Experience of successful use of axitinib in therapy of metastatic renal cell carcinoma after immunotargeted therapy

Abstract

The therapeutic options for clear cell renal cell carcinoma have changed significantly in recent years. Back in 2018, clinical guidelines indicated that the standard of therapy for newly diagnosed metastatic renal cell cancer, regardless of the prognosis, was monotherapy with sunitinib or pazopanib. Accumulation of scientific data and clinical experience has significantly changed approaches to the treatment of this disease – according to current recommendations, pazopanib and sunitinib are considered as a possible option only for patients with a favorable prognosis, while the priority in the treatment of CCRCC for other prognostic groups has shifted towards PD-1/PD-L1 antagonists in combination with ipilimumab or anti-VEGFR-based drugs. At the same time, selecting the optimal regimen for patients who have already received immunotherapy as part of a previous regimen can be very challenging. This publication describes a clinical case of successful therapy with axitinib in a patient with clear cell renal cell carcinoma with a favorable prognosis according to IMDC, with disease progression after using a combination of lenvatinib and pembrolizumab in first-line therapy. The data are presented and discussed in the context of the available evidence base for the use of axitinib in the treatment of metastatic kidney cancer, including after progression of the disease on the background of immunotherapy.