Eric Jonasch, MD
Axitinib (Inlyta) never reached the frontline potential in metastatic renal cell carcinoma (RCC) once envisioned. Nevertheless, the tyrosine kinase inhibitor (TKI) established a lucrative niche as a preferred second-line treatment for RCC, and it held that niche until newer medications displaced it.
It is not unusual for newer medications to displace older ones, of course, but the story of axitinib is worthy of note because it is not an old medication by any traditional definition of the word “old.” Axitinib was first approved in 2012.
The rapidity with which axitinib sales reached a peak and began to decline may well be a harbinger of things to come. If so, it is both a vivid illustration of how quickly options are improving for patients with many tumor types and how hard oncologists must work to keep abreast of rapidly changing treatment protocols. Looking forward, the story of axitinib may end up illustrating yet another important point: that an apparent weakness in a medication can, in some cases, turn out to be a strength.
“The treatment of advanced metastatic RCC was largely stagnant for decades on end, but when the first VEGF inhibitor was approved for RCC in 2005, it began a series of upheavals that continues to this day,” said Eric Jonasch, MD, a professor of genitourinary medical oncology at The University of Texas MD Anderson Cancer Center and vice chair of the Kidney Cancer Guidelines Committee for the National Comprehensive Cancer Network (NCCN).
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