Given the number of available therapies for RCC, prior drug exposure is an important consideration for clinicians when selecting therapy for patients with advanced disease.
A small phase 2 study of 52 patients with metastatic RCC and prior cytokine-based treatment showed an objective response rate of 44.2% with axitinib and a median time to progression of 15.7 months.4
Unfortunately, there are no established biomarkers to identify which patients will benefit most from axitinib.
“These drugs have been out for a while, and we have been looking for a long time, but have not definitely found anything that helps us pick patient A vs patient B for this specific drug,” Dr Rini said. “Some patients do wonderfully well and have been on the drug for 2, 3, of 4 years, but I don’t know how to identify those folks up front.”
More research is being done in 2 areas of interest, according to Dr Rini.
Clinicians have a lot of experience titrating the dose of axitinib up or down to find the right dose for each patient; there is, therefore, an interest in conducting studies to help identify the most effective doses. Researchers are, according to Dr Rini, also working on studies combining axitinib with immunotherapy.
“There are a number of large trials going that are studying the combination of axitinib plus various checkpoint inhibitors that are likely to change the standard of care for these patients,” Dr Rini said.
- Motzer RJ, Bacik J, Murphy BA, Russo P, Mazumdar M. Interferon-alfa as a comparative treatment for clinical trials of new therapies against advanced renal cell carcinoma. J Clin Oncol.2002;20:289-96.
- Rini BI, Escudier B, Tomczak P, et al. Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomized phase 3 trial. Lancet. 2011;378(9807):1931-9.
- Qi WX, He AN, Shen Z, Yao Y. Incidence and risk of hypertension with a novel multi-targeted kinase inhibitor axitinib in cancer patients: a systemic review and meta-analysis. Br J Clin Pharmacol. 2013;76:348-57.
- Rixe O, Bukowski RM, Michaelson MD, et al. Axitinib treatment in patients with cytokine-refractory metastatic renal-cell cancer: a phase II study. Lancet Oncol. 2007;8:975-84.