The short term future of cancer therapeutics is combinations of targeted drugs. Sutent could be one of those miracle targeted drugs. It is a "multi-targeted" kinase inhibitor. That means it inhibits several proteins involved in triggering replication in cancer cells.
Until Sutent, you had to take one type of drug for anti-tumor effects of human neoplasms, and another drug for anti-microvascular effects. With Sutent, multiple proteins are involved in both tumor proliferation (growth) and angiogenesis (blood vessels feeding a tumor). It has has both "anti-tumor" as well as "anti-angiogenic" properties. In addition, because it inhibits "multiple" kinases, it possesses activity against "multiple" types of tumors.
Sutent may directly bind to one of the proteins (VEGF) to directly inhibit angiogenesis (microvasculature regression). Within 24 hours of VEGF inhibition, endothelial cells have been shown to shrivel, retract, fragment and die by apoptosis (cell death). VEGF can cut off the supply of vessels that spring up to feed a tumor (angiogenesis).
How many days will Sutent take to respond on the tumors? No one really knows without testing the tumor first. Does the drug enter the cell? Once entered, does it immediately get metabolized of pumped out, or does it accumulate?
A couple of private laboratories have the abilities to take fresh "live" tumor specimens and be able to distinguish between susceptibility of the cell to different drugs in the same class and the susceptibility to combinations. They analyze the systems' response to drug treatments, not just one or a few targets or pathways.
If, by testing the tumor first, Sutent is "synergistic" (cooperative) to cancer cells, it could be a miracle drug. It will not cure, but it can prolong survival for some time (like the cronic diseases).
Cell-based functional profiling of tumor cells can measure the net effect of everything which goes on (the entire genome of a cancer cell). It can look at both the anti-tumor and anti-microvascular effects of cancer drugs. Are the cells ultimately killed, or aren't they?
http://weisenthalcancer.com