Sutent is a is a brand-name prescription medication that’s FDA-approved to treat certain forms of the following types of cancer:

  • Gastrointestinal stromal tumors. Sutent is used to treat gastrointestinal stromal tumors (GISTs) if:
    • the tumors have worsened after you’ve taken a drug called imatinib (Gleevec), or
    • your body can’t tolerate imatinib (side effects from the drug made it very hard or unsafe for you to take)
  • Advanced renal cell carcinoma. Renal cell carcinoma (RCC) is a kind of kidney cancer. “Advanced” refers to cancer that has started to grow or spread.
  • Adjuvant* treatment of RCC. Sutent is used for localized RCC that was treated with a nephrectomy (surgical removal of a kidney). “Localized” means that the cancer hasn’t spread. There’s a high risk the RCC will return. And Sutent is approved as an adjuvant treatment for RCC.
  • Advanced pancreatic neuroendocrine tumors. Sutent is approved to treat pancreatic neuroendocrine tumors (pNETs). The pNETs must be well-differentiated, which means they’re slow growing and their cells look more like normal cells. The pNETs must also be unresectable (can’t be removed with surgery). In addition, they must also be either:
    • locally advanced (grown or spread near the pancreas), or
    • metastatic (spread to other parts of the body)

* The term “adjuvant” refers to an extra treatment you have after your first cancer treatment. It’s meant to help reduce the risk of the cancer coming back.

Drug details

Sutent contains the active ingredient sunitinib and belongs to a group of medications known as kinase inhibitors.

Sutent comes as a capsule that you swallow. It’s available in four strengths: 12.5 mg, 25 mg, 37.5 mg, and 50 mg. You’ll usually take Sutent once a day.

Effectiveness

For information on the effectiveness of Sutent, please see the “Sutent uses” section below.

Sutent is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Sutent can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Sutent. These lists don’t include all possible side effects.

For more information on the possible side effects of Sutent, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to report to the FDA a side effect you’ve had with Sutent, you can do so through MedWatch.

Mild side effects

Mild side effects of Sutent can include:*

Some of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Sutent. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Sutent’s Medication Guide.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Bleeding problems. Symptoms can include:
    • bruising easily
    • coughing up blood
    • painful, swollen belly
  • Heart problems, such as heart failure, heart attack, high blood pressure, and abnormal heart rhythm. Symptoms can include:
    • swelling of feet or ankles
    • dizziness or feeling faint
  • Stomach or intestinal problems, such as holes or tears. Symptoms can include:
    • pain in the belly area
  • Tumor lysis syndrome (a condition in which cancer cells release harmful chemicals into your blood). Symptoms can include:
    • muscle cramps
    • fatigue
    • nausea
    • abnormal heart rhythm
  • Thrombotic microangiopathy (blood clots and damage to small blood vessels). Symptoms can include:
    • decreased number of red blood cells
    • acute kidney failure
    • fatigue
    • shortness of breath
    • producing less urine
    • confusion
  • Proteinuria (high levels of protein in urine and possible kidney damage). Symptoms may include:
    • frequent urination
    • swollen hands, feet, face, or abdomen (belly)
  • Serious skin reactions, such as Stevens-Johnson syndrome. Symptoms may include:
    • red or purple rash with blisters or peeling skin
    • itching
    • bumps or sores
    • body or joint aches
  • Thyroid problems such as hyperthyroidism (high thyroid hormone level) and hypothyroidism (low thyroid hormone level). Symptoms may include:
    • fatigue
    • loss of appetite
    • sweating
    • racing heartbeat
    • hair loss
    • change in menstrual periods
  • Low blood sugar. Symptoms may include:
    • sweating
    • change in heart rate or rhythm
    • confusion
    • blurred vision
    • trouble concentrating
  • Osteonecrosis (breakdown of bone cells) in the jaw. Symptoms may include:
    • pain
    • swelling
  • Wound healing problems. Symptoms may include:
    • slow healing
    • infection
  • Reversible posterior leukoencephalopathy syndrome, which is a condition that causes swelling in the brain. Symptoms can include:
    • changes in your vision
    • headache
    • seizures
  • High blood pressure. Symptoms can include:
    • headache
    • chest pain
    • vision problems
  • Allergic reaction.*
  • Liver damage.*†

* For more information about this serious side effect, see the “Side effect details” section below.
Sutent has a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information, see “FDA warning: Liver damage” at the beginning of this article.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Sutent. But the frequency of these allergic reactions is unknown.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Sutent. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Rash

A rash may occur with Sutent use. In studies, rashes occurred in:

  • 14% to 29% of people who took Sutent, depending on the condition being treated
  • 5% to 12% of people who took a placebo (treatment with no active drug), depending on the condition being treated
  • 11% of people who took a drug called interferon-alpha for advanced renal cell carcinoma (RCC)

Rashes often form on the palms of the hands and bottoms of feet. Rashes may be due to an allergic reaction and are often mild. (For more about allergic reactions, see the “Allergic reaction” section right above.) Some rashes may be signs of more serious skin conditions.

