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), with anti-tumor angiogenesis and inhibition of tumor cell proliferation.
Sorafenib, the first multi-target receptor tyrosinase inhibitor marketed for metastatic kidney cancer, also has dual anti-tumor effects, inhibiting tumor growth directly by inhibiting the RAF/MEK/ERK signaling pathway on the one hand, and inhibiting tumor angiogenesis by acting on VEGFR, PDGFR, and targets such as c-KIT, FLT-3, and MET on the other. angiogenesis.
Which is better for kidney cancer, “Sorafenib” or “Sunitinib”?
First of all, let’s see what the experts say. At present, the international and domestic kidney cancer treatment norms point out that the first-line treatment (first choice) is Sunitinib, the second-line treatment is Sorafenib, and the second-line treatment fails and then Sunitinib is changed. “The continued treatment with Sunitinib after the failure of second-line treatment resulted in a longer TTP (time from randomization to disease or death), which makes Sunitinib superior to Sorafenib.
Secondly, from the perspective of tumor driver genes, there are differences in the targets of “sorafenib” and “sunitinib”. According to past experience, in targeted therapy, whether the key tumor driving pathways are altered or not is decisive for the efficacy. Therefore, it is important to conduct “genetic testing” before treatment to determine whether there are specific targets for patients, which can help to select the appropriate targeted drugs.
In addition, the 2018 edition of the kidney cancer treatment protocol added the recommendation of “pazopanib (trade name: vincristine)” for the first-line (preferred) treatment of advanced clear cell renal cell carcinoma, which is also a multi-target receptor tyrosine kinase inhibitor, and its main targets are VEGFR1-3, PDGFRα-β and c It is also a multi-target receptor tyrosine kinase inhibitor whose main targets are VEGFR1-3, PDGFRα-β and c-KIT, and is currently available as a charity gift for patients with advanced kidney cancer.