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NCT00678392

Axitinib (AG 013736) As Second Line Therapy For Metastatic Renal Cell Cancer

Completed Phase 3 Results posted Last updated 9 January 2019
What this trial tests

Phase 3 trial testing Axitinib (AG-013736) in Kidney Neoplasms in 723 participants. Completed in 25 February 2016.

Timeline
3 September 2008
Primary endpoint
31 August 2010
25 February 2016

Quick facts

Lead sponsorPfizer
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment723
Start date3 September 2008
Primary completion31 August 2010
Estimated completion25 February 2016
Sites294 locations across Italy, Japan, Taiwan, Ireland, Poland, South Korea, Russia, Sweden

Drugs / interventions tested

Conditions studied

Sponsor

Pfizer — full company profile →

Who can join

18 and older, any sex, with Kidney Neoplasms. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Progression-Free Survival (PFS) Primary · From initiation of treatment up to follow-up period (up to 3 years)

PFS was defined as the time in months from start of study treatment to the first documentation of objective tumor progression of disease (PD) or to death due to any cause, whichever occurs first. PD was assessed by response evaluation criteria in solid tumors (RECIST) version 1.0. PD: \>=20 percent (%) increase in the sum of the longest dimensions (LD) of the target lesions taking as a reference the smallest sum of the LD recorded since the start of treatment or unequivocal progression in non-target lesions or the appearance of 1 or more new lesions. Occurrence of a pleural effusion or ascites

GroupValue95% CI
Axitinib 5 mg6.76.3 – 8.6
Sorafenib 400 mg4.74.6 – 5.6
Overall Survival (OS) Secondary · From initiation of treatment up to follow-up period (up to 3 years)

OS was defined as the duration from start of study treatment to date of death due to any cause. OS was calculated as (months) = (date of death minus the date of first dose of study medication plus 1) divided by 30.4. For participants who were alive, overall survival was censored on last date the participants were known to be alive.

GroupValue95% CI
Axitinib 5 mg20.116.7 – 23.4
Sorafenib 400 mg19.217.5 – 22.3
Objective Response Rate (ORR) Secondary · From initiation of treatment up to follow-up period (up to 3 years)

ORR = percentage of participants with confirmed complete response (CR) or confirmed partial response (PR) according to RECIST version 1.0 recorded from first dose of study treatment until PD or death due to any cause. CR: disappearance of all target, non target lesions and no appearance of new lesions, documented on 2 occasions separated by at least 4 weeks. PR: at least 30 % decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non target lesions, no appearance of new lesions. PD: \>=20% increase in sum of LD of the target lesions taking as a r

GroupValue95% CI
Axitinib 5 mg19.415.4 – 23.9
Sorafenib 400 mg9.46.6 – 12.9
Duration of Response (DR) Secondary · From initiation of treatment up to follow-up period (up to 3 years)

DR: time from first documentation of objective tumor response (CR or PR), that was subsequently confirmed, to the first documentation of PD or to death due to any cause, whichever occurred first as per RECIST version 1.0, a) CR: disappearance of all target, non target lesions and no appearance of new lesions, documented on 2 occasions separated by at least 4 weeks, b) PR: at least 30 % decrease in sum of LD of target lesions taking as reference baseline sum of LD, without progression of non target lesions, no appearance of new lesions, c) PD: \>=20% increase in sum of LD of the target lesions

GroupValue95% CI
Axitinib 5 mg11.07.4 – NA
Sorafenib 400 mg10.68.8 – 11.5
Percentage of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) Secondary · From initiation of treatment up to follow-up period (up to 3 years)

An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life- threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pre

AEs
GroupValue95% CI
Axitinib 5 mg96.1
Sorafenib 400 mg98.0
SAEs
GroupValue95% CI
Axitinib 5 mg40.7
Sorafenib 400 mg35.8
Percentage of Participants With Adverse Events (AEs) by Severity Secondary · From initiation of treatment up to follow-up period (up to 3 years)

An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Severity of the AEs was graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. Grade 1= mild; Grade 2= moderate; Grade 3= severe; Grade 4= life-threatening or disabling; Grade 5= death related to AE.

