MIAMI – Although no significant differences in overall or progression-free survival were observed between axitinib and everolimus in patients with advanced renal cell carcinoma (RCC), axitinib treatment may result in higher drug costs compared with everolimus, a new study presented at the 14th International Kidney Cancer Symposium 2015 (IKCS) has shown.1

“While multiple real-world studies have assessed the effectiveness of everolimus and other second targeted therapies, data on axitinib outcomes is only recently available and has not been widely reported,” Eric Jonasch, MD, of the University of Texas MD Anderson Cancer Center in Houston, TX, said during the poster presentation.

For the study, researchers sought to retrospectively compare progression-free survival, overall survival, dosing patterns, and drug costs per month of progression-free survival between axitinib and everolimus, which are both approved by the U.S. Food and Drug Administration as second-line targeted therapy for advanced RCC.

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Researchers analyzed data from 325 and 127 patients who received everolimus and axitinib as second targeted therapy, respectively. Patients were eligible for inclusion if they were diagnosed with advanced RCC, had initiated and discontinued a tyrosine kinase inhibitor, such as sorafenib, sunitinib, or pazopanib, as first targeted therapy, and had initiated everolimus or axitinib as second targeted therapy.

Results showed no significant differences between everolimus and axitinib in progression-free survival (HR, 1.16; 95% CI, 0.85 – 1.59) or overall survival (HR, 1.16; 95% CI, 0.74 – 1.82).

“No statistically significant differences were observed in overall survival or progression-free survival between everolimus- and axitinib-treated patients,” Dr. Jonasch said. “Longer durations of first TKI were not associated with longer overall survival or progression-free survival with axitinib versus everolimus as second targeted therapy.”

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Researchers found that a higher proportion of patients treated with axitinib-initiated therapy at a starting dose higher than the label recommends or experienced dose escalation compared with those who received everolimus.

The study also demonstrated 17% higher drug costs per month of progression-free survival per patients compared with everolimus (P<.001), suggesting that the axitinib dosing patterns may result in higher drug costs.


  1. Jonasch E, Pal SK, Signorovitch JE, et al. Real-world effectiveness, dosing, and drug costs of everolimus (EVE) and axitinib (AXI) as second targeted therapies (TTs) for advanced renal cell carcinoma (aRCC) in the US: a retrospective chart review [abstract]. BJU Int. 2015. doi: 10.1111/bju.13365.