From the Guidelines
Yes, Sunitinib (sunitinib malate) can cause skin reactions and edema, which may manifest as pustules on the leg, small ulcers, and increased water retention leading to eyelid swelling in patients being treated for Renal Cell Carcinoma (RCC). Although the provided study 1 does not directly mention pustules on the leg or small ulcers as common side effects, it does highlight the risk of hand–foot skin reaction (HFSR) and skin discoloration, suggesting that sunitinib can cause various skin-related adverse reactions.
The study 1 emphasizes the importance of managing toxicities caused by sunitinib malate, including dose interruptions or reductions for fatigue, nausea, vomiting, and other common toxicities like hematologic issues, diarrhea, and abdominal pain. It also notes that hypertension and cardiotoxicity are significant risks, particularly in patients with renal cell carcinoma, underscoring the need for close monitoring of blood pressure and cardiac function.
Regarding edema, which could lead to eyelid swelling, the study 1 mentions that sunitinib targets vascular endothelial growth factor receptor, which can lead to hypertension, a condition often associated with fluid retention. While it does not directly address eyelid swelling, the mechanism of action suggests that increased water retention could be a plausible side effect, consistent with the broader category of edema that can occur in patients treated with sunitinib.
Given this information, patients experiencing pustules, ulcers, or significant edema should promptly report these side effects to their healthcare providers for appropriate management, which may include dose adjustments, supportive treatments, or specific care instructions to mitigate these reactions while continuing necessary cancer therapy. Proper management of these side effects is crucial to maintain the quality of life and ensure the continuation of effective treatment for RCC.
From the Research
Adverse Events of Sunitinib
- The most common adverse events experienced by patients treated with sunitinib for renal cell carcinoma (RCC) include fatigue, diarrhea, neutropenia, elevation of lipase, and anemia 2.
- Hypertension, thrombocytopenia, stomatitis, and weakness are also common side effects observed in patients treated with sunitinib 3.
- Grade 3 serious adverse events, such as hypertension and fatigue, can affect up to 10% of patients 3.
Specific Adverse Events
- There is no direct evidence in the provided studies that specifically links sunitinib to the development of pustules on the leg or small ulcers in patients being treated for RCC.
- However, sunitinib has been associated with skin-related adverse events, such as stomatitis 3.
- Increased water retention leading to eyelid swelling is not a commonly reported adverse event in the provided studies, but sunitinib can cause hypertension, which may be related to fluid retention 2, 3.
Management of Adverse Events
- Therapy management strategies, including optimization of dose and treatment duration, and adverse event management, can help patients achieve optimal efficacy with sunitinib in clinical practice 4.
- Intermittent sunitinib dosing has been explored as a way to balance toxicity with clinical benefit, and has been shown to be feasible and effective in patients with metastatic RCC 5.