The following is a summary of “Efficacy and safety of axitinib for metastatic renal cell carcinoma: Real-world data on patients with renal impairment,” published in the November 2023  issue of Urology by Minami, et al.

Not much was known about how well and safely axitinib works for people with metastatic renal cell cancer (mRCC) who also have kidney problems. For a study, researchers sought to look into how well and how dangerous axitinib is for people with chronic kidney disease. They did post-hoc analyses on a Japanese multicenter cohort study of 477 mRCC patients who got axitinib and then either one or two cycles of systemic antiangiogenic treatment between January 2012 and December 2016. Based on how well the kidneys worked before treatment, differences in clinical features and taxitinib’s effectiveness and safety were examined

Based on their initial kidney function, patients were put into 5 groups: those with an estimated glomerular filtration rate (eGFR) of ≥60 ml/min (n = 133), those with an eGFR of 45 ml/min or less (n = 153), those with an eGFR of 30 ml/min or less (n = 130), those with an eGFR of less than 30 ml/min (n = 45), and those on dialysis (16). The median progression-free survival (PFS) (95% CI) for the 5 groups was 11 (8–16), 14 (11–19), 14 (10–19), 12 (8–24), and 6 (3–NR) months, in that order (p = 0.781). 

The kidney function group was not a significant predictor of PFS after treatment-related confounders were taken into account. There were 5 groups, and the objective answer rates were 22%, 23%, 23%, 18%, 20%, and 38%, in that order (P = 0.468). The group with an eGFR of less than 30 ml/min had more adverse events of all grades. More often than in the other groups, hypertension (P = 0.0006) and kidney and urine problems (P < 0.0001) were seen in this group. Since renal function at the start of axitinib treatment doesn’t affect how well VEGF-TKI therapy works, doctors don’t have to avoid giving it to mRCC patients with poor renal function because of the chance of them getting end-stage renal disease.

Source: sciencedirect.com/science/article/abs/pii/S1078143923002867