Only physicians working as part of a multi-disciplinary team should prescribe Pfizer's Sutent (sunitinib malate) for renal cell cancer, say experts

speaking at the recent European Association of Urology congress held in


Prof Joaquim Bellmunt of the University Hospital del Mar, Barcelona, said:

“Targeted therapies need specialised treatment, and should be prescribed by medical oncologists working as part of a specialised multi-disciplinary team that meets regularly to discuss patients’ overall treatment.

“In the UK there’s not a great deal of experience with the newer, targeted

therapies in the urological cancers but there’s a need for all professionals

to work more closely together.”

Prof Bellmunt explained that the side effects seen with Sutent and other

tyrosine kinase inhibitors were milder than those associated with cytokine

therapy but they could be distressing to patients. As the newer therapies

are oral, and so self administered, it was crucial that patients were told

of potential side effects and actively managed.

“Early identification of adverse events and intervention is important so

that dose interruption or reduction can be avoided, as well as easing

patient’s discomfort,” said Prof Bellmunt. Side effects include fatigue, hypertension, hand and foot syndrome, GI, haematological and dermatological changes, and very rarely changes in left ventricular ejection fraction.

The EAU has just issued new guidelines that recommend Sutent as first line treatment in all patients with advanced and/or metastatic renal cell

carcinoma (mRCC). The advice is based on data that shows patients taking

Sutent had more than doubled prolonged progression-free survival (PFS)

compared to patients on interferon, which is known to work in only a small

proportion of patients with RCC.

Experts at the Congress hailed targeted therapies as a major advance in

mRCC. While they agreed that nephrectomy would remain gold standard for most patients with RCC Prof Jean-Jaques Patard from Rennes University

Hospital, France said: “Not all patients will benefit from nephrectomy and

we should go straight to systemic treatment.” He added that despite a lack

of evidence regarding adjuvant treatment for RCC the positive data for

tyrosine kinase inhibitors made them a logical choice for adjuvant

treatment. By Maya Anaokar