Assessment of Efficacy, Safety, and Quality of Life of 124 Patients Treated With Axitinib as Second-Line Therapy for Metastatic Renal-Cell Carcinoma: Experience in Real-World Clinical Practice in Japan

作者：Miyake Hideaki^*; Harada Ken ichi; Ozono Seiichiro; Fujisawa Masato

来源：Clinical Genitourinary Cancer, 2017, 15(1): 122-128.

DOI：10.1016/j.clgc.2016.06.019

• Adverse event
• Molecular-targeted agent
• Quality of life
• Prognosis
• Sequential therapy

Encouraging data, including efficacy, safety, and quality of life, could be achieved in Japanese patients with metastatic renal-cell carcinoma (mRCC) who received axitinib as a second-line agent in a real-world clinical setting. The introduction of axitinib as a standard of care may thus be strongly recommended for Japanese mRCC patients after the failure of first-line systemic therapy.
Purpose: To comprehensively analyze the efficacy of axitinib for metastatic renal-cell carcinoma (mRCC) patients. Patients and Methods: This study included 124 consecutive Japanese patients treated with axitinib as second-line systemic therapy for mRCC in a routine clinical setting. Results: In addition to 4 indeterminate patients (3.2%), 0 (0%), 21 (16.9%), 87 (70.2%), and 12 (9.7%) were judged to show complete response, partial response, stable disease, and progressive disease, respectively, as the best responses to axitinib. The median progression-free survival (PFS) and overall survival (OS) after initiating treatment with axitinib were 9.3 and 27.0 months, respectively. Multivariate analyses of several parameters identified the following independent predictors of PFS and OS: Memorial Sloan Kettering Cancer Center (MSKCC) classification and C-reactive protein level for PFS; and MSKCC classification, C-reactive protein level, bone metastasis, and liver metastasis for OS. Common grade 3 or higher adverse events associated with axitinib were hypertension in 41 (33.1%), proteinuria in 14 (11.3%), and hand foot syndrome in 14 (11.3%). Quality-of-life analysis using the Medical Outcomes Study 36-Item Short Form showed that 2 scores were significantly improved 12 weeks after the administration of axitinib, while there were no significant differences in the remaining 6 scores between surveys administered before and 12 weeks after the treatment with axitinib. Conclusion: Favorable disease control could be achieved with acceptable tolerability by introducing axitinib as second-line systemic therapy, resulting in improvement of the prognosis and quality of life of Japanese patients with mRCC.

• 出版日期2017-2