If you develop a rash while taking Sutent, tell your doctor right away. They’ll see what kind of rash you have. If it’s serious, they may have you stop taking Sutent and recommend other cancer treatment options.

Mouth sores

Sutent may cause mouth sores or blisters. In studies, mouth sores occurred in:

  • 29% to 61% of people who took Sutent, depending on the condition being treated
  • 15% to 18% of people who took a placebo, depending on the condition being treated
  • 5% of people who took interferon-alpha for advanced RCC

The mouth sores or blisters can occur inside the mouth or on the lips and range from mild to severe.

Tell your doctor if you develop mouth sores or blisters while taking Sutent. They can suggest ways to help ease your discomfort.

Lack of appetite

A decreased appetite or a loss of appetite may occur with Sutent use. In studies, these side effects occurred in:

  • 19% to 48% of people who took Sutent, depending on the condition being treated
  • 5% to 29% of people who took a placebo, depending on the condition being treated
  • 42% of people who took interferon-alpha for advanced RCC

These appetite changes can be caused directly by Sutent, or they could be the result of changes in your thyroid function. (See the “Serious side effects” list above for more information on thyroid side effects and symptoms.)

While you take Sutent, tell your doctor if you have concerns about changes in your appetite or are losing weight. They can recommend treatments or suggest a different treatment option for you.

Digestive system problems

Digestive system problems are common with Sutent and include diarrhea, nausea, and vomiting. The most common digestive system problem was diarrhea.

In studies, diarrhea occurred in:

  • 40% to 66% of people who took Sutent, depending on the condition being treated
  • 22% to 39% of people who took a placebo, depending on the condition being treated
  • 21% of people who took interferon-alpha for advanced RCC

If your digestive system problems don’t go away or bother you while taking Sutent, talk with your doctor. They can suggest ways to help ease your symptoms or recommend other treatment options for your cancer.

Changes in skin color

Changes in skin color may occur with Sutent use. In studies, this side effect occurred in:

  • 18% to 30% of people who took Sutent, depending on the condition being treated
  • 1% to 23% of people who took a placebo, depending on the condition being treated

No changes in skin color were reported in people who took interferon-alpha for advanced RCC.

Changes in hair color may also occur. In studies, this side effect occurred in:

  • 7% to 29% of people who took Sutent, depending on the condition being treated
  • 1% to 4% of people who took a placebo, depending on the condition being treated
  • less than 1% of people who took interferon-alpha for advanced RCC

Sutent may cause these changes because the drug itself is yellow. So your skin or hair may become lighter or your skin may develop a yellowish look to it. But your skin and hair should return to their usual colors after your treatment with Sutent is complete.

If you’re bothered by skin or hair color changes when taking Sutent, talk with your doctor. Skin color changes can also be a sign of something more serious, such as liver problems.* So your doctor will likely test you to find the cause.

* Sutent has a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information, see “FDA warning: Liver damage” at the beginning of this article.

Liver damage

Liver damage, which is also called hepatotoxicity, has been reported in people who have taken Sutent.* In rare cases, the damage caused liver failure or death. In studies, liver failure occurred in less than 1% of people who took Sutent for any of the conditions the drug is used to treat. It wasn’t reported how often liver failure occurred in people who took interferon-alpha or a placebo.

Tell your doctor if you notice any of the following symptoms, which can be signs of liver damage:

  • yellowing of skin
  • dark urine
  • itching
  • pain in the upper abdomen

While you take Sutent, your doctor will likely monitor your liver function. Depending on the results, they may reduce your dose or pause or stop your treatment.

* Sutent has a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information, see “FDA warning: Liver damage” at the beginning of this article.

When do Sutent side effects start?

Side effects can occur after the first dose of Sutent. It’s possible some of your side effects could worsen within the first couple of weeks of treatment. But sometimes side effects can ease with time.

If you have side effects that bother you or cause discomfort, tell your doctor. They can suggest possible treatments.

As with all medications, the cost of Sutent can vary. To find current prices for Sutent in your area, check out WellRx.com. The cost you find on WellRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Sutent. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Sutent, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Sutent, or if you need help understanding your insurance coverage, help is available.

Pfizer Inc., the manufacturer of Sutent, offers several programs that may help lower the cost of Sutent. For more information and to find out if you’re eligible for support, call 877-744-5675 or visit the drug manufacturer’s website.

Generic version

Sutent isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Here are answers to some frequently asked questions about Sutent.

