Resistance to chemotherapeutic agents constitutes a major problem in the treatment of cancer. Over the past years, multitargeted protein kinase inhibitors such as Gleevec, Sunitinib and Sorafenib are gaining wider acceptance for cancer treatment. These drugs show anti-tumor activity in vitro and in patients. Extended usage of these drugs in therapy commonly results in disease progression due to formation of resistance caused by rearrangements and accumulation of mutations in the unstable cancer cell genome. However, the underlying drug-specific mechanisms for the development of resistance remain elusive. Hence, a detailed understanding of the molecular genetic events involved in this processes is pivotal to counteract are not directly targeted by Sunitinib (unpublished data). Therefore, development of specific or multi-targeted inhibitors for these kinases for combinatorial therapy with e.g., an IL-8 neutralizing antibody might circumvent or substantially delay Sunitinib resistance formation and enhance survival prognosis. PRKX, TTBK2 and RSK4 expression. The specific reduction of these genes employing siRNA was sufficient to sensitize the kidney-and melanoma-cell lines against Sunitinib. In line with the elevated expression of PRKX, TTBK2 or RSK4, this sensitization effect was strikingly higher in the Sunitinib resistant cell lines, suggesting an expression-based mechanism of these genes to trigger Sunitinib resistance. Hence, we propose that PRKX, TTBK2 and RSK4 are potential resistance markers in Sunitinib therapy and might therefore represent targets for the development of novel strategies to overcome resistance.In recent years, kinase inhibitors such as Sunitinib and Sorafenib have been evaluated in clinical trials for their therapeutic efficacy against multiple cancer indications. Both of these cancer drugs are ATP-competitive small molecule kinase inhibitors that have been approved by the Food and Drug Administration for the treatment of metastatic renal cell carcinoma (mRCC). In addition, Sunitinib is approved for the treatment of Gleevec-resistant gastrointestinal stromal tumors (GIST) 1,2 and pancreatic neuroendocrine tumors. It targets and thereby inhibits several receptor tyrosine kinases (RTKs) such as the platelet-derived growth factor receptor beta (PDGFR-b) and the vascular endothelial growth factor receptors 2 and 3 (VEGFR-2 and 3). [3][4][5] Competitive inhibition of these RTKs by Sunitinib is thought to downregulate critical hallmarks of cancer 6 resulting in growth inhibition, prevention of invasivity and induction of apoptosis of cancer cells. 7 These functions are important for the progression of mRCC and GIST, and because of their broad spectrum of kinase inhibitory activity appear to be relevant for the maintenance and progression of many other tumors. 8,9 Consequently, clinical trials, including single-or combinatorial therapy, with Sunitinib for a variety of cancer indications are ongoing. 10 Such efforts include the evaluation of efficacy of Sunitinib in the treatment of melanoma.Sun...