TY - JOUR
T1 - Effect of Renal Impairment on the Pharmacokinetics and Safety of Axitinib
AU - Chen, Ying
AU - Rini, Brian I.
AU - Motzer, Robert J.
AU - Dutcher, Janice P.
AU - Rixe, Olivier
AU - Wilding, George
AU - Stadler, Walter M.
AU - Tarazi, Jamal
AU - Garrett, May
AU - Pithavala, Yazdi K.
N1 - Publisher Copyright:
© 2015, Springer International Publishing Switzerland.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Background: Axitinib, an inhibitor of vascular endothelial growth factor (VEGF) receptors, is approved as second-line treatment for advanced renal cell carcinoma (RCC). Agents targeting the VEGF pathway may induce renal toxicities, which may be influenced by pre-existing renal dysfunction. Objective: The objective was to characterize axitinib pharmacokinetics and safety in patients with renal impairment. Patients and Methods: Effect of renal function (baseline creatinine clearance [CrCL]) on axitinib clearance was evaluated in a population pharmacokinetic model in 207 patients with advanced solid tumors who received a standard axitinib starting dose, and in 383 healthy volunteers. Axitinib safety according to baseline CrCL was assessed in previously treated patients with RCC (n = 350) who received axitinib in the phase 3 AXIS study. Results: Median axitinib clearance was 14.0, 10.7, 12.3, 7.81, and 12.6 L/h, respectively, in individuals with normal renal function (≥90 ml/min; n = 381), mild renal impairment (60–89 ml/min; n = 139), moderate renal impairment (30–59 ml/min; n = 64), severe renal impairment (15–29 ml/min; n = 5), and end-stage renal disease (<15 ml/min; n = 1). The population pharmacokinetic model adequately predicted axitinib clearance in individuals with severe renal impairment or end-stage renal disease. Grade ≥3 adverse events (AEs) were reported in 63 % of patients with normal renal function or mild impairment, 77 % with moderate impairment, and 50 % with severe impairment; study discontinuations due to AEs were 10 %, 11 %, and 0 %, respectively. Conclusions: Axitinib pharmacokinetics and safety were similar regardless of baseline renal function; no starting-dose adjustment is needed for patients with pre-existing mild to severe renal impairment. [MediaObject not available: see fulltext.]
AB - Background: Axitinib, an inhibitor of vascular endothelial growth factor (VEGF) receptors, is approved as second-line treatment for advanced renal cell carcinoma (RCC). Agents targeting the VEGF pathway may induce renal toxicities, which may be influenced by pre-existing renal dysfunction. Objective: The objective was to characterize axitinib pharmacokinetics and safety in patients with renal impairment. Patients and Methods: Effect of renal function (baseline creatinine clearance [CrCL]) on axitinib clearance was evaluated in a population pharmacokinetic model in 207 patients with advanced solid tumors who received a standard axitinib starting dose, and in 383 healthy volunteers. Axitinib safety according to baseline CrCL was assessed in previously treated patients with RCC (n = 350) who received axitinib in the phase 3 AXIS study. Results: Median axitinib clearance was 14.0, 10.7, 12.3, 7.81, and 12.6 L/h, respectively, in individuals with normal renal function (≥90 ml/min; n = 381), mild renal impairment (60–89 ml/min; n = 139), moderate renal impairment (30–59 ml/min; n = 64), severe renal impairment (15–29 ml/min; n = 5), and end-stage renal disease (<15 ml/min; n = 1). The population pharmacokinetic model adequately predicted axitinib clearance in individuals with severe renal impairment or end-stage renal disease. Grade ≥3 adverse events (AEs) were reported in 63 % of patients with normal renal function or mild impairment, 77 % with moderate impairment, and 50 % with severe impairment; study discontinuations due to AEs were 10 %, 11 %, and 0 %, respectively. Conclusions: Axitinib pharmacokinetics and safety were similar regardless of baseline renal function; no starting-dose adjustment is needed for patients with pre-existing mild to severe renal impairment. [MediaObject not available: see fulltext.]
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U2 - 10.1007/s11523-015-0389-2
DO - 10.1007/s11523-015-0389-2
M3 - Article
C2 - 26400730
AN - SCOPUS:84944699278
SN - 1776-2596
VL - 11
SP - 229
EP - 234
JO - Targeted oncology
JF - Targeted oncology
IS - 2
ER -