Sutent (Sunitinib)

Sutent is a pharmaceutical drug made by Pfizer approved to treat carcinoid tumors. This cutting-edge drug differs from those typically used in chemotherapy. Sutent is designed to target certain enzymes in cancer cells and has been effective in treating kidney cancer, gastrointestinal stromal tumors, and pancreatic neuroendocrine tumorscertain cancers specifically. It was first approved by the U.S. Food and Drug Administration (FDA) in 2006

Developed by Pfizer to target certain pathways in cancer cells, Sutent can cause potentially serious side effects. However, recent studies show this drug may help some patients struggling with mesothelioma. More research is necessary to discover biomarkers to determine which patients would benefit from Sutent.

What is Sutent?

Sutent is a brand name drug with the generic name sunitinib. It was first approved by the FDA in 2006 to treat advanced renal cell cancers, pancreatic neuroendocrine tumors in patients who are not candidates for surgery, and gastrointestinal stromal tumors that do not respond well to other treatments. Unlike other chemotherapy drugs, Sutent is taken as an oral tablet, making it easier for patients. Like traditional chemotherapy, Sutent is given in cycles. There is time allotted between cycles for the body to heal. Although Sutent is not approved for mesothelioma, studies are underway to determine if it can be used as an effective treatment.

How it Works

Sutent is a a receptor tyrosine kinase inhibitor. As such, it targets several receptor tyrosine kinases, which are enzymes on the surface of cancer cells. These enzymes play an important role in how cancer progresses. In targeting these enzymes, Sutent halts signaling inside the cell. Specifically, it inhibits the formation of new blood vessels required for tumor growth. It also inhibits the division of cancer cells and helps trigger cell death.

Some types of cancers are especially driven by receptor tyrosine kinases. This is why Sutent has been approved for a few very specific cancers. This is also the reason Sutent may work for some mesothelioma patients. Mesothelioma is a complex cancer and is different in every individual. In some patients, the receptor tyrosine kinases play a big role in how the cancer grows. In other patients, it does not. Researchers are still determining which patients can benefit from this targeted drug therapy.

Side Effects

Even these highly targeted drugs, there are potential side effects and adverse reactions. For Sutent, the most commonly reported side effects are fatigue, weakness, fever, nausea, diarrhea, vomiting, high blood pressure, abdominal pain, peripheral edema, constipation, skin rashes, skin discoloration, skin dryness, back pain, changes in taste, cough, shortness of breath, anorexia, and bleeding. Sutent can also cause hand and foot syndrome, which is a condition caused by some chemotherapy drugs, resulting in cracked skin, stinging sensation, redness, swelling, thickening, and blistering on the palms of the hands and soles of the feet.

Black Box Warnings

The FDA reserves the black box warning for serious side effects and complications that may be severe or life threatening. For Sutent, there is a black box warning concerning liver toxicity. The drug can cause significant damage to the liver. This damage could be potentially severe and life threatening. Patients should be carefully screened for liver enzymes before using Sutent and should continue screening while taking it. Some patients with a history of liver disease or damage or heavy alcohol use may not be good candidates for the drug. Patients should watch for signs of liver damage, including yellowing eyes and skin, itchiness, dark urine, and pain in the upper right abdominal area.

Sutent and Mesothelioma

Sutent is not approved to treat mesothelioma. However, researchers are considering it a possible treatment for this difficult cancer. Because Sutent is a targeted drug and cancer differs by patient, some patients respond well while others do not. Therefore, this drug will affect tumor growth in some patients and not others. This is in contrast to traditional chemotherapy drugs which are not very targeted and tend to work on any fast-growing cells, cancerous or healthy.

Preliminary results from a phase II clinical trial with Sutent show that as a single agent, this drug may not be useful in mesothelioma patients. Overall average survival time was just over eight months, which is not a great improvement over other treatments. However, there were some patients who responded very well to treatment.

Other studies have been more promising. One was a phase II clinical trial involving 53 mesothelioma patients. All participating patients had previously undergone chemotherapy that did not slow disease progression. In this study, 12 percent of patients had a reduction in tumor size and 65 percent achieved stability. Only 22 percent of the patients continued to progress. Researchers also attempted to determine if certain biomarkers could indicate which patients would respond well to Sutent but were unsuccessful. They concluded that the drug should be used in mesothelioma patients but more work is necessary to pinpoint biomarkers to determine which patients will respond favorably to the drug.

Sutent is a new type of drug with the potential to treat various types of cancer including mesothelioma. Targeted drugs like Sutent are making cancer treatment more individualized and ultimately more effective. Currently, Sutent works well for some mesothelioma patients but not others. As researchers learn more, they hope to identify biomarkers that will indicate which patients should be treated with Sutent for disease stability.