Diastolic blood pressure as a biomarker of axitinib efficacy in solid tumors

Area of Science:

• Oncology
• Pharmacology
• Cardiovascular Medicine

Background:

• Axitinib is a tyrosine kinase inhibitor used in cancer treatment.
• Blood pressure monitoring is crucial during targeted therapy.
• The relationship between blood pressure and axitinib efficacy requires further elucidation.

Purpose of the Study:

• To determine if diastolic blood pressure (dBP) ≥90 mm Hg during axitinib therapy serves as a predictive marker for treatment efficacy.
• To analyze the correlation between elevated dBP and patient outcomes in axitinib-treated cancer patients.

Main Methods:

• Retrospective analysis of 5 phase II clinical trials involving single-agent axitinib across 4 tumor types.
• Patients (n=230) with baseline BP ≤140/90 mm Hg were stratified by dBP levels (≥90 mm Hg vs. <90 mm Hg) post-therapy initiation.
• Evaluated outcomes included median overall survival (mOS), median progression-free survival (mPFS), objective response rate (ORR), and adverse events.

Main Results:

• Patients with dBP ≥90 mm Hg exhibited a significantly lower risk of death (adjusted HR=0.55) and higher ORR (43.9% vs. 12.0%) compared to those with dBP <90 mm Hg.
• A trend towards a lower risk of progression was observed in the dBP ≥90 mm Hg group (HR=0.76).
• Landmark analysis at 8 weeks showed improved mOS (25.8 vs. 14.9 months) and mPFS (10.2 vs. 7.1 months) for patients with dBP ≥90 mm Hg. Adverse events were comparable between groups.

Conclusions:

• Axitinib efficacy demonstrates a significant correlation with achieving a diastolic blood pressure of ≥90 mm Hg.
• Elevated diastolic blood pressure during axitinib treatment may serve as a predictive biomarker for enhanced treatment outcomes.
• Further research is warranted to validate diastolic blood pressure as a reliable predictive biomarker in axitinib therapy.