@article{TCR2870,
author = {Denis L.F. Jardim and David S. Hong},
title = {Axitinib for the first line therapy of renal cancer: failure of a trial or failure of a strategy?},
journal = {Translational Cancer Research},
volume = {3},
number = {6},
year = {2014},
keywords = {},
abstract = {The vascular endothelial growth factor (VEGF) pathway has been extensively studied in renal cell carcinoma (RCC) and represents the main target for systemic treatment of this disease. Over the last 10 years, five different VEGF blocking agents were granted approval by the FDA and are currently available in clinical practice. With an increased number of agents, selection of treatment is a real challenge. While some agents are known to inhibit the VEGF receptor more effectively in vitro, clinical data is needed to demonstrate if this will indeed translate into better clinical outcomes. Axitinib is a more potent VEGF receptor tyrosine kinase inhibitor (TKI), currently approved for second line treatment of metastatic RCC (mRCC). In this editorial, we comment a phase III trial conducted by Hutson et al., which evaluates axitinib against sorafenib as a first line therapy in mRCC. This trial had an ambitious primary outcome of a 78% improvement in progression free survival (PFS) with axitinib. With 288 patients, this trial failed to achieve its primary endpoint and axitinib was not superior compared to sorafenib. In favor of axitinib, a subgroup analysis showed prolongation of PFS in patients with excellent performance status and a general acceptable safety profile. Although axitinib demonstrated relevant clinical activity in this trial and the negative result may be in part explained by a small sample size to detect a large magnitude of benefit, these results challenged the strategy of bringing more potent VEGF inhibitors to the clinic with the aim of improving clinical outcomes.},
issn = {2219-6803}, url = {https://tcr.amegroups.org/article/view/2870}
}