TY - JOUR
T1 - Axitinib for the treatment of metastatic renal cell carcinoma
T2 - Recommendations for therapy management to optimize outcomes
AU - Larkin, James
AU - Fishman, Mayer
AU - Wood, Laura
AU - Negrier, Sylvie
AU - Olivier, Kara
AU - Pyle, Linda
AU - Gorbunova, Vera
AU - Jonasch, Eric
AU - Andrews, Lori
AU - Staehler, Michael
PY - 2014/8
Y1 - 2014/8
N2 - Axitinib is a novel, oral, multitargeted tyrosine kinase inhibitor, which inhibits vascular endothelial growth factor receptors 1, 2, and 3 at subnanomolar concentrations in vitro. In the phase III clinical trial in patients with metastatic renal cell carcinoma, axitinib showed a high objective response rate, and significantly prolonged progression-free survival compared with sorafenib. Thus, it is the first drug that has proven the concept of sequencing tyrosine kinase inhibitors in second-line treatment in a phase III prospective randomized trial. Although generally well tolerated and associated with a low incidence of grade 3 or 4 toxicities, axitinib shows a distinct pattern of adverse events that require monitoring and management. The most common adverse events observed with axitinib include diarrhea, hypertension, fatigue, nausea, and vomiting. This article summarizes the most important adverse events observed and proposes recommendations for their monitoring, prevention, and treatment. The recommendations are based on the existing literature and discussion by an expert group of international physicians and nurses specialized in oncologic treatment of metastatic renal cell carcinoma, which gathered in July 2011 in London, UK. Proactive assessment and management of adverse events during axitinib therapy can minimize treatment interruptions and ensure optimal effect of treatment.
AB - Axitinib is a novel, oral, multitargeted tyrosine kinase inhibitor, which inhibits vascular endothelial growth factor receptors 1, 2, and 3 at subnanomolar concentrations in vitro. In the phase III clinical trial in patients with metastatic renal cell carcinoma, axitinib showed a high objective response rate, and significantly prolonged progression-free survival compared with sorafenib. Thus, it is the first drug that has proven the concept of sequencing tyrosine kinase inhibitors in second-line treatment in a phase III prospective randomized trial. Although generally well tolerated and associated with a low incidence of grade 3 or 4 toxicities, axitinib shows a distinct pattern of adverse events that require monitoring and management. The most common adverse events observed with axitinib include diarrhea, hypertension, fatigue, nausea, and vomiting. This article summarizes the most important adverse events observed and proposes recommendations for their monitoring, prevention, and treatment. The recommendations are based on the existing literature and discussion by an expert group of international physicians and nurses specialized in oncologic treatment of metastatic renal cell carcinoma, which gathered in July 2011 in London, UK. Proactive assessment and management of adverse events during axitinib therapy can minimize treatment interruptions and ensure optimal effect of treatment.
KW - Axitinib
KW - Renal cell carcinoma
KW - Side effect management
KW - Toxicity
KW - Treatment optimization
KW - Tyrosine kinase inhibitor
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UR - http://www.scopus.com/inward/citedby.url?scp=84905109365&partnerID=8YFLogxK
U2 - 10.1097/COC.0b013e31827b45f9
DO - 10.1097/COC.0b013e31827b45f9
M3 - Review article
C2 - 23357974
AN - SCOPUS:84905109365
SN - 0277-3732
VL - 37
SP - 397
EP - 403
JO - American Journal of Clinical Oncology: Cancer Clinical Trials
JF - American Journal of Clinical Oncology: Cancer Clinical Trials
IS - 4
ER -