What’s the success rate of Sutent in treating my condition?

The success rate of treating your cancer will depend on a few factors. These include other medical conditions you have, how long you take Sutent for, and the severity of your condition.

For information on how successful Sutent has been in treating your specific type of cancer in clinical studies, see the “Sutent uses” section below.

Is Sutent considered chemotherapy?

No, Sutent isn’t considered chemotherapy. It’s a targeted therapy.

Chemotherapy drugs tend to affect all the cells in your body that are quickly multiplying, not just cancer cells. Because of this, chemotherapy may cause a number of side effects.

Targeted drugs, such as Sutent, treat cancer by working on certain cells. As a result, the side effects are usually not as widespread as with chemotherapy. (To learn more about the side effects of Sutent, see the “Sutent side effects” section above.)

Does Sutent shrink tumors?

In some cases it’s possible for Sutent to shrink tumors. A tumor is a mass of cancerous tissue.

A study of people with advanced kidney cancer showed that Sutent can shrink tumors. But it’s important to note that Sutent won’t work the same way for everyone. So for some people who take Sutent, their tumors may not shrink.

If you have questions about how well Sutent works to shrink tumors for your type of cancer, talk with your doctor.

How long will Sutent keep working to treat my cancer?

The length of time Sutent will keep working to treat your cancer depends on a few factors. These are the condition you’re taking the drug for, other medical conditions you have, and how well you tolerate the medication.

For more information how long Sutent may work for you, talk with your doctor.

The Sutent dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using Sutent to treat
  • other medical conditions you may have
  • other medications you are taking

Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Sutent comes as a capsule that you swallow. It’s available in these strengths: 12.5 milligrams (mg), 25 mg, 37.5 mg, and 50 mg.

Dosage for gastrointestinal cancer

The usual dosage of Sutent for gastrointestinal stromal tumors (GISTs) is 50 mg once per day for 4 weeks. This is followed by 2 weeks without medication. Then, you’ll repeat the cycle.

You’ll likely continue taking Sutent until your cancer worsens or your body can’t tolerate treatment with the drug. Your doctor will determine when you should stop taking Sutent.

For details on how Sutent is used to treat GISTs, see the “Sutent uses” section below.

Dosage for kidney cancer

Sutent is also used to treat a type of kidney cancer called advanced renal cell carcinoma (RCC). The usual dosage of Sutent for advanced RCC is 50 mg once per day for 4 weeks. This is followed by 2 weeks without medication. Then, you’ll repeat the cycle.

You’ll likely continue taking Sutent until your cancer worsens or your body can’t tolerate treatment with the drug. Your doctor will determine when you should stop taking Sutent.

For more information on how Sutent is used to treat advanced RCC, see the “Sutent uses” section below.

Dosage for the adjuvant treatment of kidney cancer

Sutent is also used as an adjuvant treatment for a type of kidney cancer called RCC after a nephrectomy (the surgical removal of a kidney). The usual dosage of Sutent for this use is 50 mg once per day for 4 weeks. This is followed by 2 weeks without medication. You’ll typically repeat this cycle up to nine times.

For details on how Sutent is used as an adjuvant treatment for RCC, see the “Sutent uses” section below.

Dosage for pancreatic cancer

The usual dosage of Sutent for advanced pancreatic neuroendocrine tumors (pNETs) is 37.5 mg once per day.

You’ll likely continue taking Sutent until your cancer worsens or your body can’t tolerate treatment with the drug. Your doctor will determine when you should stop taking Sutent.

For more information on how Sutent is used for pNETs, see the “Sutent uses” section below.

What if I miss a dose?

If you miss a dose of Sutent, take it as soon as you remember if it’s within 12 hours of the time you normally take it. But if it’s been more than 12 hours, wait until it’s time for your next dose, then take the medication as usual. Don’t double up on your doses.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too. It may also help to put your treatment schedule on a calendar.

Will I need to use this drug long term?

Sutent is meant to be used as a long-term treatment. If you and your doctor determine that Sutent is safe and effective for you, you’ll likely take it long term. The length of time you take it depends on the condition being treated and how your condition responds to the medication.

Altering Sutent dosages or stopping Sutent treatment

If your doctor recommends that your daily Sutent dosage be changed, they’ll likely alter it by 12.5 mg. They’ll determine whether or not your dosage needs to be changed based on how your body is responding to the drug during treatment. In some cases, your doctor may have you pause or stop your Sutent treatment. These include the following:

  • Developing certain side effects. If you develop a rash or have a change in your liver function,* your doctor may have you pause your Sutent use. They’ll likely monitor you and make sure the side effects go away before you restart your treatment. And in some situations, your doctor may have you stop taking Sutent for good.
  • Becoming pregnant. Sutent isn’t safe to take during pregnancy. So your doctor will likely have you stop taking the drug and may switch you to a different one.
  • Taking Sutent for certain conditions. Depending on the type of cancer you have, you may take Sutent in cycles. These are times when you’ll use the drug for a certain number of weeks and then stop for a couple of weeks. For details on dosages, see above.

