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Axitinib yielded poor results in adrenocortical carcinoma
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Axitinib, a drug with an anti-VEGF mechanism, has poor anti-tumor efficacy in treating adrenocortical carcinoma, according to recent study findings.
The phase 2, open-label, nonrandomized trial enrolled 13 patients with recurrent, metastatic or primary unresectable adrenocortical carcinoma. All patients had previously undergone chemotherapy, either with or without mitotane.
Patients were given oral axitinib (Inlyta, Pfizer) twice daily in 4-week rotations. The initial dose of axitinib was 5 mg; the study protocol allowed for an increase to 7 mg if the original dose was tolerated for at least 8 weeks. A further increase to 10 mg was permitted under the guidelines if the 7 mg dose was tolerated for a minimum of 8 additional weeks.
The researchers used the RECIST criteria to evaluate patients for response every 8 weeks.
Most patients did not tolerate a sustained dosage increase above the original 5 mg twice daily; only seven patients were able to tolerate an increased dose of 7 mg, and only five patients were able to increase to 10 mg. Dose escalation was largely inhibited due to various toxicities; all patients experienced a minimum of one grade-1 or -2 toxicity, and 10 patients had a minimum of one grade-3 or -4 adverse event.
The therapeutic activity of axitinib was found to be limited, with no patient obtaining a complete or partial response, and only eight patients termed as having stable disease for more than 3 months.
Although a moderate decrease in the rate of tumor growth was achieved in four patients, none of the rate decreases could be designated as a RECIST response.
In terms of survival, the median progression-free survival among the 13 patients was 5.48 months (1.8 to 10.92 months), and the median overall survival was >13.7 months.
The study authors noted that treatments targeting the VEGF receptor have not, to date, proven to be useful in the treatment of adrenocortical carcinoma.
“Consideration should be given to directing future efforts elsewhere, if we are to find improved treatment options that are effective and so desperately needed in the therapy of [adrenocortical carcinoma],” the authors wrote.
Disclosures: The researchers report no relevant financial disclosures.
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