Q. Other than Sutent, which medicine can I opt for papillary renal cell carcinoma?
Hello doctor,My father is 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 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.
Hello. As per history given above. Your father as metastatic renal cell carcinoma. I would have liked to have 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 TKI (Tyrosine kinase inhibitor) that are approved and commonly used. Namely, Sunitinib, Pazopanib, and Cabozantinib. Sunitinib and pazopanib have almost the same progression-free and survival benefit. Cabozantinib has benefit in progression, but final overall survival was the same as sunitinib. Toxicities are bit different for Pazopanib with more chances of hepatitis, weight loss, and diarrhea. If you are not affording for 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 toxicities of these drugs. TKI.