KDR and adrenal cortex carcinoma: [64] [65] Sunitinib, another multikinase inhibitor with activity against VEGFR and PDGFR, was also investigated in a phase II trial with 35 patients with refractory ACC.[66] There were no documented tumor responses and the median PFS was 2.8 months.[67] However sunitinib serum levels might have been reduced by mitotane induced CYP3A4 activity attenuating its antitumor activity and adverse effects.