Overall Survival Analysis From a Randomized Phase II Study of Axitinib With or Without Dose Titration in First-Line Metastatic Renal Cell Carcinoma

Clin Genitourin Cancer. 2016 Dec;14(6):499-503. doi: 10.1016/j.clgc.2016.04.005. Epub 2016 Apr 22.

Abstract

Background: In a randomized phase II trial in metastatic renal cell carcinoma (mRCC), objective response rate was significantly higher with axitinib versus placebo titration (54% vs. 34%; 1-sided P = .019).

Patients and methods: Treatment-naive patients with mRCC (n = 213) received axitinib 5 mg twice per day (b.i.d.) for 4 weeks. Patients meeting dose titration criteria were randomized to receive axitinib 5 mg b.i.d. with axitinib or placebo titration (n = 56 each); 91 patients ineligible for randomization continued axitinib 5 mg b.i.d.; 10 discontinued before randomization.

Results: Median overall survival (95% confidence interval [CI]) was 42.7 months (24.7-not estimable) with axitinib titration versus 30.4 months (23.7-45.0) with placebo titration (stratified hazard ratio, 0.785; 95% CI, 0.485-1.272; 1-sided P = .162), and 41.6 months (95% CI, 33.0-not estimable) in nonrandomized patients. Safety data were consistent with previous reports.

Conclusion: Median overall survival was numerically longer in patients with first-line mRCC who received axitinib versus placebo titration. No new safety signal was observed after long-term axitinib treatment in first-line mRCC.

Keywords: First-line treatment; Kidney cancer; Phase II; VEGFR inhibitor; mRCC.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Angiogenesis Inhibitors / therapeutic use
  • Axitinib
  • Carcinoma, Renal Cell / drug therapy*
  • Disease-Free Survival
  • Double Bind Interaction
  • Drug Administration Schedule
  • Female
  • Humans
  • Imidazoles / administration & dosage*
  • Imidazoles / therapeutic use
  • Indazoles / administration & dosage*
  • Indazoles / therapeutic use
  • Kidney Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Survival Analysis
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Imidazoles
  • Indazoles
  • Axitinib