Individualized dosing with axitinib: rationale and practical guidance

Axitinib is a potent, selective, vascular endothelial growth factor receptor inhibitor with demonstrated efficacy as second-line treatment for metastatic renal cell carcinoma. Analyses of axitinib drug exposures have demonstrated high interpatient variability in patients receiving the 5 mg twice-daily (b. i.d.) starting dose. Clinical criteria can be used to assess whether individual patients may benefit further from dose modifications, based on their safety and tolerability data. This review provides practical guidance on the 'flexible dosing' method, to help physicians identify who would benefit from dose escalations, dose reductions or continuation with manageable toxicity at the 5 mg b.i.d. dose. This flexible approach allows patients to achieve the best possible outcomes without compromising safety.

Future oncology (London, England). 2017 Dec 21 [Epub ahead of print]

Manuela Schmidinger, Romano Danesi, Robert Jones, Ray McDermott, Lynda Pyle, Brian Rini, Sylvie Négrier

Clinical Division of Oncology, Department of Medicine I & Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Department of Clinical & Experimental Medicine, University of Pisa, Pisa, Italy., Institute of Cancer Sciences, University of Glasgow, The Beatson West of Scotland Cancer Centre, Glasgow, UK., Department of Medical Oncology, St Vincent's University Hospital & The Adelaide & Meath Hospital, Dublin, Ireland., Renal Cancer Unit, Department of Medicine, Royal Marsden Hospital, London, UK., Department of Hematology & Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA., Medical Oncology Department, University of Lyon, Centre Léon Bérard, Lyon, France.