Comparison of the efficacy and applicable patients of pazopanib (Viant) and axitinib

Pazopanib (Pazopanib) and axitinib (Axitinib) are oral small molecule tyrosine kinase inhibitors (TKI), which mainly act on angiogenesis-related targets such as VEGFR, thereby inhibiting tumor angiogenesis and growth. Pazopanib was initially mainly used for the treatment of advanced renal cell carcinoma (RCC) and soft tissue sarcoma, while axitinib is also used for advanced renal cell carcinoma, and differs in the selectivity of VEGF inhibitory targets. Both slow down tumor progression by blocking the vascular supply of the tumor microenvironment, and provide targeted treatment options for patients who cannot be surgically resected or who have failed previous treatments.

In terms of efficacy, pazopanib has shown a significant prolongation of progression-free survival (PFS) in patients with advanced renal cell carcinoma, and it also has certain effects on some soft tissue sarcomas. Axitinib has shown a higher objective response rate (ORR) in first- and second-line treatment, especially in patients who have been pretreated with other VEGFR inhibitors, and can still maintain a certain efficacy. This shows that the potential advantages of axitinib are more obvious in patients with drug resistance or relapse, while pazopanib has a robust efficacy in treatment-naïve patients or in multiple indications.

In terms of applicable patients, pazopanib is more suitable for patients with advanced renal cell carcinoma who are new to treatment or have not used other TKI, as well as some patients with soft tissue sarcoma. Axitinib is suitable for patients with advanced renal cell carcinoma who have previously received TKI treatment but whose disease has progressed. Especially in cases of resistance to previous VEGFR inhibitors, axitinib can still provide clinical benefit. There are also differences between the two in dose adjustment, tolerability, and adverse reaction spectrum. Common side effects of axitinib are hypertension, fatigue, and diarrhea, while pazopanib may cause abnormal liver function, headache, and increased blood pressure.

Taken together, pazopanib and axitinib have similar targeting mechanisms, but there are differences in patient selection and efficacy focus. Pazopanib is suitable for patients with initial treatment or multiple indications, and has a stable effect; axitinib is more suitable for relapsed or drug-resistant patients, and has certain advantages in objective response rate and tolerance management. Clinically, doctors will formulate an individualized treatment plan based on the patient's previous treatment history, tumor type, tolerance and accompanying diseases, combined with the drug characteristics of the two, so as to maximize the efficacy.

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