Sunitinib induced colitis manifesting as invasive diarrhea in a patient with renal cell carcinoma

• Published in: Journal of oncology pharmacy practice Vol. 28; no. 2; p. 516
• Main Authors: Gündoğdu, Yasemin, Deniz, Orhan Cem, Saka, Didem, Şişman, Gürhan, Erdamar, Sibel, Köksal, İftihar
• Format: Journal Article
• Language: English
• Published: England 01.03.2022
• Subjects: Antineoplastic Agents - adverse effects; Carcinoma, Renal Cell - drug therapy; Colitis - chemically induced; Diarrhea - chemically induced; Humans; Indoles - adverse effects; Kidney Neoplasms - drug therapy; Pyrroles - adverse effects; Sunitinib - therapeutic use; Sunitinib; renal cell carcinoma; colitis; diarrhea
• ISSN: 1477-092X
• DOI: 10.1177/10781552211061183

Sunitinib is a tyrosine kinase inhibitor that binds to vascular endothelial factor receptor currently used for the treatment of renal cell carcinoma, as well as for several other conditions such as gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. We present a patient with invasive diarrhea who was treated with sunitinib for metastatic renal cell carcinoma. Drug induced colitis was confirmed with colonoscopy from histopathological specimens. Clinical recovery of diarrhea was achieved with oral budesonide. Remarkably, the pathologic findings were observed in both the macroscopically normal mucosa and the mucosa with aphthous ulcers in the colon. The patient was treated for sunitinib associated diarrhea, after exclusion of the other reasons. Metronidazole and piperacillin/tazobactam treatment were prescribed. Diarrhea is a frequent symptom in patients treated with tyrosine kinase inhibitors, however the described pathologic findings have rarely been reported. Our aim is to emphasize the importance of close follow-up in patients treated with tyrosine kinase inhibitors, and to raise awareness on the management of sunitinib induced colitis.