* Sutent has a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information, see “FDA warning: Liver damage” at the beginning of this article.

The Food and Drug Administration (FDA) approves prescription drugs such as Sutent to treat certain conditions. Sutent may also be used off-label for other conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Sutent for gastrointestinal cancer

Sutent is used to treat gastrointestinal stromal tumors (GISTs) if:

  • the tumors have worsened after you’ve taken a drug called imatinib (Gleevec), or
  • your body can’t tolerate imatinib (side effects from the drug made it very hard or unsafe for you to take)

Tumors are masses of cancerous tissue. And GISTs are a rare type of digestive system cancer. They start in the walls of your digestive tract, most often in the stomach or small intestine. The tumors can occur in other parts of the digestive tract as well.

Effectiveness for gastrointestinal cancer

A study looked at people with GISTs who had previously used imatinib, but they stopped taking the drug. Researchers compared the results of people who took either Sutent or a placebo (no active treatment).

The study looked at how long Sutent kept people’s tumors from progressing (getting worse).

  • For half of the Sutent group, their tumors didn’t progress for at least 27.3 weeks.
  • For half of the placebo group, their tumors didn’t progress for at least 6.4 weeks.

Sutent for kidney cancer

Sutent is used to treat a kind of kidney cancer called advanced renal cell carcinoma (RCC).

RCC usually forms in cells that line parts of the kidneys known as tubules. These cells gather and form tumors. When RCC is advanced, it means the cancer has grown outside of the kidney or spread to other parts of the body.

Effectiveness for kidney cancer

A study looked at people with advanced RCC who hadn’t received treatment for the condition. Researchers compared the results of people who took either Sutent or a medication called interferon-alfa.

The study looked at how long Sutent kept people’s RCC from progressing (getting worse).

  • For half of the Sutent group, their cancer didn’t progress for at least 47.3 weeks.
  • For half of the interferon-alfa group, their cancer didn’t progress for at least 22.0 weeks.

Sutent for the adjuvant treatment of kidney cancer

Sutent is used for localized RCC that was treated with a nephrectomy (surgical removal of a kidney). “Localized” means that the cancer hasn’t spread. There’s a high risk the RCC will return.

Sutent is approved as an adjuvant treatment for RCC. The term “adjuvant” refers to an extra treatment you have after your first cancer treatment. It’s meant to help reduce the risk of the cancer coming back.

For more information on RCC, see the “Sutent for kidney cancer” section right above.

Effectiveness for the adjuvant treatment of kidney cancer

A study looked at people who had a high risk for RCC recurring (coming back) after a nephrectomy. Researchers compared people who took either Sutent or a placebo after surgery.

The study looked at how long Sutent kept people’s RCC from coming back.

  • For half of the Sutent group, their cancer didn’t come back for at least 6.8 years.
  • For half of the placebo group, their cancer didn’t come back for at least 5.6 years.

Sutent for pancreatic cancer

Sutent is approved to treat pancreatic neuroendocrine tumors (pNETs). The pNETs must be well-differentiated, which means they’re slow growing and their cells look more like normal cells. The pNETs must also be unresectable (can’t be removed with surgery). In addition, they must also be either:

  • locally advanced (grown or spread near the pancreas), or
  • metastatic (spread to other parts of the body)

pNETs are a form of pancreatic cancer. This type of cancer affects an organ known as the pancreas. pNETs start in pancreas cells that make a hormone called insulin. (Insulin works in your body to help lower blood sugar levels.)

Effectiveness for pancreatic cancer

A study looked at people with the pNETs described above. Researchers compared people who took either Sutent or a placebo.

The study looked at how long Sutent kept people’s pNETs from progressing (getting worse).

  • For half of the Sutent group, their tumors didn’t progress for at least 10.2 months.
  • For half of the placebo group, their tumors didn’t progress for at least 5.4 months.

Sutent for other conditions

In addition to the uses listed above, Sutent may be used off-label. Off-label drug use is when a drug that’s approved for one or more uses is prescribed for a different one that’s not approved. Below is information on another possible use for Sutent.

Sutent for thyroid cancer (previously studied)

Sutent isn’t FDA-approved for the treatment of thyroid cancer, but it has been studied in the past for this condition.

More information is needed to understand Sutent’s role in the treatment of thyroid cancer. But according to guidelines from the National Comprehensive Cancer Network, studies have shown that Sutent has potential in helping treat thyroid cancer, especially when other treatments have failed.

