| Summary: | Shukui Qin,1 Feng Bi,2 Jie Jin,3 Ying Cheng,4 Jun Guo,5 Xiubao Ren,6 Yiran Huang,7 Jamal Tarazi,8 Jie Tang,9 Connie Chen,9 Sinil Kim,8 Dingwei Ye10 1Department of Medical Oncology, PLA Cancer Center, Nanjing Bayi Hospital, Nanjing, Jiangsu, People’s Republic of China; 2Department of Medical Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 3Department of Urology, Peking University First Hospital, Beijing, People’s Republic of China; 4Department of Oncology, Jilin Provincial Cancer Hospital, Changchun, Jilin Province, People’s Republic of China; 5Department of Renal Cancer and Melanoma, Peking University Cancer Hospital/Institute, Beijing, People’s Republic of China; 6Department of Biology Treatment, Tianjin Oncology Hospital, Tianjin, People’s Republic of China; 7Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 8Clinical Development, Pfizer Oncology, San Diego, CA, USA; 9Global Outcomes Research, Pfizer Inc., New York, NY, USA; 10Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China Background: This registrational trial evaluated the efficacy, safety, and patient-reported outcomes of axitinib versus sorafenib as a second-line treatment in Asian patients with clear-cell metastatic renal cell carcinoma (mRCC). Methods: In this open-label, multicenter study, previously treated Asian patients with clear-cell mRCC were stratified by Eastern Cooperative Oncology Group performance status and prior therapy and randomized in a 2:1 ratio to receive axitinib (5 mg twice daily) or sorafenib (400 mg twice daily). The primary end point was progression-free survival (PFS) assessed by a masked independent review committee.Results: A total of 204 Asian patients received axitinib (n=135) or sorafenib (n=69). Median PFS (95% confidence interval [CI]) was 6.5 (4.7–9.1) months with axitinib versus 4.8 (3.0–6.5) months with sorafenib (hazard ratio, 0.731; 95% CI, 0.506–1.058; one-sided P=0.0531). The objective response rate (95% CI) was 23.7% (16.8%–31.8%) with axitinib versus 10.1% (4.2%–19.8%) with sorafenib. Common, grade ≥3, all-causality adverse events were hypertension (19.3%), weight decrease (5.2%), and proteinuria (5.2%) with axitinib and hypertension (8.7%) and palmar-plantar erythrodysesthesia (7.2%) with sorafenib. In a time-to-deterioration composite end point of death, progression, and worsening of Functional Assessment of Cancer Therapy Kidney Symptom Index score, patients treated with axitinib demonstrated a 17%–24% risk reduction compared with sorafenib-treated patients. Conclusion: Axitinib is clinically active and well tolerated in previously treated Asian patients with mRCC, consistent with the results from the global Phase III trial. These results establish axitinib as a second-line treatment option for Asian patients with mRCC. Keywords: axitinib, renal cell carcinoma, sorafenib, vascular endothelial growth factor receptor inhibitor
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