# Sunitinib

Source: https://onco.cc/drugs/sunitinib/  
OnCo record `sunitinib` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Sunitinib is an anti-angiogenic pill approved for pancreatic neuroendocrine tumours, kidney cancer and GIST.

## Summary

Sunitinib is an oral inhibitor of VEGFR1-3, PDGFR, KIT, FLT3 and RET that blocks tumour blood-vessel growth and, in GIST, the KIT driver itself. It is approved for advanced renal cell carcinoma and imatinib-resistant GIST (2006), progressive pancreatic neuroendocrine tumours (2011, 37.5 mg daily continuously) and, little used, as adjuvant therapy in high-risk RCC (S-TRAC, 2017). The pancreatic NET phase 3 (Raymond 2011) showed PFS of 11.4 versus 5.5 months and was stopped early for benefit. In kidney cancer it has been largely displaced by immunotherapy combinations and is the control arm they beat in CheckMate 214, KEYNOTE-426, CheckMate 9ER and CLEAR, while it is still standard second line in GIST. Fatigue, diarrhoea, hand-foot syndrome, hypertension and hypothyroidism are common. For a newcomer, sunitinib defined first-line kidney cancer treatment before immunotherapy.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Sutent
- Modality: Small-molecule multi-kinase inhibitor (VEGFR, PDGFR, KIT)
- Mechanism: Oral inhibitor of VEGFR1-3, PDGFR, KIT, FLT3, RET.
- Approvals: US 2006: Advanced RCC; GIST after imatinib; US 2011: Progressive pancreatic NETs; US 2017: Adjuvant RCC at high risk (S-TRAC), little used
- Dosing: Oral; 37.5 mg daily continuously (pNET)
- Toxicity (grade 3+): Hypertension 10%; Hand-foot syndrome 6%

## Notes

- In kidney cancer: Motzer 2007 showed PFS 11 versus 5 months against interferon alfa and OS 26.4 versus 21.8 months, and sunitinib then served as the control arm of CheckMate 214, KEYNOTE-426, CheckMate 9ER and CLEAR; it is now mainly used in favourable-risk disease, where immunotherapy doublets show no OS gain, and in GIST, and has been generic since 2021. Resistance runs through alternative angiogenic pathways (FGF, MET, AXL).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Sunitinib
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Sunitinib

