Efficacy and safety of axitinib for metastatic renal cell carcinoma: Real-world data on patients with renal impairment

被引：2

作者：

Minami, Keita ^{[1
]}

Osawa, Takahiro ^{[2
]}

Kojima, Takahiro ^{[3
]}

Hara, Tomohiko ^{[4
]}

Eto, Masatoshi ^{[5
]}

Takeuchi, Ario ^{[5
]}

Nakai, Yasutomo ^{[6
]}

Ueda, Kosuke ^{[7
]}

Ozawa, Michinobu ^{[8
]}

Uemura, Motohide ^{[9
]}

Ohba, Kojiro ^{[10
]}

Tamura, Keita ^{[11
]}

Shindo, Tetsuya ^{[12
]}

Nakagomi, Hiroshi ^{[13
]}

Takahashi, Atsushi ^{[14
]}

Anai, Satoshi ^{[15
]}

Yokomizo, Akira ^{[16
]}

Morizane, Shuichi ^{[17
]}

Kimura, Takahiro ^{[18
]}

Shimazui, Toru ^{[19
]}

Miyauchi, Yasuyuki ^{[20
]}

Mitsuzuka, Koji ^{[21
]}

Hara, Hiroaki ^{[22
]}

Yoshimura, Koji ^{[23
]}

Shiina, Hiroaki ^{[24
]}

Ito, Youichi M. ^{[25
]}

Murai, Sachiyo ^{[2
]}

Nishiyama, Hiroyuki ^{[26
]}

Shinohara, Nobuo ^{[2
]}

Kitamura, Hiroshi ^{[27
]}

机构：

[1] Sapporo City Gen Hosp, Dept Urol, Sapporo, Hokkaido, Japan

[2] Hokkaido Univ Hosp, Dept Urol, Sapporo, Hokkaido, Japan

[3] Aichi Canc Ctr, Dept Urol, Nagoya, Aichi, Japan

[4] Off Pharmacovigilance II Pharmaceut & Med Devices, Tokyo, Japan

[5] Kyushu Univ, Dept Urol, Fukuoka, Japan

[6] Osaka Int Canc Inst, Dept Urol, Osaka, Japan

[7] Kurume Univ Hosp, Dept Urol, Kurume, Fukuoka, Japan

[8] Yamagata Univ Fac Med, Dept Urol, Yamagata, Japan

[9] Osaka Univ Hosp, Dept Urol, Suita, Osaka, Japan

[10] Nagasaki Univ Hosp, Dept Urol, Nagasaki, Japan

[11] Hamamatsu Univ Sch Med, Dept Urol, Hamamatsu, Shizuoka, Japan

[12] Sapporo Med Univ, Dept Urol, Sapporo, Hokkaido, Japan

[13] Univ Yamanashi Hosp, Dept Urol, Chuo, Japan

[14] Hakodate Goryoukaku Hosp, Dept Urol, Hakodate, Hokkaido, Japan

[15] Nara Med Univ, Dept Urol, Kashihara, Nara, Japan

[16] Harasanshin Hosp, Dept Urol, Fukuoka, Japan

[17] Tottori Univ, Dept Urol, Yonago, Tottori, Japan

[18] Jikei Univ, Sch Med, Dept Urol, Tokyo, Japan

[19] Dept Urol, Ibaraki Prefectural Cent Hosp, Ibaraki Canc Ctr, Kasama, Ibaraki, Japan

[20] Kagawa Univ, Dept Urol, Takamatsu, Kagawa, Japan

[21] Tohoku Univ, Dept Urol, Sendai, Miyagi, Japan

[22] Shinshu Univ Hosp, Dept Urol, Matsumoto, Nagano, Japan

[23] Shizuoka Prefectural Gen Hosp, Dept Urol, Shizuoka, Japan

[24] Shimane Univ, Dept Urol, Izumo, Shimane, Japan

[25] Hokkaido Univ Hosp, Inst Hlth Sci Innovat Med Care, Promot Unit, Data Sci Ctr, Sapporo, Hokkaido, Japan

[26] Univ Tsukuba Hosp, Dept Urol, Tsukuba, Ibaraki, Japan

[27] Toyama Univ Hosp, Dept Urol, Toyama, Japan

来源：

UROLOGIC ONCOLOGY-SEMINARS AND ORIGINAL INVESTIGATIONS | 2023年 / 41卷 / 11期

关键词：

Renal cell carcinoma; Metastatic; Axitinib; Renal impairment; PLUS AXITINIB; SORAFENIB; SUNITINIB; JAPAN;

D O I：

10.1016/j.urolonc.2023.08.008

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objectives: Limited information is currently available on the efficacy and safety of axitinib for metastatic renal cell carcinoma (mRCC) patients with renal impairment. Therefore, the present study investigated the efficacy and toxicity of axitinib in patients with chronic kidney disease. Methods: Post-hoc analyses were performed on a Japanese multicenter cohort study of 477 mRCC patients who received axitinib fol-lowed by 1 or 2 regimens of systemic antiangiogenic therapy between January 2012 and December 2016. Differences in clinical characteris-tics and the efficacy and safety of axitinib were assessed based on pretreatment renal function. Results: Patients were categorized into the following 5 renal function groups according to baseline renal function: estimated glomerular filtration rate (eGFR) >= 60 ml/min (n = 133), 45 ml/min <= eGFR <60 ml/min (n = 153), 30 ml/min <= eGFR< 45 ml/min (n = 130), eGFR <30 ml/min (n = 45), and dialysis (n = 16). Median progression-free survival (PFS) (95% confidence interval [CI]) in the 5 groups was 11 (8-16), 14 (11-19), 14 (10-19), 12 (8-24), and 6 (3-NR) months, respectively (p = 0.781). After adjustments for treatment-related con-founders, the renal function group was not a significant prognostic factor for PFS. Objective response rates in the 5 groups were 22%, 23%, 23%, 18%, 20%, and 38%, respectively (p = 0.468). Regarding adverse events of all grades, hypertension (p = 0.0006) and renal and urinary disorders (p < 0.0001) were more frequently observed in the eGFR <30 ml/min group than in the other groups. Conclusions: Since renal function at the initiation of treatment with axitinib does not adversely affect the efficacy of VEGF-TKI therapy, clinicians do not need to avoid its administration to mRCC patients with impaired renal function in consideration of the risk of progression to end-stage renal disease. (c) 2023 Elsevier Inc. All rights reserved.

引用

页码：458.e9 / 458.e19

页数：11

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