Sutent and children

It’s not known whether Sutent is safe and effective for use in children.

Sutent can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Sutent and other medications

Below is a list of medications that can interact with Sutent. This list doesn’t contain all drugs that may interact with Sutent.

Before taking Sutent, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Sutent and CYP inhibitors

Taking Sutent with medications that decrease the activity of an enzyme called CYP3A4 can increase the level of Sutent in your body. CYP3A4 helps your body process drugs to get rid of them. When this action is slowed down, the risk of side effects from Sutent increase. (For more about Sutent side effects, see the “Sutent side effects” section above.)

Examples of CYP3A4 inhibitors include:

  • antibiotics, such as erythromycin (Ery-Tab), clarithromycin
  • antifungals, such as itraconazole (Sporanox), ketoconazole
  • antivirals, such as atazanavir (Reyataz), darunavir (Prezista), ritonavir (Norvir)
  • calcium channel blockers, such as verapamil (Verelan, Calan SR), diltiazem (Cardizem CD, Cartia XT)

Before you start taking Sutent, tell your doctor if you’re using any of these medications. They may want to decrease your Sutent dosage, have you stop taking the medication, or suggest other treatment options for you.

Sutent and CYP inducers

Taking Sutent with medications that increase the activity of an enzyme called CYP3A4 can decrease the level of Sutent in your body. CYP3A4 helps your body process drugs to get rid of them. When this process is sped up, Sutent can be less effective.

Examples of CYP3A4 inducers include:

  • antibiotics such as rifabutin (Mycobutin), rifampin (Rifadin)
  • antivirals, such as nevirapine (Viramune), efavirenz (Sustiva)
  • anticonvulsants, such as oxcarbazepine (Trileptal), phenytoin (Dilantin), carbamazepine (Carbatrol, Tegretol)
  • corticosteroids, such as dexamethasone

Before you start using Sutent, tell your doctor if you are taking any of these medications. They may want to adjust your Sutent dosage, have you stop taking the drug, or suggest other treatment options for you.

Sutent and herbs and supplements

Taking Sutent with the supplement St. John’s wort can speed up the activity of CYP3A4 enzyme. This decreases the level of Sutent in the body, which can make it less effective.

If you’re taking St. John’s Wort, tell your doctor. They may have you stop using it during your Sutent treatment or may adjust your Sutent dose.

Sutent and foods

It’s recommended that you avoid eating grapefruit or drinking grapefruit juice while taking Sutent. Consuming grapefruit while taking Sutent may increase the level of Sutent in your body. This can cause side effects to be worse. (For more about Sutent side effects, see the “Sutent side effects” section above.)

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Sutent, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Alternatives for gastrointestinal cancer

Examples of other drugs that may be used to treat gastrointestinal stromal tumors (GISTs) include:

  • regorafenib (Stivarga)
  • avapritinib (Ayvakit)
  • imatinib (Gleevec)

Alternatives for kidney cancer

Examples of other drugs that may be used to treat a form of kidney cancer called renal cell carcinoma (RCC) include:

Alternatives for the adjuvant treatment of kidney cancer

RCC is a form of kidney cancer. Sutent is generally the recommended medication for adjuvant treatment of RCC when:

  • you’ve had RCC in the past, and
  • you’re at high risk of having the RCC return after a nephrectomy (surgical removal of kidney)

The term “adjuvant” refers to an extra treatment you have after your first cancer treatment. It’s meant to help reduce the risk of the cancer returning.

Currently, the Food and Drug Administration (FDA) hasn’t approved any other medications than Sutent for this specific use.

But if Sutent isn’t an option for you, guidelines from the National Comprehensive Cancer Network recommend two options. One is to consider enrolling in a clinical trial. The other option is having your doctor monitor you consistently for a return of your cancer, depending on the specific type you have (the stage and features).

To find information about clinical trials, talk with your doctor. You can also search here. Examples of medications that are being studied include:

  • nivolumab (Opdivo)
  • ipilimumab (Yervoy)

Alternative for pancreatic cancer

Pancreatic neuroendocrine tumors (pNETs) are a form of pancreatic cancer. Another FDA-approved drug that may be used to treat pNETs is everolimus (Afinitor).

You may wonder how Sutent compares with other medications that are prescribed for similar uses. Here we look at how Sutent and Votrient are alike and different.

Ingredients

Sutent contains the active ingredient sunitinib. Votrient includes the active ingredient pazopanib.

Uses

The Food and Drug Administration (FDA) has approved both Sutent and Votrient to treat certain forms of a kind of kidney cancer called advanced renal cell carcinoma (RCC).*

Sutent is also FDA-approved to treat certain forms of the following conditions:

Votrient is also FDA-approved for the treatment of advanced soft tissue sarcoma.

