Optimisation of sunitinib therapy in metastatic renal cell carcinoma: adverse-event management

Reliance on cytokine therapy for the treatment of metastatic renal cell carcinoma (mRCC) has been all but eliminated by the introduction of novel targeted agents. Several of these agents, including the receptor tyrosine kinase inhibitor sunitinib, have demonstrated efficacy in the treatment of mRCC. Sunitinib treatment is generally well tolerated, and is associated with a low incidence of grade 3 or 4 adverse events. However, a distinct pattern of novel adverse events associated with sunitinib treatment has been identified. These events require monitoring and management to help reduce their frequency, severity, clinical significance and nature. This article summarises the most important adverse events observed during sunitinib treatment and suggests measures to manage the event, while also helping patients to sustain an optimal treatment schedule and gain maximum clinical benefit from sunitinib. (C) 2007 Elsevier Ltd. All rights reserved.