Grade 1
GroupValue95% CI
Axitinib 5 mg3.9
Sorafenib 400 mg3.1
Grade 2
GroupValue95% CI
Axitinib 5 mg20.1
Sorafenib 400 mg21.7
Grade 3
GroupValue95% CI
Axitinib 5 mg47.6
Sorafenib 400 mg52.4
Grade 4
GroupValue95% CI
Axitinib 5 mg10.6
Sorafenib 400 mg11.5
Grade 5
GroupValue95% CI
Axitinib 5 mg13.9
Sorafenib 400 mg9.3
Percentage of Participants With Treatment-Related Adverse Events (AEs) and Serious Adverse Events (SAEs) Secondary · From initiation of treatment up to follow-up period (up to 3 years)

An AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life -threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included both serious and non -serious AEs.

AEs
GroupValue95% CI
Axitinib 5 mg92.2
Sorafenib 400 mg95.2
SAEs
GroupValue95% CI
Axitinib 5 mg15.3
Sorafenib 400 mg13.8
Number of Participants With Clinically Significant Laboratory Abnormalities: Hematology Secondary · From initiation of treatment up to follow-up period (up to 3 years)

Hematology laboratory test included hemoglobin, platelet count, white blood cells count, neutrophils and lymphocytes. Abnormalities were assessed by CTCAE Grade Version 2 for severity: Grade 1= mild; Grade 2= moderate; Grade 3= severe and Grade 4= life-threatening or disabling.

Hemoglobin: Grade 1 (n =320, 316)
GroupValue95% CI
Axitinib 5 mg93
Sorafenib 400 mg112
Hemoglobin: Grade 2 (n =320, 316)
GroupValue95% CI
Axitinib 5 mg19
Sorafenib 400 mg41
Hemoglobin: Grade 3 (n =320, 316)
GroupValue95% CI
Axitinib 5 mg1
Sorafenib 400 mg11
Hemoglobin: Grade 4 (n =320, 316)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg1
Lymphocytes: Grade 1 (n =317, 309)
GroupValue95% CI
Axitinib 5 mg7
Sorafenib 400 mg7
Lymphocytes: Grade 2 (n =317, 309)
GroupValue95% CI
Axitinib 5 mg89
Sorafenib 400 mg93
Lymphocytes: Grade 3 (n =317, 309)
GroupValue95% CI
Axitinib 5 mg10
Sorafenib 400 mg11
Lymphocytes: Grade 4 (n =317, 309)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg0
Number of Participants With Clinically Significant Laboratory Abnormalities: Biochemistry Secondary · From initiation of treatment up to follow-up period (up to 3 years)

Biochemistry laboratory test included parameters: alanine aminotransferase, alkaline phosphatase, amylase, aspartate aminotransferase, bicarbonate, bilirubin, creatinine, hypercalcemia, hyperglycemia, hyperkalemia, hypernatremia, hypoalbuminemia, hypocalcemia, hypoglycemia, hypokalemia, hyponatremia, hypophosphatemia and lipase. Abnormalities were assessed by CTCAE Grade Version 2 for severity: Grade 1= mild; Grade 2= moderate; Grade 3= severe and Grade 4= life-threatening or disabling.

Alanine aminotransferase: Grade 1 (n =331, 313)
GroupValue95% CI
Axitinib 5 mg65
Sorafenib 400 mg57
Alanine aminotransferase: Grade 2 (n =331, 313)
GroupValue95% CI
Axitinib 5 mg8
Sorafenib 400 mg6
Alanine aminotransferase: Grade 3 (n =331, 313)
GroupValue95% CI
Axitinib 5 mg1
Sorafenib 400 mg2
Alanine aminotransferase: Grade 4 (n =331, 313)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg3
Alkaline phosphatase: Grade 1 (n =336, 319)
GroupValue95% CI
Axitinib 5 mg88
Sorafenib 400 mg92
Alkaline phosphatase: Grade 2 (n =336, 319)
GroupValue95% CI
Axitinib 5 mg8
Sorafenib 400 mg15
Alkaline phosphatase: Grade 3 (n =336, 319)
GroupValue95% CI
Axitinib 5 mg4
Sorafenib 400 mg3
Alkaline phosphatase: Grade 4 (n =336, 319)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg0
Number of Participants With Clinically Significant Laboratory Abnormalities: Urinalysis Secondary · From initiation of treatment up to follow-up period (up to 3 years)

