Sorafenib / sunitinib
Sunitinib and sorafenib
Sunitinib (Sutent®) and sorafenib (Nexavar®) are both indicated for the treatment of advanced "clear cell" kidney carcinoma after failure of, or resistance to, other treatments. Sunitinib is also indicated for gastrointestinal stromal tumors (GIST) and sorafenib for hepatocellular carcinoma.
Both drugs inhibit the tyrosine-kinase activity of a number of growth factor receptors (platelet derived growth receptor (PDGFR-α and -β), vascular endothelial growth factor receptor (VEGFR-1, -2 and -3), and stem
cell factor receptor (KIT)). Sorafenib has an additional inhibitory effect on serine/threonine-kinase activity in the signal transduction pathway. The general outcome is a decreased signal transduction and inhibition of tumor cell growth and angiogenesis.
The adverse effects of the two drugs are: fatigue, gastrointestinal discomfort, diarrhoea, rash, alopecia, palmar-plantar erythrodysaesthesia, and hypertension.