AXITINIB

Axitinib is an oral, small-molecule tyrosine kinase inhibitor (TKI) that selectively inhibits vascular endothelial growth factor receptors (VEGFR-1, VEGFR-2, and VEGFR-3). By blocking these receptors, axitinib reduces tumor angiogenesis and slows cancer growth.

Indications

- Advanced or metastatic renal cell carcinoma (RCC) - Typically used after failure of one prior systemic therapy - Also used in combination with immunotherapy agents in first-line RCC (as per approved guidelines)

Dosage

- Usual starting dose: 5 mg orally twice daily - Dose may be increased to 7 mg or 10 mg twice daily if tolerated - Dose reduction required in case of adverse reactions - Taken with or without food - Treatment duration depends on clinical response and tolerance

Contra-Indications

- Known hypersensitivity to axitinib or any of its components - Severe uncontrolled hypertension - Pregnancy and breastfeeding

Special Precautions

- Monitor blood pressure regularly; manage hypertension before and during therapy - Use with caution in patients with hepatic impairment - Risk of thromboembolic events and hemorrhage - Monitor thyroid function, liver enzymes, and proteinuria Temporary interruption may be required before surgery

Side Effects

Common side effects include: - Hypertension - Diarrhea - Fatigue - Decreased appetite - Nausea and vomiting - Hand-foot syndrome - Weight loss Serious side effects may include bleeding, blood clots, heart failure, and liver toxicity

Drug Interactions

- Strong CYP3A4 inhibitors (e.g., ketoconazole) may increase axitinib levels - Strong CYP3A4 inducers (e.g., rifampicin) may reduce effectiveness - Caution with antihypertensive drugs and anticoagulants