Urinalysis included urine blood/ hemoglobin, glucose and protein. Abnormalities were assessed by CTCAE Grade Version 2 for severity: Grade 1= mild; Grade 2= moderate; Grade 3= severe and Grade 4= life-threatening or disabling.

Urine blood/ hemoglobin: Grade 1 (n =304, 272)
GroupValue95% CI
Axitinib 5 mg45
Sorafenib 400 mg35
Urine blood/ hemoglobin: Grade 2 (n =304, 272)
GroupValue95% CI
Axitinib 5 mg1
Sorafenib 400 mg0
Urine blood/ hemoglobin: Grade 3 (n =304, 272)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg0
Urine blood/ hemoglobin: Grade 4 (n =304, 272)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg0
Urine glucose: Grade 1 (n =322, 286)
GroupValue95% CI
Axitinib 5 mg12
Sorafenib 400 mg13
Urine glucose: Grade 2 (n =322, 286)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg3
Urine glucose: Grade 3 (n =322, 286)
GroupValue95% CI
Axitinib 5 mg0
Sorafenib 400 mg0
Urine glucose: Grade 4 (n =322, 286)
GroupValue95% CI
Axitinib 5 mg1
Sorafenib 400 mg1
Functional Assessment of Cancer Therapy Kidney Symptom Index-15 (FKSI-15) Score Secondary · Baseline (Predose on Cycle 1 Day 1) , Day 1 of each cycle until Cycle 21, End of treatment (Day 670) and Follow-up visit (Day 698)

FKSI was used to assess quality of life (QoL) for those diagnosed with renal cell cancer and consisted of 15 items (lack of energy, side effects, pain, losing weight, bone pain, fatigue, enjoying life, short of breath, worsened condition, appetite, coughing, bothered by fevers, ability to work, hematuria and sleep). Each of the 15 items was answered on a 5-point Likert-type scale ranging from 0 to 4 (0= not at all, 1= a little bit, 2= somewhat, 3= quite a bit, 4= very much). Total FKSI score = sum of the 15 item scores; total range: 0 - 60; 0 (no symptoms) to 60 (very much); higher scores indi

Baseline (n =346, 342)
GroupValue95% CI
Axitinib 5 mg43.199± 8.416
Sorafenib 400 mg43.339± 8.162
Cycle 2/Day1 (n =319, 296)
GroupValue95% CI
Axitinib 5 mg42.351± 8.305
Sorafenib 400 mg41.668± 7.696
Cycle 3/Day1 (n =279, 246)
GroupValue95% CI
Axitinib 5 mg42.590± 7.729
Sorafenib 400 mg42.424± 7.888
Cycle 4/Day1 (n =257, 221)
GroupValue95% CI
Axitinib 5 mg42.791± 8.180
Sorafenib 400 mg43.424± 7.345
Cycle 5/Day1 (n =238, 203)
GroupValue95% CI
Axitinib 5 mg42.968± 8.152
Sorafenib 400 mg42.907± 7.255
Cycle 6/Day1 (n =213, 179)
GroupValue95% CI
Axitinib 5 mg42.949± 7.842
Sorafenib 400 mg43.057± 7.724
Cycle 7/Day1 (n =206, 158)
GroupValue95% CI
Axitinib 5 mg42.747± 7.621
Sorafenib 400 mg43.578± 7.621
Cycle 8/Day1 (n =177, 136)
GroupValue95% CI
Axitinib 5 mg43.580± 7.578
Sorafenib 400 mg44.074± 7.757
Functional Assessment of Cancer Therapy Kidney Symptom Index-Disease Related Symptoms (FKSI-DRS) Score Secondary · Baseline (Predose on Cycle 1 Day 1) , Day 1 of each cycle until Cycle 21, End of treatment (Day 670) and Follow-up visit (Day 698)

