Neoadjuvant axitinib in renal cell carcinoma tied to reduced body weight, skeletal muscle
Use of axitinib in the neoadjuvant setting appears to result in weight loss, with notable reductions in skeletal muscle and subcutaneous adipose tissue in patients with localized renal cell carcinoma, a recent study has shown.
Furthermore, there was a trend toward a lower neoadjuvant axitinib response rate in the presence of sarcopenia.
The study included 23 patients who underwent nephrectomy following 12 weeks of treatment with oral axitinib. All patients completed computed tomography scans at baseline, after 7 weeks of treatment and at treatment completion at 12 weeks.
The primary outcome of interest was change in body compartment composition. Secondary outcomes were development of new-onset sarcopenia and changes in body weight.
Of the patients, 19 (82.6 percent) lost weight at 12 weeks, with a median weight loss of 4.5 kg (p<0.001). There were seven patients (30.4 percent) who had sarcopenia at baseline, and five more patients who developed the condition during treatment.
Reductions were also seen in skeletal muscle (median, 2.9 cm2/m2; p<0.001), visceral adipose tissue (median, 4.9 cm2/m2; p=0.132) and subcutaneous adipose tissue (1.0 cm2/m2; p=0.043).
A partial response to treatment was reported for 10 of the 16 patients (62.5 percent) without baseline sarcopenia vs only one of the seven patients (14.3 percent) with baseline pretreatment sarcopenia (p=0.069).
According to researchers, the lower response rates to axitinib in the sarcopenic group may be partially explained by the presence of elevated vascular endothelial growth factor A levels in patients with cancer-related weight loss.
Larger studies evaluating the use of neoadjuvant axitinib in renal cell carcinoma are needed to confirm the current findings and to investigate the association between baseline sarcopenia and response to targeted therapy, researchers added.