Comprehensive overview of axitinib development in solid malignancies: focus on metastatic renal cell carcinoma

Courtney Carmichael1, Clayton Lau, David Y Josephson

  • 1City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA. ccarmichael@coh.org

Insights

Axitinib, a targeted therapy, improves progression-free survival in metastatic renal cell carcinoma (mRCC) patients. This vascular endothelial growth factor receptor inhibitor offers a new option for second-line treatment in advanced kidney cancer.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Metastatic renal cell carcinoma (mRCC) remains an incurable disease despite recent therapeutic advancements.
  • The development of novel targeted therapies is crucial for improving patient outcomes in mRCC.

Purpose of the Study:

  • To describe the preclinical and clinical development of axitinib, a tyrosine kinase inhibitor.
  • To evaluate the role of axitinib in the treatment of metastatic renal cell carcinoma.

Main Methods:

  • Phase I trials assessed safety and dose-limiting toxicities in advanced solid tumors.
  • Phase II trials explored axitinib's efficacy in various cancers, including renal cell carcinoma.
  • The Phase III AXIS trial compared axitinib with sorafenib in second-line mRCC treatment.

Main Results:

  • Axitinib demonstrated dose-limiting toxicities including hypertension, stomatitis, and diarrhea in Phase I.
  • The Phase III AXIS trial showed improved progression-free survival for axitinib compared to sorafenib in second-line mRCC therapy.

Conclusions:

  • Axitinib is a potent vascular endothelial growth factor receptor tyrosine kinase inhibitor with a defined role in mRCC treatment.
  • Axitinib represents a significant therapeutic advancement for patients with metastatic renal cell carcinoma receiving second-line therapy.

Related Concept Videos

Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...
Treatment Resistent Cancers02:56

Treatment Resistent Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal Drug Excretion: Overview01:15

Renal Drug Excretion: Overview

As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
A nephron consists of two primary structures: the renal corpuscle and the renal tubule. The renal corpuscle contains the glomerulus, a network of capillaries where the first step of renal excretion, glomerular filtration, occurs. Blood pressure forces water, ions, and small molecules out...