Critical appraisal of axitinib in the treatment of advanced renal cell carcinoma

Figures & data

Figure 1 Biological pathways and targets for molecular targeted agents in renal cell carcinoma.

Abbreviations: APK, activated protein kinase; BNIP3, BCL2/adenovirus E1B 19 kDa protein-interacting protein 3; CA IX, carbonic anhydrase IX; EGFR, epidermal growth factor receptor; EPO, erythropoietin; ERK, extracellular signal-regulated kinase; GLUT1, glucose transporter 1; HIF, hypoxia-inducible factor; MAPK, mitogen-activated protein kinase; MEK, mitogen-activated protein kinase kinase; mTOR, mammalian target of rapamycin; PI3K, phosphatidylinositol 3-kinases; PDGF, platelet-derived growth factor; PDGFR, platelet-derived growth factor receptor; TGF, transforming growth factor; VEGF, vascular endothelial growth factor; VEGFR, vascular endothelial growth factor receptor.

Table 1 Summary of Phase III clinical trial results for targeted agents approved for first-line treatment of metastatic renal cell carcinoma

References	Indication	n	Drugs	OR (CR + PR) (%)	Median PFS (months)	P value	Median OS (months)	P value
Motzer et al^Citation6	Treatment naïve	750	Sunitinib	47	11	<0.001	26.4	0.051
			IFN-á	12	5		21.8
Sternberg et al^Citation7	Treatment naïve and cytokine pretreated	435	Pazopanib	30	9.2	<0.0001	NR
			Placebo	3	4.2
Escudier et al^Citation9	Treatment naïve	649	Bevacizumab + iFN-á	31	10.4	0.0001	23.3	0.3360
			IFN-á	12	5.5		21.3
Rini et al^Citation11	Treatment naïve	732	Bevacizumab + iFN-á	25.5	8.5	<0.0001	18.3	0.097
			IFN-á	13.1	5.2		17.4
Hudes et al^Citation8	Treatment naïve	626	Temsirolimus (25 mg/wk)	8.6	5.5		10.9
			Temsirolimus (15 mg/wk) + iFN-á	8.1	4.7		8.4
			iFN-á	4.8	3.1		7.3

Abbreviations: CR, complete response; IFN, interferon; OR, objective response; OS, overall survival; PFS, progression-free survival; PR, partial response.

Figure 2 Chemical structure of axitinib.

Table 2 Summary of second-line Phase II clinical trials of Axitinib in metastatic renal cell carcinoma

References	Previous treatments	Drugs	n	OR (%)	Median PFS (months)	OS (months)
Rini et al^Citation22	Sorafenib	Axitinib 5 mg bd	62	22.6	7.4 (95% CI 6.7–11)	13.6 (95% CI 8.4–18.8)
Rixe et al^Citation23 and Motzer et al^Citation24	Cytokines	Axitinib 5 mg bd	52	44.2	15.7 (95% CI 8.4–23.4)	29.9 (95% CI 20.3–NR)

Abbreviations: CI, confidence interval; NR, not reached; OR, objective response; OS, overall survival; PFS, progression-free survival.

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