What is the effect of axitinib combined with immunotherapy?

Axitinib is an oral small molecule tyrosine kinase inhibitor that mainly acts on VEGFR-1, 2, and 3, inhibiting angiogenesis, thereby preventing the nutrient supply and growth of tumors. In recent years, with the development of tumor immunotherapy, axitinib has been increasingly used in combination with PD-1 or PD-L1 immune checkpoint inhibitors, becoming a new combination regimen in the treatment of various cancers, especially in advanced renal cell carcinoma (RCC).

The basic logic of combined immunotherapy lies in the synergy of dual mechanisms: axitinib creates an "immune-friendly" tumor microenvironment by blocking angiogenesis and improves the permeability and activity of immune cells; while immune checkpoint inhibitors activate T cells and fundamentally relieve tumor immunosuppression. This complementary mechanism allows the combination of drugs to show superior tumor control effects than single drugs in multiple international clinical practices.

In multiple overseas research reports, axitinib combined with PD-1/PD-L1 inhibitors such as pembrolizumab and atezolizumab has shown strong tumor shrinkage and survival prolongation trends, especially in the first-line treatment of advanced RCC, gradually replacing traditional tyrosine kinase monotherapy. Combination therapy is also recommended by multiple international guidelines such as NCCN and ESMO as the preferred option for advanced renal cancer.

However, combination therapy also brings additional challenges, such as an increased risk of toxicity. Immune-related adverse reactions may overlap with those of axitinib itself (such as hypertension, hand-foot syndrome, gastrointestinal discomfort), resulting in patients requiring closer monitoring and individualized dose adjustment during treatment. Therefore, clinicians need to weigh efficacy and tolerability when implementing combination regimens.

Reference materials:https://en.wikipedia.org/wiki/Axitinib