Hemodialysis does not impact axitinib exposure: clinical case of a patient with metastatic renal cell carcinoma

Cancer Chemother Pharmacol. 2017 Jun;79(6):1273-1276. doi: 10.1007/s00280-017-3320-y. Epub 2017 Apr 27.

Abstract

Axitinib is approved with indication in patients with advanced renal cell carcinoma (RCC). Due to the localization of this cancer, physicians sometimes have to deal with hemodialyzed patients. Data exploring hemodialysis (HD) impact on axitinib pharmacokinetic (PK) or safety are lacking. To date, no data have been published on that problematic. This is the first publication discussing the assessment of axitinib PK for a patient undergoing HD. Our results suggest that there is no influence of HD on axitinib blood concentration. Interestingly, the membranes used are common and represent around 90% of the membranes used in routine for HD. Our data are also reassuring both from activity and from safety perspectives. In that case, axitinib administered at a dose of 6 mg twice a day was well tolerated and allowed 12 months of disease control. These results are in line with previous publications discussing other anti-angiogenic tyrosine kinase inhibitors pharmacokinetics, safety and activity among patients with metastatic RCC undergoing hemodialysis.

Keywords: Axitinib; Hemodialysis; Pharmacokinetic; Renal cell carcinoma; Renal failure.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / pharmacokinetics*
  • Angiogenesis Inhibitors / therapeutic use
  • Axitinib
  • Carcinoma, Renal Cell / complications
  • Carcinoma, Renal Cell / drug therapy
  • Carcinoma, Renal Cell / metabolism
  • Disease-Free Survival
  • Humans
  • Imidazoles / pharmacokinetics*
  • Imidazoles / therapeutic use
  • Indazoles / pharmacokinetics*
  • Indazoles / therapeutic use
  • Kidney Neoplasms / complications
  • Kidney Neoplasms / drug therapy
  • Kidney Neoplasms / metabolism
  • Male
  • Membranes, Artificial
  • Middle Aged
  • Protein Kinase Inhibitors / pharmacokinetics*
  • Protein Kinase Inhibitors / therapeutic use
  • Renal Dialysis*
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Imidazoles
  • Indazoles
  • Membranes, Artificial
  • Protein Kinase Inhibitors
  • Axitinib