* For details on these conditions, see the “Sutent uses” section above.

Drug forms and administration

Both Sutent and Votrient are oral medications, meaning that you take them by mouth.

Sutent comes as a capsule. Votrient comes as a tablet.

Side effects and risks

Sutent and Votrient both treat RCC. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 common mild side effects that can occur with each drug, or with both Sutent and Votrient (when taken individually).

  • Can occur with Sutent:
    • mild sores and swelling in the mouth
  • Can occur with Votrient:
    • no unique side effects
  • Can occur with both Sutent and Votrient:
    • mild rash
    • hand-foot syndrome (redness or swelling in the hands or feet)
    • changes in hair or skin color
    • fatigue (lack of energy) or weakness
    • changes in taste

Serious side effects

These lists contain examples of serious side effects that can occur with Sutent, with Votrient, or with both drugs (when taken individually).

* Sutent and Votrient have a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information on Sutent, see “FDA warning: Liver damage” at the beginning of this article.

Effectiveness

The only condition both Sutent and Votrient are used to treat is advanced RCC.

The use of Sutent and Votrient in treating metastatic RCC has been directly compared in a clinical study. “Metastatic” means the cancer spread to other parts of the body. The medications had similar effectiveness in the two measures mentioned below.

Researchers looked at how long the drugs kept RCC from progressing (getting worse).

  • For half of the Sutent group, their RCC didn’t progress for at least 9.5 months.
  • For half of the Votrient group, their RCC didn’t progress for at least 8.4 months.

Researchers also looked at how long people in the study survived.

  • Half of the Sutent group survived for at least 29.3 months.
  • Half of the Votrient group survived for at least 28.4 months.

Costs

Sutent and Votrient are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Sutent and Votrient prices will vary depending on your prescribed treatment plan. The actual cost you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Like Votrient (above), the drug Stivarga has uses similar to those of Sutent. Here’s a comparison of how Sutent and Stivarga are alike and different.

Ingredients

Sutent contains the active ingredient sunitinib. Stivarga contains the active ingredient regorafenib.

Uses

The Food and Drug Administration (FDA) has approved both Sutent and Stivarga to treat certain forms of gastrointestinal stromal tumors (GISTs).*

Sutent is used to treat GISTs if:

  • the tumors have worsened after you’ve taken a drug called imatinib (Gleevec), or
  • your body can’t tolerate imatinib (side effects from the drug made it very hard or unsafe for you to take)

Stivarga is used to treat GISTs if you’ve already tried imatinib and sunitinib (the active ingredient in Sutent). In addition, the tumors must also be either:

  • locally advanced (spread nearby), or
  • metastatic (spread to other parts of the body), or
  • can’t be treated with surgery

Sutent is also FDA-approved to treat certain forms of other cancers. These cancers are advanced renal cell carcinoma (RCC) and advanced pancreatic neuroendocrine tumors.* In addition, Sutent is approved as an adjuvant treatment of RCC.*

Stivarga is also FDA-approved for the treatment of metastatic colorectal cancer and hepatocellular carcinoma.

* For details on these conditions, see the “Sutent uses” section above.

Drug forms and administration

Both Sutent and Stivarga are oral medications, meaning that you take them by mouth.

Sutent comes as a capsule. Stivarga comes as a tablet.

Side effects and risks

Sutent and Stivarga both treat GISTs. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 common mild side effects that can occur with Sutent, with Stivarga, or with both drugs (when taken individually).

  • Can occur with Sutent:
    • changes in taste
    • changes in skin or hair color
  • Can occur with Stivarga:
    • belly or stomach pain
    • voice changes, such as hoarseness or weakness
    • fever
    • weight loss
  • Can occur with both Sutent and Stivarga:
    • fatigue (lack of energy) or weakness
    • mild sores and swelling in the mouth
    • mild rash
    • hand-foot syndrome (redness or swelling on hands or feet)

Serious side effects

These lists contain examples of serious side effects that can occur with Sutent, with Stivarga, or with both drugs (when taken individually).

  • Can occur with Sutent:
    • thrombotic microangiopathy (blood clots and damage to small blood vessels)
    • severe sores and swelling in the mouth
  • Can occur with Stivarga:
    • infections
    • serious forms of high blood pressure, including hypertensive crisis (a blood pressure reading of 180/120 mm Hg or higher)
  • Can occur with both Sutent and Stivarga:
    • wound healing problems, such as slow healing
    • reversible posterior leukoencephalopathy syndrome (a condition that affects the brain)
    • high blood pressure

* Sutent and Stivarga have a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information on Sutent, see “FDA warning: Liver damage” at the beginning of this article.

Effectiveness

Sutent and Stivarga are both used to treat GISTs.

