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Axitinib for the treatment of advanced renal cell carcinoma

Hideyuki Akaza1, Tomofusa Fukuyama

  • 1The University of Tokyo, Research Center for Advanced Science and Technology , Tokyo , Japan.

Expert Opinion on Pharmacotherapy
|December 17, 2013
PubMed
Abstract

Insights

Axitinib offers significant benefits in progression-free survival and response rates for advanced renal cell carcinoma (RCC) patients. However, it does not improve overall survival, requiring careful consideration for second-line therapy selection.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • The pathogenesis of renal cell carcinoma (RCC) has advanced, leading to targeted therapies since 2005.
  • Axitinib selectively inhibits vascular endothelial growth factor receptors (VEGFRs) 1, 2, and 3.

Purpose of the Study:

  • To summarize the properties, clinical efficacy, adverse events, pharmacokinetics, and pharmacodynamics of axitinib.
  • To describe axitinib's position within the therapeutic landscape for metastatic RCC.

Main Methods:

  • Review of properties, clinical efficacy, adverse events, pharmacokinetics, and pharmacodynamics of axitinib.
  • Comparative analysis of axitinib versus sorafenib in the Phase III AXIS trial.

Main Results:

  • Axitinib significantly prolonged progression-free survival (6.7 vs 4.7 months) and improved objective response rate (19% vs 9%) compared to sorafenib in advanced RCC.
  • Overall survival rates were similar between axitinib and sorafenib.
  • Common adverse events include diarrhea, hypertension, and fatigue.

Conclusions:

  • Axitinib is a well-tolerated second-line therapy for advanced or metastatic RCC, offering clinical benefits.
  • Axitinib, like other tyrosine kinase inhibitors, does not prolong overall survival.
  • Careful patient selection is crucial when considering axitinib as a second-line tyrosine kinase inhibitor therapy.

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