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Impact of Therapy Management on Axitinib-Related Adverse Events in Patients With Advanced Renal Cell Carcinoma Receiving First-Line Axitinib plus Checkpoint Inhibitor
Journal article   Open access   Peer reviewed

Impact of Therapy Management on Axitinib-Related Adverse Events in Patients With Advanced Renal Cell Carcinoma Receiving First-Line Axitinib plus Checkpoint Inhibitor

Yousef Zakharia, Lynn Huynh, Shawn Du, Rose Chang, Selina Pi, Sanjana Sundaresan, Mei S. Duh, Giovanni Zanotti and Despina Thomaidou
Clinical genitourinary cancer, Vol.21(5), pp.E343-E351
10/01/2023
DOI: 10.1016/j.clgc.2023.03.017
PMID: 37087399
url
https://doi.org/10.1016/j.clgc.2023.03.017View
Published (Version of record) Open Access

Abstract

Axitinib and checkpoint inhibitor (CPI) combinations are a standard-of-care for frontline treatment of advanced renal cell carcinoma (aRCC). Limited information exists on managing real-world adverse events (AEs) in patients with aRCC treated with axitinib plus CPI. The current study found that modifying axitinib (by dose reduction and/or treatment interruption) is an effective AE management strategy that may prolong treatment duration.Introduction: There are limited real-world data on the effectiveness of strategies used to manage adverse events (AEs) in patients with advanced renal cell carcinoma (RCC) treated with axitinib. This retrospective chart review examined the AE profile and effect of axitinib modifications on AE resolution/improvement and treatment discontinuation. Methods: A retrospective physician-administered chart review was conducted. Adult patients with advanced RCC treated with first-line axitinib plus checkpoint inhibitor (CPI) therapy (ie, avelumab or pembrolizumab) and who had documented frequently reported axitinib-related AEs of fatigue, diarrhea, nausea, hypertension, or palmar-plantar erythrodysesthesia were included. Physician characteristics, patient characteristics, AE characteristics, AE management strategies used, AE resolution/improvement, and treatment duration were described. The effect of strategies used to manage AEs (axitinib dose reduction or treatment interruption) on AE resolution/improvement was evaluated by logistic regression. Results: Among 219 patients (median age: 62 years, 65% male), 70 (32%) were treated with axitinib + avelumab and 149 (68%) received axitinib + pembrolizumab. Axitinib modifications increased the likelihood of AE resolution/improvement compared with no modifications (adjusted odds ratio: 6.34, P < .001). In the subset of patients who discontinued treatment among those with or without axitinib modifications, mean treatment duration was 7.0 and 1.7 months, respectively. Conclusion: Toxicities experienced by patients with advanced RCC treated with firstline axitinib-CPI in the real world can be effectively managed by axitinib modifications, thereby prolonging treatment duration.
 Life Sciences & Biomedicine Oncology Science & Technology Urology & Nephrology

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