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Sunitinib in kidney cancer: 10 years of experience and development
Elise Nassif1, Constance Thibault1,2, Yann Vano1,3,2
1a Oncology Department , Georges Pompidou European Hospital , Paris , France.
Introduction:
Sunitinib is a multi-target, anti-angiogenic tyrosine kinase inhibitor and a key molecule in the treatment of metastatic renal cell carcinoma (mRCC). Since it first demonstrated its efficacy ten years ago, overall survival of mRCC has more than doubled, in part due to sunitinib. In most recent years, progress has been made in the comprehension of its mechanism of action and resistance. Areas Covered: In this article, clinical trials involving sunitinib in kidney cancer have been reviewed, defining its different indications in metastatic and localized RCC. The rationale of sunitinib's efficacy, preclinical trials, past-clinical trials and ongoing clinical trials are summarized. Dose and scheme base are discussed, as the recommended dosage is frequently not well tolerated. Combination therapies appear to be toxic. Novel immunotherapies are changing the landscape of mRCC treatment and challenging sunitinib. Special attention has been paid towards cancer cell biology and immunity involved in treatment response. Expert Commentary: Sunitinib's place in the therapeutic arsenal is being redefined with the arrival of major challengers. Dosage and scheduling of sunitinib remains a major challenge.
Insights
Sunitinib has significantly improved survival for metastatic renal cell carcinoma (mRCC) by targeting angiogenesis. However, its optimal use, including dosage and combination therapies, faces challenges with emerging immunotherapies.
Area of Science:
- Oncology
- Pharmacology
- Immunology
Background:
- Sunitinib, a tyrosine kinase inhibitor, has been a cornerstone in metastatic renal cell carcinoma (mRCC) treatment for a decade.
- It has contributed to a significant increase in overall survival for mRCC patients.
- Recent research has advanced the understanding of sunitinib's mechanism of action and resistance patterns.
Purpose of the Study:
- To review clinical trials of sunitinib in kidney cancer, including metastatic and localized indications.
- To summarize the rationale behind sunitinib's efficacy, supported by preclinical and clinical data.
- To discuss current challenges and future directions for sunitinib therapy.
Main Methods:
- Review of clinical trials involving sunitinib in renal cell carcinoma.
- Analysis of preclinical data on sunitinib's efficacy and resistance.
- Examination of combination therapies and emerging immunotherapies.
Main Results:
- Sunitinib has demonstrated efficacy in various stages of renal cell carcinoma.
- Optimal dosage and scheduling remain a challenge due to tolerability issues.
- Combination therapies with sunitinib have shown potential toxicity concerns.
Conclusions:
- Sunitinib's role in mRCC treatment is evolving with the advent of new therapies like immunotherapies.
- Further research is needed to optimize sunitinib's use, particularly regarding dosage and combination strategies.
- Understanding cancer cell biology and immunity is crucial for improving treatment response.
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