These drugs haven’t been directly compared in clinical studies, but studies have found both Sutent and Stivarga to be effective for treating GISTs. That said, it’s important to note that Stivarga is recommend for GISTs after treatment with imatinib and sunitinib (the active ingredients in Sutent) has already been tried.

Costs

Sutent and Stivarga are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on WellRx.com, Sutent and Stivarga prices will vary depending on your prescribed treatment plan. The actual cost you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

There are no reported interactions between Sutent and alcohol. However, certain side effects of Sutent could become worse if you take the drug with alcohol. Examples of these side effects include:

If you drink alcohol, talk with your doctor about it before you take Sutent.

* Sutent has a boxed warning for the risk of liver damage. This is the most serious warning from the FDA. For more information, see “FDA warning: Liver damage” at the beginning of this article.

Here’s some information on what occurs with the conditions Sutent is used for and how the drug works to treat them.

What are gastrointestinal stromal tumors?

Sutent is used to treat gastrointestinal stromal tumors (GISTs). Tumors are masses of cancerous tissue.

GISTs are a rare type of digestive system cancer. They start in the walls of your digestive tract, most often in the stomach or small intestine. The tumors can occur in other parts of the digestive tract as well.

What is renal cell carcinoma?

Sutent is used to treat a kind of kidney cancer called advanced renal cell carcinoma (RCC).

RCC usually forms in cells that line parts of the kidneys known as tubules. These cells gather and form tumors. When RCC is advanced, it means the cancer has spread to other parts of the body.

What are pancreatic neuroendocrine tumors?

Sutent is also used to treat pancreatic neuroendocrine tumors (pNETs), which are a form of pancreatic cancer.

Pancreatic cancer affects an organ known as the pancreas. pNETs start in pancreas cells that make a hormone called insulin. (Insulin works in your body to help lower blood sugar levels.)

What does Sutent do?

Sutent works by decreasing the activity of certain proteins called receptor tyrosine kinases. These proteins can be abnormal and cause cells to grow too fast, leading to cancer. When Sutent slows down the action of these proteins, it decreases the growth and spread of the cancer.

How long does it take to work?

Sutent starts to work after the first dose, but you may not notice. You may not feel different because the drug doesn’t treat the symptoms of cancer. Instead, it works to decrease the growth and spread of cancer cells.

Your doctor will order tests to monitor your condition and make sure Sutent is working. Ask your doctor if you have questions about how they will check your progress during treatment.

How long does Sutent stay in your system?

Sutent stays in your system for several weeks after you stop taking it.

You should take Sutent according to your doctor’s or healthcare provider’s instructions.

Sutent comes as a capsule that you swallow.

When to take

You’ll usually take Sutent once a day. It’s important to try to take the medication at about the same time every day.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too. It may also help to put your treatment schedule on a calendar.

Taking Sutent with food

You can take Sutent with or without food.

Can Sutent be crushed, split, or chewed?

No. You should swallow Sutent capsules whole with some water or another beverage. Don’t crush, split, or chew Sutent.

You shouldn’t take Sutent during pregnancy. This is based on animal studies in which Sutent given to pregnant females caused birth defects or death of the fetus. It’s unknown whether these same effects would occur in humans.

Before you start Sutent treatment, your doctor may give you a pregnancy test to make sure that you aren’t pregnant. And while you’re taking Sutent, you should use effective birth control if you’re able to become pregnant. See the “Sutent and birth control” section below for details.

If you become pregnant while taking Sutent, tell your doctor right away.

Sutent and fertility

Taking Sutent may cause both men and women to have fertility problems.

If you or your partner is trying to become pregnant, talk with your doctor before starting Sutent treatment.

You shouldn’t take Sutent during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Sutent.

For more information about taking Sutent during pregnancy, see the “Sutent and pregnancy” section above.

For women using Sutent

If you’re a woman who can become pregnant and are taking Sutent, you should use birth control during your treatment. And you should keep using birth control for at least 4 weeks after you take your last dose of Sutent.

For men using Sutent

If you’re a man who is taking Sutent and you’re sexually active with a female who’s able to become pregnant, you should use birth control during your treatment. And you should keep using birth control for at least 7 weeks after you take your last dose of Sutent.

You shouldn’t breastfeed while taking Sutent and for at least 4 weeks after you have your last dose of the drug.

It’s unknown whether Sutent passes into human breast milk. But animal studies show that the medication does pass into breast milk. So it’s recommended that women avoid breastfeeding while taking Sutent to avoid possible harm to the breastfed child.

If you’re breastfeeding or are planning to breastfeed, tell your doctor before you start using Sutent. They can recommend healthy ways to feed your child and other treatments if needed.

This drug comes with several precautions.

