TricDB

sunitinib

Drug Code : 22020124249
Drug Brand : Sutent
Company : Pfizer Inc
Approved by : NCCN
Approval Time :
Direct Target : PDGFRA,PDGFRB,FLT1,KDR,FLT4,KIT,RET,FMS3
Drug Type : Multi-target inhibitor
Gene : KIT
Alteration : p.D816E
Disease : Thymic Tumor
Indications : Based on NCCN Guidelines, sunitinib is one of the options for second-line systemic therapy for thymic carcinomas. Sunitinib is recommended for patients with thymic carcinoma regardless of c-Kit mutation status (although these mutations occur in <10% of patients).
Mechanism Of Action :
Sunitinib is a small molecule that inhibits multiple receptor tyrosine kinases (RTKs), some of which are implicated in tumor growth, pathologic angiogenesis, and metastatic progression of cancer. Sunitinib was evaluated for its inhibitory activity against a variety of kinases (>80 kinases) and was identified as an inhibitor of platelet-derived growth factor receptors (PDGFRα and PDGFRβ), vascular endothelial growth factor receptors (VEGFR1, VEGFR2 and VEGFR3), stem cell factor receptor (KIT), Fms-like tyrosine kinase-3 (FLT3), colony stimulating factor receptor Type 1 (CSF-1R), and the glial cell-line derived neurotrophic factor receptor (RET). Sunitinib inhibition of the activity of these RTKs has been demonstrated in biochemical and cellular assays, and inhibition of function has been demonstrated in cell proliferation assays. The primary metabolite exhibits similar potency compared to sunitinib in biochemical and cellular assays. Sunitinib inhibited the phosphorylation of multiple RTKs (PDGFRβ, VEGFR2, KIT) in tumor xenografts expressing RTK targets in vivo and demonstrated inhibition of tumor growth or tumor regression and/or inhibited metastases in some experimental models of cancer. Sunitinib demonstrated the ability to inhibit growth of tumor cells expressing dysregulated target RTKs (PDGFR, RET, or KIT) in vitro and to inhibit PDGFRβ- and VEGFR2-dependent tumor angiogenesis in vivo.
Clinical Trial : NCT01621568, NCT01306045
Efficacy & Safety : An open-label phase II trial (NCT01621568) of sunitinib in patients with refractory thymic epithelial tumours showed that sunitinib was active in patients with thymic carcinoma, whereas activity was limited in those with thymoma (PMID: 25592632). An objective response was recorded in 26% of patients with thymic carcinoma, with median duration of response of 16.4 months. The most common treatment-related adverse events included lymphocytopenia (20%), fatigue (20%), and oral mucositis (20%).
Reference Source : Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Guideline Name V.1.2021.◎ National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed [Dec, 4, 2020]. To view the most recent and complete version of the guideline, go online to NCCN.org.
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