FKSI-DRS was used to assess quality of life for those diagnosed with renal cell cancer and consisted of 9 items (lack of energy, pain, losing weight, bone pain, fatigue, short of breath, coughing, bothered by fevers, and hematuria). Each of the 9 items was answered on a 5-point Likert-type scale ranging from 0 to 4 (0= not at all, 1= a little bit, 2= somewhat, 3= quite a bit, 4= very much). Total FKSI-DRS score = sum of the 9 item scores; total range: 0 - 36; 0 (no symptoms) to 36 (very much); higher scores indicate greater presence of symptoms.

Baseline (n =346, 341)
GroupValue95% CI
Axitinib 5 mg28.874± 5.187
Sorafenib 400 mg28.975± 5.193
Cycle 2/Day1 (n =319, 295)
GroupValue95% CI
Axitinib 5 mg28.211± 4.920
Sorafenib 400 mg28.399± 5.064
Cycle 3/Day1 (n =279, 244)
GroupValue95% CI
Axitinib 5 mg28.640± 4.837
Sorafenib 400 mg28.640± 4.868
Cycle 4/Day1 (n =257, 220)
GroupValue95% CI
Axitinib 5 mg28.822± 4.952
Sorafenib 400 mg29.130± 4.322
Cycle 5/Day1 (n =238, 202)
GroupValue95% CI
Axitinib 5 mg28.869± 4.880
Sorafenib 400 mg29.007± 4.379
Cycle 6/Day1 (n =213, 178)
GroupValue95% CI
Axitinib 5 mg29.159± 4.462
Sorafenib 400 mg29.098± 4.697
Cycle 7/Day1 (n =206, 157)
GroupValue95% CI
Axitinib 5 mg29.042± 4.581
Sorafenib 400 mg29.361± 4.558
Cycle 8/Day1 (n =177, 135)
GroupValue95% CI
Axitinib 5 mg29.520± 4.346
Sorafenib 400 mg29.619± 4.386

Adverse events — posted to ClinicalTrials.gov

Time frame: From initiation of treatment up to follow-up period (up to 3 years). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Axitinib 5 mg
Serious: 146/359 (41%)
Deaths:
Sorafenib 400 mg
Serious: 127/355 (36%)
Deaths:

Serious adverse events (214 terms)

ReactionSystemAxitinib 5 mgSorafenib 400 mg
Disease progressionGeneral disorders
DehydrationMetabolism and nutrition disorders
AnaemiaBlood and lymphatic system disorders
DiarrhoeaGastrointestinal disorders
PyrexiaGeneral disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
Myocardial infarctionCardiac disorders
DeathGeneral disorders
Gastrointestinal haemorrhageGastrointestinal disorders
VomitingGastrointestinal disorders
General physical health deteriorationGeneral disorders
PneumoniaInfections and infestations
Pleural effusionRespiratory, thoracic and mediastinal disorders
Intestinal obstructionGastrointestinal disorders
FatigueGeneral disorders
Lower respiratory tract infectionInfections and infestations
Acute kidney injuryRenal and urinary disorders
PneumothoraxRespiratory, thoracic and mediastinal disorders
HypotensionVascular disorders
Inguinal herniaGastrointestinal disorders
PainGeneral disorders
InfectionInfections and infestations
Decreased appetiteMetabolism and nutrition disorders
HyponatraemiaMetabolism and nutrition disorders
Other adverse events (50 terms — click to expand)

