Sunitinib for the treatment of gastrointestinal stromal tumours

Sunitinib (Sutent, Pfizer) is one of a group of closely related tyrosine kinase inhibitors. It inhibits vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) receptors on cancer cells, vascular endothelial cells and pericytes. This reduces tumour cell proliferation and tumour blood vessel development. Sunitinib has a UK marketing authorisation for the treatment of people with unresectable and/or metastatic malignant gastrointestinal stromal tumour (GIST) after failure of imatinib mesilate treatment due to resistance or intolerance.

Sunitinib is contraindicated in people who have hypersensitivity to sunitinib malate or to any of the excipients. The summary of product characteristics (SPC) lists the following conditions that may be associated with sunitinib treatment: cardiovascular events, skin and tissue problems, gastrointestinal events, haemorrhage, hypertension, haematological problems, venous thromboembolic events, pulmonary embolism and hypothyroidism. For full details of side effects and contraindications, see the SPC.

Sunitinib is administered orally. The recommended dosage is 50 mg once daily, for 4 consecutive weeks, followed by a 2-week rest period (that is, a complete treatment cycle of 6 weeks). The dose may be adjusted in steps of 12.5 mg according to tolerability (within the dose range 25 to 75 mg). The price for a 28-capsule pack of 50‑mg capsules is £2,730.76 (excluding VAT; Pfizer). This updated list price was confirmed by the manufacturer in September 2025 and replaces the previously agreed patient access scheme for sunitinib. Costs of subsequent treatment cycles may vary in different settings because of negotiated procurement discounts.