Sunitinib is a multi-target tyrosine kinase inhibitor mainly used to treat specific types of malignant tumors. Its use requires attention to multiple adverse reactions and special population management. The following will explain from two aspects: indications and medication precautions.

1. Indications

(1) Gastrointestinal stromal tumor (GIST)

Suitable for patients with unresectable/metastatic GIST who have failed or cannot tolerate imatinib treatment.

(2) Advanced renal cell carcinoma (RCC)

Used as first-line treatment for advanced renal cell carcinoma, it can significantly prolong progression free survival.

(3) Pancreatic neuroendocrine tumor (pNET)

Used for unresectable locally advanced or metastatic advanced pNET patients.

2. Medication precautions

(1) Cardiovascular toxicity

May cause QT interval prolongation and left ventricular dysfunction. Prior to medication, electrocardiogram and cardiac function should be evaluated, and regular monitoring should be conducted during treatment.

(2) Hepatotoxicity

Regular monitoring of liver function is necessary, and medication should be discontinued when ALT/AST>5 times normal or bilirubin>3 times normal.

(3) Hematological toxicity

Common neutropenia and thrombocytopenia require weekly blood routine testing during the early stages of treatment, and dosage adjustments may be necessary.

(4) Gastrointestinal reactions

May cause severe diarrhea, requiring timely antidiarrheal treatment and adjusting medication plans according to the severity.

(5) Skin toxicity

The incidence of hand foot syndrome is relatively high, and skin care needs to be strengthened. In severe cases, dosage adjustment is necessary.

(6) Thyroid dysfunction

May induce hypothyroidism, TSH levels need to be monitored during treatment.

(7) Medication for special populations

Pregnant women are prohibited from using contraception, and contraceptive measures should be taken during the reproductive age period; Breastfeeding should be stopped during the lactation period; Patients with liver dysfunction need to reduce their dosage.