Axitinib as first-line therapy in metastatic renal cell carcinoma

Axitinib is a highly potent and selective VEGF receptor inhibitor. Previous trials suggested a significant advantage of axitinib versus sorafenib in progression-free survival (PFS) of patients with metastatic renal cell carcinoma (RCC) treated with prior cytokine therapy. Recently an important negative study was reported, which evaluated the PFS with axitinib and with sorafenib in treatment-naïve metastatic RCC. This study was underpowered but conveyed an important message on the limit of current VEGF signal targeted drugs as a first-line therapy. In the future, more emphasis should be put on arrangement of dosing and scheduling of drugs already approved as well as development of new agents targeting novel molecules in this disease.