Sunitinib malate in the treatment of urothelial cancer

Urothelial cancer (UC) is the fourth most common cancer in men, worldwide. After cystectomy, muscle invasive disease progresses up to 50%, either regionally or as distant metastases, and treatment of metastatic disease remains a challenge, with a median survival that not exceeded 14 months with current chemotherapy regimens. Angiogenesis has been shown to play a role in UC progression and targeting this pathway may improve treatment outcomes. Sunitinib , an anti-angiogenic tyrosine kinase inhibitor, has been tested in preclincal models and Phase II trials in UC.

In this review, the authors discuss the rational for targeting angiogenesis pathway in UC with sunitinib. They also discuss its mechanisms of action, and the data from its preclinical and clinical data studies.

Sunitinib monotherapy has clinical activity in UC, identifying the potential role of the angiogenic pathway as a target for therapy in this tumor type. However, overlapping toxicity with chemotherapy has limited further development. Future research should be focused on improving patient selection which is based on the identification of validated predictive markers for sunitinib treated patients.