Sunitinib is a multi-target receptor tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor 1-2 (VEGFR1-2), platelet-derived growth factor receptor (PDGFR-α, PDGFR-β), stem cell growth factor receptor (c-KIT), and FMS-like tyrosine kinase 3 (FLT-3). It has anti-tumor angiogenesis and inhibits tumor cell proliferation.
Sorafenib, the first multi-target receptor tyrosinase inhibitor marketed for metastatic kidney cancer, also has a dual anti-tumor effect, directly inhibiting tumor growth by inhibiting the RAF/MEK/ERK signaling pathway on the one hand, and acting on VEGFR, PDGFR, and targets such as c-KIT, FLT-3, and MET on the other. inhibit tumor angiogenesis.
Which is better: sorafenib or sunitinib for kidney cancer?
First of all, let’s see what the experts say. The current international and domestic treatment protocols for kidney cancer state that the first-line treatment (first choice) is sunitinib, the second-line treatment is sorafenib, and the second-line treatment fails and then changes to sunitinib. Sunitinib” and “Sorafenib” in the second line and “Sunitinib” in the second line after the failure of the second line treatment all resulted in a longer TTP (time from randomization to disease or death), thus, “Sunitinib” is better than “Sorafenib”. This is better than sorafenib.
Second, from the perspective of tumor driver genes, there are differences in the targets of action between sorafenib and sunitinib. In the past, in targeted therapy, whether the key tumor driving pathways are altered is decisive for efficacy, so it is important to perform “genetic testing” before treatment to determine if there is a specific target for the patient to help select the right targeted drug.
In addition, the 2018 edition of the Kidney Cancer Protocol added a recommendation for first-line (preferred) treatment of advanced clear cell renal cell carcinoma with pazopanib, a multi-target receptor tyrosine kinase inhibitor whose primary targets are VEGFR1-3, PDGFRα-β, and cGMP. It is also a multi-target receptor tyrosine kinase inhibitor with the primary targets of VEGFR1-3, PDGFRα-β, and c-KIT, and is currently available as a charity gift for patients with advanced kidney cancer.