## Connected records

- cancers: [Alveolar soft part sarcoma](https://onco.cc/cancers/alveolar-soft-part-sarcoma/), [Chromophobe renal cell carcinoma](https://onco.cc/cancers/chromophobe-rcc/), [Clear cell renal cell carcinoma](https://onco.cc/cancers/clear-cell-rcc/), [Dermatofibrosarcoma protuberans](https://onco.cc/cancers/dermatofibrosarcoma-protuberans/), [Desmoplastic small round cell tumour](https://onco.cc/cancers/desmoplastic-small-round-cell-tumour/), [Gastrointestinal stromal tumour (GIST)](https://onco.cc/cancers/gist/), [Glucagonoma](https://onco.cc/cancers/glucagonoma/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Imatinib-resistant GIST](https://onco.cc/cancers/gist-imatinib-resistant/), [KIT exon 11-mutant GIST](https://onco.cc/cancers/gist-kit-exon-11/), [Meningioma](https://onco.cc/cancers/meningioma/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://onco.cc/cancers/multiple-endocrine-neoplasia/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Papillary renal cell carcinoma](https://onco.cc/cancers/papillary-rcc/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/), [Renal cell carcinoma](https://onco.cc/cancers/rcc/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/), [Somatostatinoma](https://onco.cc/cancers/somatostatinoma/), [TFE3-rearranged (translocation) renal cell carcinoma](https://onco.cc/cancers/tfe3-rearranged-renal-cell-carcinoma/), [Thymic carcinoma](https://onco.cc/cancers/thymic-carcinoma/), [Thymoma (WHO types A, AB, B1, B2 and B3)](https://onco.cc/cancers/thymoma/), [Thymoma and thymic carcinoma](https://onco.cc/cancers/thymic-epithelial/), [VIPoma](https://onco.cc/cancers/vipoma/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- targets: [KIT](https://onco.cc/targets/kit/), [PDGFRA](https://onco.cc/targets/pdgfra/), [PDGFRB](https://onco.cc/targets/pdgfrb/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- companies: [Pfizer (incl. Seagen)](https://onco.cc/companies/pfizer/)
- trials: [A Study of Bempegaldesleukin (NKTR-214: BEMPEG) in Combination With Nivolumab Compared With the Investigator's Choice of a Tyrosine Kinase Inhibitor (TKI) Therapy (Either Sunitinib or Cabozantinib Monotherapy) for Advanced Metastatic Renal Cell Carcinoma (RCC)](https://onco.cc/trials/nct03729245/), [A Study of Ripretinib vs Sunitinib in Advanced GIST Patients After Treatment With Imatinib](https://onco.cc/trials/nct03673501/), [CARMENA](https://onco.cc/trials/carmena/), [CheckMate 214](https://onco.cc/trials/checkmate-214/), [CheckMate 9ER](https://onco.cc/trials/checkmate-9er/), [CLEAR (KEYNOTE-581)](https://onco.cc/trials/clear/), [FIRSTMAPPP](https://onco.cc/trials/firstmappp/), [KEYNOTE-426](https://onco.cc/trials/keynote-426/), [NCI-MATCH (EAY131)](https://onco.cc/trials/nci-match/), [PAPMET (SWOG S1500)](https://onco.cc/trials/papmet/), [Pembrolizumab (MK-3475) Plus Epacadostat vs Standard of Care in mRCC (KEYNOTE-679/ECHO-302)](https://onco.cc/trials/nct03260894/), [Phase Ib/II Trial of Envafolimab Plus Lenvatinib for Subjects With Solid Tumors](https://onco.cc/trials/nct05024214/), [Savolitinib Plus Durvalumab Versus Sunitinib and Durvalumab Monotherapy in MET-Driven, Unresectable and Locally Advanced or Metastatic PRCC](https://onco.cc/trials/nct05043090/), [Savolitinib vs. Sunitinib in MET-driven PRCC.](https://onco.cc/trials/nct03091192/), [TAPUR (Targeted Agent and Profiling Utilization Registry)](https://onco.cc/trials/tapur/)
- key papers: [ASPEN: everolimus versus sunitinib in metastatic non-clear cell renal cell carcinoma](https://onco.cc/key-papers/paper-aspen-armstrong-lancet-oncol-2016/), [CheckMate 214: nivolumab plus ipilimumab versus sunitinib in advanced renal cell carcinoma](https://onco.cc/key-papers/paper-checkmate-214-nejm-2018/), [FIRSTMAPPP: sunitinib for metastatic progressive phaeochromocytomas and paragangliomas](https://onco.cc/key-papers/paper-firstmappp-sunitinib-metastatic-ppgl-baudin-lancet-2024/), [GRID: regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib](https://onco.cc/key-papers/paper-grid-regorafenib-gist-lancet-2013/), [INTRIGUE: ripretinib versus sunitinib in advanced gastrointestinal stromal tumour after imatinib](https://onco.cc/key-papers/paper-intrigue-ripretinib-vs-sunitinib-jco-2022/), [KEYNOTE-426: pembrolizumab plus axitinib versus sunitinib for advanced renal cell carcinoma](https://onco.cc/key-papers/paper-keynote-426-nejm-2019/), [PAPMET (SWOG 1500): cabozantinib versus sunitinib for metastatic papillary renal cell carcinoma](https://onco.cc/key-papers/paper-papmet-pal-lancet-2021/), [Sunitinib in advanced gastrointestinal stromal tumour after failure of imatinib](https://onco.cc/key-papers/paper-demetri-sunitinib-gist-lancet-2006/), [Sunitinib malate for the treatment of pancreatic neuroendocrine tumours](https://onco.cc/key-papers/paper-raymond-sunitinib-pnet-nejm-2011/), [Thymic epithelial tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up](https://onco.cc/key-papers/paper-esmo-thymic-epithelial-tumours-guideline-ann-oncol-2015/)
- terms: [SDH deficiency (SDHB immunohistochemistry loss)](https://onco.cc/terms/sdh-deficiency/)
- pathways: [Renal cell carcinoma (KEGG map)](https://onco.cc/pathways/renal-cell-carcinoma-signalling/), [The angiogenic switch & tumour vessels](https://onco.cc/pathways/angiogenic-switch/)
- drugs: [Cediranib](https://onco.cc/drugs/cediranib/)

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