To the Editor: Sunitinib malate is a multitargeted tyrosinekinase inhibitor approved for the treatment of advanced renal-cellcarcinoma. We report on an asymptomatic increase in the meancorpuscular volume of erythrocytes and cobalamin deficiencyin six patients with metastatic renal-cell carcinoma who weretreated for more than 5 months with sunitinib as part of a clinicaltrial evaluating the efficacy and safety of continuous dailyadministration of the drug. The starting dose of sunitinib was37.5 mg daily; three patients required a dose reduction to 25mg, and one patient had a dose escalation to 50 mg daily. An. . . [Full Text of this Article]
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