Medical Information

Sunitinib, as a multi-target tyrosine kinase inhibitor, has a wide and dose-dependent spectrum of side effects, and clinical risk control needs to be achieved through preventive measures and personalized adjustments.

1. Hematological toxicity

(1) Thrombocytopenia: The incidence rate is about 38%, and it is necessary to monitor blood routine every week to avoid traumatic operations.

(2) Neutropenia: It is recommended to administer G-CSF preventively and suspend medication when ANC<1.0 × 10 ⁹/L.

2. Digestive system response

(1) Diarrhea: 33.3% of patients experienced it, and loperamide is recommended for symptomatic treatment and maintenance of electrolyte balance.

(2) Oral inflammation: 24.6% incidence, using mouthwash containing lidocaine can alleviate pain.

3. Skin adverse reactions

(1) Palms and soles redness and swelling: 49.3% of patients experience it. Mechanical friction should be avoided and urea ointment should be applied locally.

(2) Rash: It is recommended to use soap free cleaning agents, and in severe cases, short-term topical corticosteroids should be used.

4. Special organ toxicity

(1) Cardiotoxicity: Risk of QT interval prolongation. Hypokalemia should be corrected before medication and regular ECG monitoring should be performed.

(2) Thyroid dysfunction: 35% of patients experience elevated TSH levels and require thyroid function testing every 6-8 weeks.

5. Dose adjustment strategy

(1) Grade 3 toxicity: Suspend administration until it returns to ≤ Grade 1, then reduce dosage by 25% and restart.

(2) Grade 4 toxicity: permanent discontinuation of medication and replacement of alternative treatment plan.