Abstract
We sought to investigate safety of axitinib or sorafenib in renal cell carcinoma (RCC) patients and compare toxicity of these two vascular endothelial growth factor receptor inhibitors. Databases of PubMed and Embase were searched. We included phase II and III prospective trials, as well as retrospective studies, in which patients diagnosed with RCC were treated with axitinib or sorafenib monotherapy at a starting dose of 5 mg and 400 mg twice daily, respectively. The overall incidence of high grade hypertension, fatigue, gastrointestinal toxicity and hand-foot syndrome, along with their 95% confidence intervals (CI), were calculated using fixed- or random- effects model according to heterogeneity test results. A total of 26 trials, including 4790 patients, were included in our meta-analysis. Among them, 6 arms were related to axitinib and 22 were associated with sorafenib. The incidences of hypertension (24.9% vs. 7.9%), fatigue (8.2% vs. 6.6%), and gastrointestinal toxicity (17.6% vs. 11.3%) were higher in patients receiving axitinib versus those receiving sorafenib, while the incidence of hand-foot syndrome was lower in patients receiving axitinib versus those receiving sorafenib (9.5% vs. 13.3%). In conclusion, axitinib showed noticeably higher risks of toxicity versus sorafenib. Close monitoring and effective measures for adverse events are recommended during therapy.
Highlights
Renal cell carcinoma (RCC) accounts for 2-3% of all malignant diseases in adults worldwide[1]
Receptor (VEGFR) which were approved by the US Food and Drug Administration (FDA) in 2005 and 2012, respectively[3–28]
Sorafenib is a tyrosine kinase inhibitor (TKI) that targets molecules involved in tumor cell proliferation and angiogenesis, such as vascular endothelial growth factor receptor (VEGFR)-2, VEGFR-3, platelet-derived growth factor (PDGF) receptor-b, cKIT and FLT-3[10,29]
Summary
Renal cell carcinoma (RCC) accounts for 2-3% of all malignant diseases in adults worldwide[1]. It was surmised that about 63,000 new cases and 14,000 deaths associated with RCC occurred in the USA in 2016[2]. Therapeutic options for this chemotherapyrefractory disease have been constantly updated according to availability of targeted drugs over the past few years. Sorafenib and axitinib are two representative drugs targeting vascular endothelial growth factor receptor (VEGFR) which were approved by the US Food and Drug Administration (FDA) in 2005 and 2012, respectively[3–28]. Sorafenib is a tyrosine kinase inhibitor (TKI) that targets molecules involved in tumor cell proliferation and angiogenesis, such as VEGFR-2, VEGFR-3, platelet-derived growth factor (PDGF) receptor-b, cKIT and FLT-3[10,29]. A second generation TKI, is more potent and selective for VEGFR 1-3[30]. The efficacy of axitinib and sorafenib have been demonstrated and compared in two phase III clinical
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
