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AUA 2021: Role of the Tumor Microenvironment and Response to Axitinib in Renal Cell Carcinoma

By: Kayci Reyer
Posted: Friday, September 17, 2021

Translational results from the phase II NAXIVA study, presented during the 2021 American Urological Association (AUA) Annual Meeting (Abstract LBA02-05), suggest that neoadjuvant axitinib may contribute to the reduction of venous tumor thrombus in patients with stage IVC renal cell carcinoma. Sarah J. Welsh, PhD, of the University of Cambridge, and colleagues performed translational studies to determine how the tumor microenvironment may impact a patient’s response to the tyrosine kinase inhibitor axitinib.

“Translational work has identified potential biomarkers for validation in future studies, with work ongoing,” commented the investigators.

Between December 15, 2017, and January 6, 2020, the study recruited 21 patients with clear cell renal cell carcinoma who had not yet undergone nephrectomy or thrombectomy. During the study, patients underwent translational sampling, including tissue, blood, and urine, at three time points: prior to receiving axitinib, while receiving axitinib, and at nephrectomy. Analyses for circulating tumor DNA (ctDNA), tumor microenvironment, and cytokines were performed.

Overall, few patients (n = 3) had detectable ctDNA at baseline, and none of those with detectable ctDNA experienced a Response Evaluation Criteria in Solid Tumors response or an altered surgical approach. Following 8 weeks of treatment, responders experienced a higher baseline vessel density and a greater reduction than did nonresponders. Of note, CD8+PD+ tumor infiltration was lower among responders than nonresponders. All patients had a vessel density reduction following axitinib treatment. No predictive cytokine or peripheral immune cell–based biomarkers were identified, though multiparameter analysis is incomplete.

Disclosure: For full disclosures of the study authors, visit auajournals.org.



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