

Sunitinib may affect your hair and skin color. Your hair may lose its color and become more thin. Thinning of the hair is temporary. Your skin may lose its color and turn yellow. Other changes to the skin may include a skin rash, reddening, dryness, or itchiness. Tell your doctor or nurse if you have any of these symptoms.

HIGH BLOOD PRESSURE

Sunitinib can cause high blood pressure in some people. This is most likely to happen in the first weeks of taking the medication. If you develop high blood pressure, the treatment can be interrupted or you may be prescribed medication to keep your blood pressure under control.

DIARRHEA

This is the most common side effect of pazopanib, and it develops around a week after the treatment. Normally, this can be easily controlled with drugs, so tell your doctor if your diarrhea is severe or ongoing. It's important to drink lots of fluids if you have diarrhea.

NAUSEA AND VOMITING

Your doctor can prescribe antiemetic drugs to prevent or greatly reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your doctor.

Some of these drugs can cause constipation. Tell your doctor or nurse if this is a problem.

THYROID PROBLEMS

Sunitinib may cause your thyroid to function less effectively. Symptoms of hypothyroidism include tiredness, weight gain, constipation, pain, and a feeling of coldness or dryness of the skin and hair. Tell your doctor if you develop any new symptoms. You may need to have a blood test to determine how well your thyroid is working.

BLEEDING PROBLEMS

This drug may cause bleeding, especially of the nose. You should get in touch with your doctor immediately if you notice any unexplained bleeding, such as bleeding gums, bleeding through the anus, or blood in your stool. They will give you advice on this and on what precautions to take.

HEART PROBLEMS

Sunitinib may cause hear problems, though this is rare. If you have pain in your chest or difficulty breathing, it may mean that your heart is affected, so get in touch with your doctor immediately.

BLOOD CLOTS

Sunitinib can increase your chances of having a blood clot. If you experience breathlessness or have pain in your limbs, tell your doctor immediately.

SLOW WOUND HEALING

Wounds may take longer to heal while you are being treated with sunitinib. If you have any surgical procedures scheduled, you may have to stop taking sunitinib before the operation and not start taking it again for a few weeks afterward. Your doctor can give you further advice on this.

ADDITIONAL INFORMATION ON SUNITINIB

OTHER MEDICINES

Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking sunitinib. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.

FERTILITY

This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.

CONTRACEPTION

Little is known about the effects of sunitinib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.

It is unknown whether sunitinib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.

BREASTFEEDING

There is a potential risk that sunitinib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.

HOSPITAL ADMISSION

If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are receiving treatment with sunitinib.

OTHER ISSUES TO KEEP IN MIND ABOUT SUNITINIB CAPSULES

It is important to take your capsules as your doctors said.

Keep them in a safe place out of the reach of children. Pregnant women should not handle the capsules.

If you forget to take a capsule, do not take a double dose. Tell your doctor and maintain your normal dose schedule.

Tell your doctor if you vomit right after taking the capsules. You may have to take another dose. Do not take any more until you talk to your doctor, nurse, or pharmacist.

If your doctor decides to halt your treatment, return the remaining capsules to the hospital. Do not flush them down the toilet or throw them away.