Summary

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• Inlyta (axitinib) is indicated in combination with avelumab for the first-line treatment of patients with advanced renal cell carcinoma (RCC); in combination with pembrolizumab for the first-line treatment of patients with advanced RCC; and as a single agent for the treatment of advanced RCC after failure of one prior systemic therapy.
• This summary is based on the review of 23 systematic review(s)/meta-analysis(es). ^[1-23]
• Pembrolizumab plus Axitinib (PemAxi): Demonstrates consistent superiority in overall survival (OS) across studies, with notable effectiveness in progression-free survival (PFS) and objective response rate (ORR) compared to sunitinib and other combinations. Demonstrates a higher incidence of serious adverse events (SAEs) compared to some other combinations, but with an overall lower incidence than the Lenvatinib plus Pembrolizumab combination.
• Lenvatinib plus Pembrolizumab (LenPem): Shows dominance in PFS, with advantageous hazard ratios for PFS, while also being effective in improving OS. Associated with the highest risk of serious adverse events (grade ≥3) among the combinations reviewed.
• Nivolumab plus Ipilimumab (NivIpi): Significantly improves OS, particularly in intermediate and poor-risk groups. Exhibits the lowest rates of serious adverse events compared to other combination therapies reviewed.
• Avelumab plus Axitinib (AveAxi): Effective in PFS with a better ORR compared to sunitinib.
• Intermediate and poor-risk groups benefit more from Nivolumab plus Ipilimumab (NivIpi) and Pembrolizumab plus Axitinib (PemAxi) in overall survival (OS) and progression-free survival (PFS), while favorable-risk groups may have improved PFS with Avelumab plus Axitinib (AveAxi); combination therapies are recommended for elderly patients with further validation needed.