Sunitinib side effects and contraindications: risks and precautions you must know before use

As a multi-target tyrosine kinase inhibitor, Sunitinib inhibits the growth of tumors such as renal cell carcinoma (RCC) and gastrointestinal stromal tumor (GIST). At the same time, it may also affect normal cell signaling pathways, leading to a series of side effects. Clinical trials show that the most common adverse reactions of sunitinib (≥25%) include fatigue, diarrhea, stomatitis, nausea, decreased appetite, vomiting, hypertension, hand-foot syndrome, bleeding, etc. Therefore, before using this drug, patients need to fully understand the possible risks and follow their doctor's recommendations for monitoring and management. Common side effects and management measures:

1. Fatigue and weakness (Fatigue): About50% of patients will experience varying degrees of fatigue during treatment, which may be related to the suppression of thyroid function by drugs. It is recommended that patients exercise moderately, ensure adequate sleep, and regularly monitor thyroid function. If hypothyroidism occurs, thyroid hormone supplementation may be considered.

2. Gastrointestinal discomfort (diarrhea, nausea, vomiting, loss of appetite): The incidence of diarrhea is high and can usually be alleviated by adjusting the diet (eating smaller meals more often, low-fat diet), and taking antidiarrheal drugs (such as loperamide) if necessary. Patients with nausea and vomiting may consider using antiemetics for symptomatic treatment.

3. Stomatitis/Mucositis: Oral ulcers are relatively common. Patients can use warm salt water to rinse their mouths to keep their mouths clean and avoid spicy and irritating foods.

4. Hand-foot syndrome: This side effect manifests as redness, swelling, peeling, and pain on the palms and soles of the feet. In severe cases, it may affect daily activities. Symptoms can be relieved by using moisturizer, avoiding bathing in hot water, and reducing friction (such as avoiding long walks).

5. Hypertension: Because sunitinib inhibitsVEGFR, it may cause vasoconstriction and cause hypertension. Patients should monitor their blood pressure regularly during treatment. If severe hypertension occurs, antihypertensive drugs can be used under the guidance of a doctor.

6. Bleeding events: Because sunitinib affects platelet function, some patients may experience nose bleeding, gum bleeding, or even gastrointestinal or intracranial bleeding. If abnormal bleeding occurs, seek medical attention immediately and avoid concurrent use of anticoagulant drugs.

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