Axitinib

Axitinib Brand Name– INLYTA

What is Axitinib

Axitinib is an oral agent that works by inhibiting receptor tyrosine kinases, including vascular endothelial growth factor receptors (VEGFR)-1, VEGFR-2, and VEGFR-3.

It is approved for the treatment of advanced renal cell carcinoma (RCC) after failure of one prior systemic therapy.

Progression-free survival was significantly improved with axitinib compared with sorafenib in a multicenter, randomized, phase 3 study in patients with progressive RCC after one first-line therapy including a sunitinib-, temsirolimus-, or cytokine-based regimen or bevacizumab plus interferon alfa.

Patients should not receive axitinib for at least 2 days before elective surgery due to wound healing complications that may be associated with treatment; do not administer axitinib for at least 2 weeks after major surgery and until adequate wound healing has occurred.

Indications

  • renal cell cancer

For the treatment of renal cell cancer

for the first-line treatment of advanced renal cell cancer, in combination with pembrolizumab

Side Effects

  1. abdominal pain
  2. alopecia
  3. anemia
  4. anorexia
  5. arthralgia
  6. asthenia
  7. bleeding
  8. constipation
  9. cough
  10. dehydration
  11. diarrhea
  12. dizziness
  13. dysgeusia
  14. dyspepsia
  15. dysphonia
  16. dyspnea
  17. elevated hepatic enzymes
  18. epistaxis
  19. erythema
  20. fatigue
  21. gastrointestinal fistula
  22. GI bleeding
  23. GI perforation
  24. headache
  25. heart failure
  26. hematuria
  27. hemoptysis
  28. hemorrhoids
  29. hyperamylasemia
  30. hypercalcemia
  31. hyperglycemia
  32. hyperkalemia
  33. hypernatremia
  34. hypertension
  35. hypertensive crisis
  36. hyperthyroidism
  37. hypoalbuminemia
  38. hypocalcemia
  39. hypoglycemia
  40. hyponatremia
  41. hypophosphatemia
  42. hypothyroidism
  43. intracranial bleeding
  44. leukoencephalopathy
  45. leukopenia
  46. lymphopenia
  47. melena
  48. myalgia
  49. myocardial infarction
  50. nausea
  51. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  52. polycythemia
  53. proteinuria
  54. pruritus
  55. pulmonary embolism
  56. rash
  57. retinal thrombosis
  58. stomatitis
  59. stroke
  60. thrombocytopenia
  61. thrombosis
  62. tinnitus
  63. vomiting
  64. weight loss
  65. xerosis

Monitoring Parameters

  • blood pressure
  • LFTs
  • pregnancy testing
  • thyroid function tests (TFTs)
  • urinalysis

Contraindications

  • bleeding
  • breast-feeding
  • cardiac disease
  • children
  • contraception requirements
  • diabetes mellitus
  • encephalopathy
  • fistula
  • GI bleeding
  • GI perforation
  • heart failure
  • hepatic disease
  • hepatotoxicity
  • hyperlipidemia
  • hypertension
  • hyperthyroidism
  • hypothyroidism
  • impaired wound healing
  • infants
  • infertility
  • myocardial infarction
  • neonates
  • pregnancy
  • pregnancy testing
  • proteinuria
  • renal impairment
  • reproductive risk
  • surgery
  • thromboembolic disease
  • thyroid disease

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Aldesleukin, IL-2
  • Amobarbital
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Apalutamide
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bexarotene
  • Bosentan
  • Butabarbital
  • Carbamazepine
  • Cenobamate
  • Ceritinib
  • Chloramphenicol
  • Clarithromycin
  • Cobicistat
  • Cocaine
  • Conivaptan
  • Dabrafenib
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Dexamethasone
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enzalutamide
  • Eslicarbazepine
  • Etravirine
  • Fosamprenavir
  • Fosphenytoin
  • grapefruit juice
  • Idelalisib
  • Indinavir
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketoconazole
  • Letermovir
  • Lopinavir; Ritonavir
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Mephobarbital
  • Methohexital
  • Mifepristone
  • Mitotane
  • Modafinil
  • Nafcillin
  • Nefazodone
  • Nelfinavir
  • Nevirapine
  • Octreotide
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Pentobarbital
  • Phenobarbital
  • Phenytoin
  • Posaconazole
  • Primidone
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Ritonavir
  • Saquinavir
  • Secobarbital
  • St. John’s Wort, Hypericum perforatum
  • Telithromycin
  • Thiopental
  • Tipranavir
  • Tucatinib
  • Voriconazole
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