FDA warning: Liver damage

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Liver damage, which is also called hepatotoxicity, has been reported in people who have taken Sutent. In rare cases, the damage caused liver failure or death. While you take Sutent, your doctor will likely monitor your liver function. Depending on the results, they may reduce your dose or pause or stop your treatment.

Other precautions

Before taking Sutent, talk with your doctor about your health history. Sutent may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Heart problems. Taking Sutent can cause heart problems that include heart failure and changes to your heart rate or rhythm. Before starting Sutent treatment, tell your doctor if you have any heart problems. Depending on how severe your condition is, they may monitor you more closely or recommend other medications for you.
  • High blood pressure. Using Sutent can cause increases in blood pressure. Before you first take Sutent, tell your doctor if you have high blood pressure. Depending on how severe it is, they may monitor you more closely or suggest different medications.
  • Bleeding problems. Sutent use can cause various bleeding problems such as nose bleeds or blood in the urine or stool. Before taking Sutent, tell your doctor if you have a bleeding disorder or a history of bleeds. They may monitor you more closely or choose a different treatment option.
  • Kidney problems. Sutent use can cause kidney problems, including protein in the urine. Before you start taking Sutent, tell your doctor if you have kidney problems. They may want to order some tests before your treatment, monitor you more closely, or choose a different medication for you.
  • Thyroid problems. Taking Sutent may affect your thyroid, so tell your doctor if you have a thyroid condition before taking the drug. These conditions include hyperthyroidism (high thyroid hormone level) and hypothyroidism (low thyroid hormone level). Your doctor may want to monitor you more closely during your treatment.
  • Diabetes. It may be harder for you to manage your blood sugar and help prevent hypoglycemia (low blood sugar) when taking Sutent. So before starting treatment with Sutent, tell your doctor if you have diabetes. They may want you to check your blood sugar more often, monitor you more closely, or adjust your diabetes medications.
  • Jaw or dental problems. Before using Sutent, tell your doctor if you have any dental problems or have had a recent dental procedure. These include tooth or jaw pain, dental surgery, or tooth extractions. Taking Sutent when you have dental issues can increase your risk for jaw problems such as a serious infection. It’s best to avoid having dental procedures when taking Sutent.
  • Bisphosphonate use. Medications called bisphosphonates help with bone density. Taking these drugs with Sutent can increase your risk for jaw problems, such as a serious infection. So before you start taking Sutent, tell your doctor if you’re using a bisphosphonate. Examples of bisphosphonates include alendronate (Fosamax), risedronate (Actonel), ibandronate (Boniva), and zoledronic acid (Reclast).
  • Recent surgery. Taking Sutent can cause wounds to heal more slowly than usual, making it harder for your body to recover. Before taking Sutent, tell your doctor if you have had recent surgery. They may wait until you’ve healed before starting your Sutent treatment.
  • Pregnancy. You shouldn’t take Sutent during pregnancy. For more information, please see the “Sutent and pregnancy” section above.
  • Breastfeeding. You shouldn’t breastfeed while taking Sutent and for at least 4 weeks after you have your last dose of the drug. For more information, please see the “Sutent and breastfeeding” section above.
  • Allergic reaction. If you’re allergic to Sutent or any of its ingredients, you shouldn’t use the drug. Ask your doctor what other medications may be better options for you.

Note: For more information about the potential negative effects of Sutent, see the “Sutent side effects” section above.

Do not use more Sutent than your doctor recommends.

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When you get Sutent from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

You should store Sutent capsules at room temperature, which is around 68°F to 77°F (20°C to 25°C). But if needed, you can keep them at 59°F to 86°F (15°C to 30°C) for a brief time. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Sutent and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The following information is provided for clinicians and other healthcare professionals.

Indications

The Food and Drug Administration (FDA) has approved Sutent for the following indications:

Mechanism of action

Sutent targets multiple receptor tyrosine kinases (RTKs) to inhibit progression of cancer, pathologic angiogenesis, as well as tumor growth. Sutent has been shown to slow growth of tumor cells with the abnormal RTK activity. Examples of RTKs include:

  • platelet-derived growth factor receptors
  • glial cell-line derived neurotrophic factor receptors
  • stem cell factor receptors
  • vascular endothelial growth factor (VEGF) receptors

Pharmacokinetics and metabolism

Sutent is converted to its active form by CYP3A4. This form is also metabolized by CYP3A4.

The estimated half-life of Sutent is 40 to 60 hours, and the estimated half-life of its metabolite is 80 to 110 hours. Sutent is eliminated through feces and urine.

Contraindications

There are no contraindications for Sutent.

Storage

Sutent tablets should be stored at room temperature, which is around 68°F to 77°F (20°C to 25°C). Brief deviations to 59°F to 86°F (15°C to 30°C) are acceptable.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.