What are the possible side effects after sudden discontinuation of axitinib?

Axitinib is an oral small molecule tyrosine kinase inhibitor, mainly used to treat solid tumors such as advanced renal cell carcinoma. It blocks tumor angiogenesis by inhibiting the vascular endothelial growth factor receptor (VEGFR) signaling pathway, thereby inhibiting tumor growth and spread. However, during clinical use, if a patient suddenly stops taking axitinib, it may cause a series of adverse reactions and risks, which requires attention.

Axitinib plays an important role in maintaining tumor control, and sudden discontinuation may lead to rapid recurrence or progression of tumors that were originally suppressed. Some patients may experience an increase in tumor size, increased pain, or recurrence of other tumor-related symptoms within a few days to a week or two after stopping the drug. This phenomenon, known as "tumor rebound" or "rapid progression," is particularly risky in patients who have not yet achieved long-term remission.

One of the common side effects of axitinib is hypertension, which is caused by its inhibition of VEGFR causing vascular regulation disorders. When the drug is stopped suddenly, some patients may experience a rapid drop in blood pressure or hemodynamic fluctuations, causing cardiovascular discomforts such as dizziness, fatigue, and even arrhythmia. In addition, the body has adapted to a certain blood pressure state during long-term use, and sudden withdrawal may disrupt this balance and increase the risk of cardiovascular and cerebrovascular events.
In addition to tumor progression, patients may also experience a series of worsening clinical symptoms related to disease activity after discontinuing axitinib, such as increased fatigue, dyspnea, and rapid weight changes. These reactions not only affect quality of life but may also make it more difficult to initiate treatment again. Therefore, for patients whose efficacy is acceptable but whose medication needs to be temporarily discontinued, doctors should develop a gradual dose reduction or transition strategy to reduce the risk of symptom rebound.
Once patients who have been using axitinib for a long time are forced to discontinue the drug due to financial pressure, side effects or changes in treatment strategies, they are often accompanied by psychological reactions such as anxiety, fear and uneasiness. Some patients will worry about relapse of the disease and loss of treatment control, which will affect sleep, mood and even treatment compliance. Therefore, doctors should fully communicate with patients before stopping medication, assess risks, and formulate follow-up monitoring or alternative treatment plans to ensure continuous management of physical and mental health.
Reference: https://en.wikipedia.org/wiki/Axitinib