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Updated: Feb 11, 2026
Modeling Spontaneous Metastatic Renal Cell Carcinoma mRCC in Mice Following Nephrectomy
Published on: April 29, 2014
Sunitinib in the treatment of renal cell carcinoma: an update on recent evidence
1Medical Oncology, Santa Chiara Hospital, Trento, Italy.
Abstract:
Sunitinib is a multitarget tyrosine kinase inhibitor endowed mainly by antiangiogenic effects, although an indirect inhibitory effect on tumor growth and, more recently, a complex activity on antitumor immune response has been described. From approval by the US Food and Drug Administration (FDA) in January 2006, sunitinib represents a key molecule in the treatment of metastatic renal cell carcinoma (mRCC) due to the peculiar molecular pathogenesis of this neoplasm. Over the past 10 years, clinical trials and real-world experiences helped clinicians to understand how, when and for how long to use sunitinib. Although a huge amount of data evidenced the relationship existing between sunitinib dose intensity and improved clinical outcome, the management of sunitinib-induced adverse events is often complex; thus, alternative schedules have been proposed over time which allow increased tolerability, without decreased daily sunitinib exposure, leading to improved clinical outcomes. To date, combinations of sunitinib with other approved targeted agents did not demonstrate any significant benefit over its single-agent use, mainly due to tolerability issues. Sunitinib has also been tested in the adjuvant setting, within the ASSURE and S-TRAC trials, with opposite results; indeed, equivocal risk-stratification criteria, as well as immature overall survival (OS) data prevent any definitive conclusion on this important issue. Despite being on the market for a long time, sunitinib still plays a role as the 'comparator arm' of a number of trials in the field of mRCC. Combinations with immune checkpoint inhibitors and vaccines look promising; once again, sunitinib can help us to optimize mRCC management.
Insights
Sunitinib is a key treatment for metastatic renal cell carcinoma (mRCC). Optimizing its use involves managing side effects and exploring novel combinations for better patient outcomes.
Area of Science:
- Oncology
- Pharmacology
- Immunology
Background:
- Sunitinib, a tyrosine kinase inhibitor, is a primary treatment for metastatic renal cell carcinoma (mRCC) approved by the FDA in 2006.
- Its efficacy is linked to antiangiogenic effects and a complex role in antitumor immunity.
- Understanding sunitinib's optimal use, including dosing and managing adverse events, has evolved over a decade of clinical experience.
Purpose of the Study:
- To review the clinical application and evolving understanding of sunitinib in mRCC treatment.
- To assess the impact of dose intensity, alternative schedules, and combination therapies on clinical outcomes.
- To evaluate sunitinib's role in the adjuvant setting and its future potential in combination therapies.
Main Methods:
- Review of clinical trials and real-world data on sunitinib in mRCC.
- Analysis of studies investigating sunitinib dose intensity and alternative administration schedules.
- Examination of combination therapy trials, including with targeted agents, immune checkpoint inhibitors, and vaccines.
- Assessment of adjuvant setting trials (ASSURE, S-TRAC).
Main Results:
- Sunitinib dose intensity correlates with improved clinical outcomes, but managing adverse events is challenging.
- Alternative schedules can improve tolerability without compromising efficacy.
- Combinations with other targeted agents have shown limited benefit due to tolerability issues.
- Adjuvant setting trials yielded conflicting results, preventing definitive conclusions.
Conclusions:
- Sunitinib remains a crucial agent in mRCC management, with ongoing research focusing on optimizing its use.
- Alternative dosing schedules and careful management of side effects are key to maximizing patient benefit.
- Future directions include exploring combinations with immune checkpoint inhibitors and vaccines to further enhance mRCC treatment.
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