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Can Axitinib Amid Immunotherapy Sequences Improve Outcomes in Renal Cell Carcinoma?

By: Vanessa A. Carter, BS
Posted: Wednesday, October 20, 2021

A study conducted by Tomonori Habuchi, MD, of Akita University Graduate School of Medicine, Japan, and colleagues comparing the outcomes with two VEGFR tyrosine kinase inhibitors—axitinib versus sunitinib—revealed that first-line axitinib demonstrated improved efficacy and survival benefit over sunitinib in patients with metastatic renal cell carcinoma. Published in Cancer Medicine, these results suggest that axitinib may be a suitable treatment option for patients requiring immuno-oncology drug–based therapy.

The investigators focused on 408 patients with metastatic renal cell carcinoma who were administered either axitinib (n = 134) or sunitinib (n = 274) as first-line therapy. These patients were from eight Japanese institutes. Axitinib was given to patients who had a higher International Metastatic Renal Cell Carcinoma Database Consortium score, were elderly, and were less likely to undergo nephrectomy.

The median patient age was 66, and the majority of participants were male (74.3%). The median duration of therapy was 20 months, and 108 patients were administered nivolumab sequentially. In the axitinib and sunitinib groups, an objective response was observed in 34 and 50 patients, respectively. Notably, there was a better disease control rate with axitinib (73.1%) than with sunitinib (62.8%).

After propensity score matching, the disease control rate (74.4% vs. 56.2%), objective response rate (26.4% vs. 14.0%), progression-free survival (18.0 months vs. 5.5 months), and overall survival (33.5 months vs. 19.8 months) were all significantly improved with axitinib versus sunitinib. Furthermore, patients in the axitinib cohort who received sequential nivolumab demonstrated a better overall survival than those given axitinib alone (75.1 months vs. 56.1 months).

“To the best of our knowledge, this is the first study to report the favorable oncological outcomes of axitinib in the immune-oncology era,” the investigators commented. “Further research is warranted to address the clinical benefit of the axitinib in patients with metastatic renal cell carcinoma.”

Disclosure: The study authors reported no conflicts of interest.



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