Is Sunitinib the only option for papillary RCC type 1?

Question

Hello doctor,

My father was recently diagnosed with papillary renal cell carcinoma type 1, and he has no BP or sugar. However, he had undergone bypass surgery ten years ago. Our doctor has suggested that targeted therapy is better for him, as there is another mass found in the lungs, too. Our doctor has prescribed Sutent 37.5 mg to begin with and slowly increase it to 50 mg.

However, due to our financial conditions, we cannot afford Sutent as it is pretty expensive for us. As we do not have any insurance. Is this the only drug available for this type of cancer, or do we have any other affordable and similar drugs with minimal side effects? We want to get your suggestion on this.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

As per the history given above, your father has metastatic renal cell carcinoma . I would have liked to have a few additional markers, like his general condition, report of CBC (complete blood count) and LFT (liver function test), RFT (renal function test), to look at his risk score. In metastatic RCC, in first-line settings, we have three TKIs (Tyrosine kinase inhibitors) that are approved and commonly used. Namely, Sunitinib, Pazopanib, and Cabozantinib.

Sunitinib and pazopanib have almost the same progression-free survival benefit. Cabozantinib has a benefit in progression, but final overall survival was the same as Sunitinib. Toxicities are a bit different for Pazopanib, with more chances of hepatitis, weight loss, and diarrhea.

If you cannot afford Sunitinib, then I would say Pazopanib would be better as it is cheaper with similar benefits and slightly different toxicities. Cabozantinib is costlier and not yet available. I hope it helps. I would be happy to help you further if you have any more queries or questions regarding the toxicities of these drugs.

I hope this helps.

Thank you.