Abstract
Introduction Sunitinib (sunitinib malate, SU11248, SUTENT; Pfizer, New York, NY) is a novel small molecule receptor tyrosine kinase inhibitor with direct antitumor as well as antiangiogenic activity via targeting the vascular endothelial growth factor, platelet-derived growth factor, KIT, and FLT3 receptor tyrosine kinases. The drug is approved multinationally for the treatment of renal cell carcinoma (RCC), gastrointestinal stromal tumor, and pancreatic neuroendocrine tumor. The safety of sunitinib has been studied in patients with RCC with only a relatively small proportion of patients with grade 2/3 liver toxicity and no grade 4 toxicity. A few case reports described serious liver toxicity, including fatal outcome ascribed to the treatment with sunitinib. Here we report a case of a patient ith RCC and chronic obstructive lung disease accompanied by evere pulmonary arterial hypertension that developed fulminant heatic failure during the first cycle of treatment with sunitinib. A ossible mechanism of toxicity in this case and review of the literature re presented in this report.
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