Efficacy of axitinib in patients with metastatic renal cell carcinoma refractory to nivolumab therapy

Abstract

We reviewed the clinical efficacy of axitinib after nivolumab treatment failure in six patients with metastatic renal cell carcinoma (RCC); the patients had received nivolumab treatment following vascular endothelial growth factor receptor (VEGFR) inhibitors. Most had undergone radical nephrectomy; five had clear-cell carcinoma and acquired cystic disease-associated carcinoma. The patients were finally diagnosed with progressive disease during nivolumab treatment. Immediately after nivolumab treatment failure, one patient receiving pazopanib had an adverse event soon after, and subsequently received axitinib, which the others received. The size of the metastatic tumors treated with axitinib after nivolumab was on average 33.9% smaller. Following treatment, three patients experienced partial response with remarkable tumor shrinkage and three had stable disease (SD), of which most maintained for >5 months. One patient with SD died from gradual tumor progression after axitinib treatment. Axitinib treatment after nivolumab treatment failure can be beneficial for some patients with metastatic RCC.

Keywords: axitinib; immune checkpoint inhibitor; metastatic renal cell carcinoma; nivolumab; tyrosine kinase inhibitor.