Axitinib plus pembrolizumab improves survival in metastatic renal cell carcinoma

The use of axitinib in combination with pembrolizumab demonstrates efficacy in the treatment of metastatic renal cell carcinoma (mRCC), according to a real-world study.

Thirty-one patients with mRCC received axitinib plus pembrolizumab therapy. Over a median follow-up of 22.6 months, progression-free survival (PFS) among participants was 37.4 months, while overall survival (OS) was not reached.

Of the patients, 94 percent experienced a treatment-related adverse event, with 32.3 percent having a grade 3 or higher severity. More than half of the patients (52 percent) required reductions in their axitinib dose, while the majority (70.9 percent) had at least one axitinib dose held. Likewise, 70.9 percent had at least one pembrolizumab dose held.

Notably, patients who underwent axitinib dose reductions showed improvements in OS at 1 year (92.9 percent vs 90 percent).

“Dose reductions and holds do not appear to impact treatment efficacy,” the authors said.

This retrospective, observational, quality improvement project was conducted at the Robert H Lurie Comprehensive Cancer Center of Northwestern University in Chicago, Illinois, US. The authors included adult patients (aged ≥18 years) with stage IV RCC treated with axitinib plus pembrolizumab between April 2019 and February 2024.

“Combination therapy with immune checkpoint inhibitors and vascular endothelial growth factor tyrosine kinase inhibitors is standard of care for mRCC,” the authors said “[H]owever, no head-to-head trials have compared [these] regimens.”