Axitinib: in advanced, treatment-experienced renal cell carcinoma.

Axitinib is a new inhibitor of vascular endothelial growth factor (VEGF) receptors 1-3, with greater inhibition potency than existing VEGF receptor inhibitors sunitinib, sorafenib and pazopanib. In a pivotal phase III trial in patients with advanced renal cell carcinoma that had progressed despite first-line therapy, axitinib 5 mg twice daily significantly prolonged median progression-free survival (primary endpoint) compared with sorafenib 400 mg twice daily. A significant between-group difference favouring axitinib over sorafenib in terms of progression-free survival was maintained in the subgroups of patients who had previously received cytokine or sunitinib therapy. However, median overall survival was not significantly different between the treatment groups. Significantly more axitinib than sorafenib recipients achieved an objective response, and axitinib therapy significantly prolonged time to deterioration (a composite endpoint of death, disease progression and symptom worsening) relative to sorafenib therapy. While its tolerability profile was generally consistent with that of other VEGF receptor inhibitors, axitinib was associated with a numerically lower incidence of palmar-plantar erythrodysaesthesia, cutaneous toxicity and anaemia than sorafenib in the phase III trial.