ReactionSystemAxitinib 5 mgSorafenib 400 mg
DiarrhoeaGastrointestinal disorders
Palmar-plantar erythrodysaesthesia syndromeSkin and subcutaneous tissue disorders
HypertensionVascular disorders
FatigueGeneral disorders
Decreased appetiteMetabolism and nutrition disorders
NauseaGastrointestinal disorders
AlopeciaSkin and subcutaneous tissue disorders
DysphoniaRespiratory, thoracic and mediastinal disorders
Weight decreasedInvestigations
RashSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
ConstipationGastrointestinal disorders
AstheniaGeneral disorders
HypothyroidismEndocrine disorders
CoughRespiratory, thoracic and mediastinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Mucosal inflammationGeneral disorders
StomatitisGastrointestinal disorders
Back painMusculoskeletal and connective tissue disorders
Abdominal painGastrointestinal disorders
HeadacheNervous system disorders
Pain in extremityMusculoskeletal and connective tissue disorders
ProteinuriaRenal and urinary disorders
PruritusSkin and subcutaneous tissue disorders
AnaemiaBlood and lymphatic system disorders
DysgeusiaNervous system disorders
Dry skinSkin and subcutaneous tissue disorders
PyrexiaGeneral disorders
DyspepsiaGastrointestinal disorders
ErythemaSkin and subcutaneous tissue disorders
Abdominal pain upperGastrointestinal disorders
DizzinessNervous system disorders
InsomniaPsychiatric disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
MyalgiaMusculoskeletal and connective tissue disorders
EpistaxisRespiratory, thoracic and mediastinal disorders
NasopharyngitisInfections and infestations
Chest painGeneral disorders
Oedema peripheralGeneral disorders

Most-reported serious reactions: Disease progression, Dehydration, Anaemia, Diarrhoea, Pyrexia, Dyspnoea, Pulmonary embolism, Myocardial infarction.

Data from ClinicalTrials.gov NCT00678392 adverse events section.

Sponsor's own description

The study is designed to demonstrate that axitinib (AG-013736) is superior to sorafenib in delaying tumor progression in patients with metastatic renal cell cancer after failure of one first line regimen.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Comparative effectiveness of axitinib versus sorafenib in advanced renal cell carcinoma (AXIS): a randomised phase 3 trial.
    Rini BI, Escudier B, Tomczak P, Kaprin A, et al · · 2011 · cited 1352× · PMID 22056247 · DOI 10.1016/s0140-6736(11)61613-9
  2. Axitinib versus sorafenib as second-line treatment for advanced renal cell carcinoma: overall survival analysis and updated results from a randomised phase 3 trial.
    Motzer RJ, Escudier B, Tomczak P, Hutson TE, et al · · 2013 · cited 519× · PMID 23598172 · DOI 10.1016/s1470-2045(13)70093-7
  3. Recent advances on anti-angiogenesis receptor tyrosine kinase inhibitors in cancer therapy.
    Qin S, Li A, Yi M, Yu S, et al · · 2019 · cited 221× · PMID 30866992 · DOI 10.1186/s13045-019-0718-5
  4. Body Mass Index and Metastatic Renal Cell Carcinoma: Clinical and Biological Correlations.
    Albiges L, Hakimi AA, Xie W, McKay RR, et al · · 2016 · cited 165× · PMID 27601543 · DOI 10.1200/jco.2016.66.7311
  5. Anti-VEGF therapies in the clinic.
    Meadows KL, Hurwitz HI. · · 2012 · cited 165× · PMID 23028128 · DOI 10.1101/cshperspect.a006577
  6. Tumor stroma as targets for cancer therapy.
    Zhang J, Liu J. · · 2013 · cited 139× · PMID 23064233 · DOI 10.1016/j.pharmthera.2012.10.003
  7. Toxicity as a biomarker of efficacy of molecular targeted therapies: focus on EGFR and VEGF inhibiting anticancer drugs.
    Dienstmann R, Braña I, Rodon J, Tabernero J. · · 2011 · cited 108× · PMID 22135123 · DOI 10.1634/theoncologist.2011-0163
  8. Angiotensin system inhibitors and survival outcomes in patients with metastatic renal cell carcinoma.
    McKay RR, Rodriguez GE, Lin X, Kaymakcalan MD, et al · · 2015 · cited 103× · PMID 25724518 · DOI 10.1158/1078-0432.ccr-14-2332

Verify or expand the search:

Other trials of Axitinib (AG-013736)

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