Axitinib in management of renal cell carcinoma: Indian perspective

Abstract

Background: Renal cell carcinoma (RCC) is the most common type of kidney cancer. Despite the availability of several tyrosine kinase inhibitors (TKI) and immunotherapies in India, the placing and sequencing of molecules in the management of RCC remains a source of dispute. The purpose of this qualitative survey was to get insight on the positioning of TKIs, specifically Axitinib, in the treatment of RCC. Methodology: This was a cross-sectional, questionnaire-based survey conducted across India among Medical Oncologist involved in the management of metastatic RCC. The questionnaire consists of 15 questions that were validated by a senior oncologist. The responses to the question were compiled in Microsoft Excel version 2018 and analyzed. Results: Total 51 oncologists completed this questionnaire. Majority preferred the International Metastatic RCC Database consortium risk stratification criteria. In favourable risk category sunitinib was preferred while in intermediate/poor risk patient's axitinib plus pembrolizumab was preferred by majority. Pazopanib and axitinib was favoured in patients with advanced age and comorbidities. Axitinib was the choice in patients who had good response to 1st line therapy and who have visceral metastasis. Majority of oncologists endorsed the use of axitinib in elderly with comorbid patients because of its favourable efficacy and tolerability. Conclusion: Axitinib is preferred choice in metastatic RCC patients who have responded well to TKIs in the first line, in elderly patients with associated comorbidities, in patients with renal impairment and in patients with poor performance status. It is a well-tolerated drug with minimal adverse effects which are transient in nature.