Effects of axitinib/axitinib and sunitinib in the treatment of advanced renal cell carcinoma

Sunitinib (Sunitinib) is marketed in China under the trade name Sutent. Axitinib and sunitinib are important targeted drugs and are widely used in the treatment of advanced renal cell carcinoma (RCC). Although both show good efficacy, they have different characteristics and effects in clinical application.

Axitinib is a selective small molecule tyrosine kinase inhibitor that mainly acts on the VEGF receptor, which is closely related to tumor angiogenesis. Sunitinib is a multi-target tyrosine kinase inhibitor that not only acts on the VEGF receptor, but also affects multiple other kinases, such as PDGFR and KIT. These different mechanisms of action may lead to differences in therapeutic effects, side effects, and patient tolerance.

In terms of efficacy, the results of multiple clinical studies have shown that axitinib has better therapeutic effects than sunitinib in some cases. In a pivotal Phase III clinical trial, axitinib showed longer progression-free survival (PFS) in patients previously treated with Sutent. Specifically, the median progression-free survival for axitinib can reach more than 6 months, while the median progression-free survival for sunitinib is usually between 4 and 5 months. In addition, axitinib's objective response rate (ORR) performance in certain patient groups is also very good, demonstrating its potential in controlling tumors. Therefore, axitinib may be a treatment option worth considering for patients whose disease is progressing despite having received other treatments.

In terms of side effects, axitinib and sunitinib exhibit different side effects profiles. The side effects of Sutent are common and diverse, including high blood pressure, fatigue, stomatitis, diarrhea, and rash. These adverse reactions often affect patients' quality of life. The side effects of axitinib are relatively concentrated. Although high blood pressure and fatigue may also occur, the overall incidence and severity vary depending on individual differences. Some studies have shown that the side effects of axitinib may be lower than those of sunitinib in some patients, especially in terms of dose adjustment. Doctors can flexibly optimize the medication regimen according to the patient's tolerance, thereby effectively reducing adverse reactions.

In addition, there are differences in the administration methods of axitinib and sunitinib, which affects patient compliance. Sunitinib is usually taken once daily, while axitinib is taken twice daily. Although axitinib is administered more frequently, its dose can be individually adjusted based on patient response, providing a more flexible treatment option. This flexibility provides patients with greater room for adaptation, especially in response to adverse reactions, and adjusting the dose can improve patient tolerance.

In terms of combination therapy, axitinib shows greater potential. In recent years, an increasing number of studies have explored the use of axitinib in combination with immune checkpoint inhibitors, such as avelumab or pembrolizumab. This combination therapy may not only enhance the anti-tumor effect, but also improve the survival rate of patients. For sunitinib, there are relatively few studies on combination therapy, and monotherapy is still the main approach. This enables axitinib to provide more treatment options in clinical practice and bring new hope to patients.