title: Response to post-axitinib treatment in patients with metastatic renal cell carcinoma.
abstract: BACKGROUND
  Axitinib is a potent inhibitor of the vascular endothelial growth factor (VEGF) receptor family with clinical activity in patients with metastatic renal cell carcinoma (mRCC). Given this biochemical potency, the clinical activity of subsequent treatment with targeted therapies in patients progressing on axitinib is of interest.
  
  
  METHODS
  Patients with advanced renal cell carcinoma of any pathologic subtype treated with at least one cycle (four weeks) of axitinib followed by at least one subsequent targeted therapy were investigated in a retrospective analysis. Patient characteristics, duration of treatment and clinical outcomes were analyzed for axitinib and each subsequent line of therapy by Response Evaluation Criteria in Solid Tumors (RECIST).
  
  
  RESULTS
  Twenty-five mRCC patients who received at least one approved targeted agent following axitinib were identified. Eight percent of patients achieved a partial response (one patient each to sunitinib and pazopanib) and 42 % had a best response of stable disease to the first therapy after axitinib. The estimated median duration of therapy was 4.4 months (range, 0.2-27.5+). Twelve patients received a second post-axitinib targeted therapy. Six out of 11 evaluable patients (55 %) had a best response of SD. The estimated median duration of treatment was 4.8 months (range, 0.7-19.1+).
  
  
  CONCLUSIONS
  Objective responses and stable disease is observed to post-axitinib targeted therapies and prospective studies are needed for validating role of predictive biomarkers.
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA. namita.chittoria@yahoo.com.|Veteran Affairs Medical Center, 800 Irving Avenue, Syracuse, NY, 13210, USA. namita.chittoria@yahoo.com.
authors.forename: Namita
authors.initials: N
authors.lastname: Chittoria
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA.
authors.forename: Housam
authors.initials: H
authors.lastname: Haddad
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Elson
authors.affiliation: University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Nizar M
authors.initials: NM
authors.lastname: Tannir
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Wood
authors.affiliation: University of Virginia, 1240 Lee St., Charlottesville, VA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Dreicer
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Garcia
authors.affiliation: Cleveland Clinic Taussig Cancer Center, 9500 Euclid Ave., Cleveland, OH, USA.
authors.forename: Brian I
authors.initials: BI
authors.lastname: Rini
authors.affiliation: University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Jonasch
mesh_terms: D000328:Adult; D000368:Aged; D000077784:Axitinib; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage*; D007191:Indazoles / Q000008:administration & dosage*; D007211:Indoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage*; D000077210:Sunitinib; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors / Q000235:genetics; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000235:genetics
chemical_list: D007093:Imidazoles; D007191:Indazoles; D007211:Indoles; D011758:Pyrroles; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077784:Axitinib; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D000077210:Sunitinib
keywords: Axitinib; Predictive biomarkers; Renal cell carcinoma; Sunitinib; VEGF inhibitors; mTOR inhibitors