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Axitinib in the treatment of renal cell carcinoma: patient selection and perspectives

Authors Narayan V, Haas N

Received 23 November 2015

Accepted for publication 29 January 2016

Published 29 March 2016 Volume 2016:9 Pages 65—72

DOI https://doi.org/10.2147/IJNRD.S83874

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Pravin Singhal


Vivek Narayan, Naomi Balzer Haas

Division of Hematology/Medical Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

Background: Axitinib is a next-generation, selective tyrosine kinase inhibitor targeting the vascular endothelial growth factor receptors. It is approved for the treatment of metastatic renal cell carcinoma (mRCC) based on a demonstrated progression-free survival advantage over sorafenib in the second-line treatment setting. However, given the variety of available targeted therapies for mRCC, appropriate patient selection for the available therapies remains a significant clinical challenge.
Purpose: This review summarizes the available evidence on the clinical, toxicity, and pharmacologic considerations for determining appropriate patient selection for axitinib therapy. In addition, it describes recent data on the use of predictive biomarkers to guide clinical management. This paper consists of material obtained via PubMed and Medline literature searches through October 2015.
Conclusion: Axitinib has a well-established role in the management of mRCC. Consistent clinical efficacy has been demonstrated across prognostic risk groups and prior therapeutic exposures. Although axitinib is generally well tolerated, appropriate toxicity management is critical to maximizing drug delivery and optimizing treatment outcomes. Although incident hypertension has been associated with improved clinical outcomes on axitinib, there are currently no validated clinical or genetic predictive biomarkers to guide patient selection.

Keywords: axitinib, vascular endothelial growth factor receptor, renal cell carcinoma, predictive marker
 

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