FCCC LOGO Faculty Publications
Rini BI , Wilding G , Hudes G , Stadler WM , Kim S , Tarazi J , Rosbrook B , Trask PC , Wood L , Dutcher JP
Phase II Study of Axitinib in Sorafenib-Refractory Metastatic Renal Cell Carcinoma
Journal of Clinical Oncology. 2009 Sep;27(27) :4462-4468
Back to previous list
Abstract
Purpose To investigate the efficacy and safety of axitinib, an oral, potent, and selective inhibitor of vascular endothelial growth factor (VEGF) receptors 1, 2, and 3 in patients with metastatic renal cell carcinoma (mRCC) refractory to prior therapies that included, but were not limited to, sorafenib. Patients and Methods In this multicenter, open-label, phase II study, patients with sorafenib-refractory mRCC received a starting dose of axitinib 5 mg orally twice daily. A one-arm, single-stage design was used to estimate the primary end point of objective response rate (ORR), defined by RECIST (Response Evaluation Criteria in Solid Tumors). Secondary end points included safety, duration of response, progression-free survival (PFS), overall survival (OS), and patient-reported outcomes. Results Of 62 patients recruited, 100% had received prior sorafenib, and 74.2% had received two or more prior systemic treatments. The axitinib dose was titrated to greater than 5 mg twice daily in 53.2% of patients, and 35.5% of patients had the dose modified to less than 5 mg twice daily. In 62 patients evaluable for response, the ORR was 22.6%, and the median duration of response was 17.5 months. Median PFS and OS times were 7.4 months (95% CI, 6.7 to 11.0 months) and 13.6 months (95% CI, 8.4 to 18.8 months), respectively. All-causality grade 3 to 4 adverse events included hand-foot syndrome (16.1%), fatigue (16.1%), hypertension (16.1%), dyspnea (14.5%), diarrhea (14.5%), dehydration (8.1%), and hypotension (6.5%). Conclusion Axitinib has antitumor activity in patients with mRCC refractory to prior VEGF-targeted therapy, including sorafenib. Toxicities were mild to moderate and were manageable. A randomized, phase III trial to compare axitinib with sorafenib in patients who have mRCC refractory to one prior first-line therapy regimen is underway. J Clin Oncol 27:4462-4468. (C) 2009 by American Society of Clinical Oncology
Notes
Rini, Brian I. Wilding, George Hudes, Gary Stadler, Walter M. Kim, Sinil Tarazi, Jamal Rosbrook, Brad Trask, Peter C. Wood, Laura Dutcher, Janice P. Amer soc clinical oncology Alexandria 496zo