In the following video interview with Practice Update, Dr Nancy Davis from Vanderbilt University Medical Center in Nashville, Tennessee, USA talks about a study looking at individualised dosing of axitinib for patients with metastatic renal cell carcinoma (RCC) based on toxicity.
This was a single-arm study in patients with metastatic predominately clear cell RCC who had already been treated with a checkpoint inhibitor, such as nivolumab. Patients started on the standard dose of axitinib (5 mg twice a day), and their dose was increased by 1 mg twice a day every 2 weeks, assuming they did not have any recurrent moderate adverse events (grade 2) or any severe, life-threatening or disabling adverse events (grade 3 or 4). In these situations, the dose of axitinib was decreased by 1 mg each time allowing for individualised dosing based on the tolerance of the patient to the medication.
The study shows that dose modification is feasible and patients still had a reasonable response to treatment and progression-free survival. The dose of axitinib can be individualised according to tolerability and not necessarily lose efficacy.