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Medical Oncology

, 36:6 | Cite as

Comparison of axitinib and sunitinib as first-line therapies for metastatic renal cell carcinoma: a real-world multicenter analysis

  • Sakae Konishi
  • Shingo HatakeyamaEmail author
  • Toshiaki Tanaka
  • Yoshinori Ikehata
  • Toshikazu Tanaka
  • Naoki Fujita
  • Yusuke Ishibashi
  • Hayato Yamamoto
  • Takahiro Yoneyama
  • Yasuhiro Hashimoto
  • Kazuaki Yoshikawa
  • Toshiaki Kawaguchi
  • Naoya Masumori
  • Hiroshi Kitamura
  • Chikara Ohyama
Original Paper
  • 203 Downloads

Abstract

We aimed to compare oncological outcomes and safety of axitinib and sunitinib in patients with treatment-naïve metastatic renal cell carcinoma (mRCC). We retrospectively evaluated 169 patients with mRCC who were treated with axitinib or sunitinib as the first-line therapy in five hospitals between October 2008 and August 2018. Oncological outcomes and safety were compared between axitinib (n = 68) and sunitinib (n = 101) groups. Inverse probability of treatment weighted (IPTW)-adjusted Cox regression analysis was performed to evaluate effects of first-line therapies on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). Patients in the axitinib group were significantly older (66 vs. 72 years) than those in the sunitinib group. Median relative dose intensity was significantly higher in the axitinib group (94 ± 62%) than in the sunitinib group (65 ± 20%; P = 0.001). Objective response rate was significantly higher in the axitinib group (21%) than in the sunitinib group (10%; P = 0.042). IPTW-adjusted Cox regression analysis revealed significant differences in CSS and OS but not in PFS between the two groups. Safety in terms of grade ≥ 3 adverse events was significantly different between the axitinib (34%) and sunitinib (55%) groups (P = 0.006). Compared with sunitinib, axitinib significantly prolonged CSS and OS and showed a safer profile as the first-line therapy for treatment-naïve mRCC.

Keywords

Axitinib Sunitinib Metastatic renal cell carcinoma First-line therapy Safety Efficacy 

Abbreviations

mRCC

Metastatic renal cell carcinoma

TKIs

Tyrosine kinase inhibitors

VEGF

Vascular endothelial growth factor

ECOG PS

Eastern Cooperative Oncology Group performance status

IMDC

International Metastatic Renal Cell Carcinoma Database Consortium

CR

Complete response

PR

Partial response

SD

Stable disease

PD

Progressive disease

PFS

Progression-free survival

CSS

Cancer-specific survival

OS

Overall survival

IPTW

Inverse probability of treatment weighted

HR

Hazard ratio

95% CI

95% confidence interval

IQR

Interquartile range

RDI

Relative dose intensity

mTORi

Mammalian target of rapamycin inhibitor

Notes

Acknowledgements

The authors would like to thank Takuma Narita, Teppei Okamoto, Itsuto Hamano, Hirotaka Horiguchi, Masaaki Oikawa, Daisuke Noro, Kazuhisa Hagiwara, Yuki Fujita, Yukie Nishizawa, and Satomi Sakamoto for their invaluable support in data collection. The authors would also like to thank Enago (http://www.enago.jp) for English language review.

Funding

This work was supported by a Grant-in-Aid for Scientific Research (Nos. 17K11118, 17K11119, 17K16768, 17K16770, 17K167711, 18K16681, 18K16682, 18K16717, 18K16718, 18K16719, and 18K09157) from the Japan Society for the Promotion of Science.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sakae Konishi
    • 1
  • Shingo Hatakeyama
    • 1
    Email author
  • Toshiaki Tanaka
    • 2
  • Yoshinori Ikehata
    • 3
  • Toshikazu Tanaka
    • 1
  • Naoki Fujita
    • 1
  • Yusuke Ishibashi
    • 1
  • Hayato Yamamoto
    • 1
  • Takahiro Yoneyama
    • 1
  • Yasuhiro Hashimoto
    • 1
  • Kazuaki Yoshikawa
    • 4
  • Toshiaki Kawaguchi
    • 5
  • Naoya Masumori
    • 2
  • Hiroshi Kitamura
    • 3
  • Chikara Ohyama
    • 1
  1. 1.Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
  2. 2.Department of UrologySapporo Medical University School of MedicineSapporoJapan
  3. 3.Department of Urology, Graduate School of MedicineUniversity of ToyamaToyamaJapan
  4. 4.Department of UrologyMutsu General HospitalMutsuJapan
  5. 5.Department of UrologyAomori Prefectural Central HospitalAomoriJapan

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