Abstract: SA-PO0221
Comparison of Efficacy and Safety of Axitinib Plus Avelumab vs. Sunitinib as First-Line Treatment for Advanced Renal Cell Carcinoma (ARCC): A Systematic Review
Session Information
- Onconephrology: MGRS, HSCT, Electrolytes, RCC, and More
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Saeed, Tanzeela Sameen, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Qureshi, Muhammad Shoaib, King Edward Medical University, Lahore, Punjab, Pakistan
- Batool, Farwa, King Edward Medical University, Lahore, Punjab, Pakistan
- Ashraf, Uswa, King Edward Medical University, Lahore, Punjab, Pakistan
- Tariq, Zoha, King Edward Medical University, Lahore, Punjab, Pakistan
- Javed, Muhammad Arsham, King Edward Medical University, Lahore, Punjab, Pakistan
- Saeed, Muhammad Ramish, King Edward Medical University, Lahore, Punjab, Pakistan
Background
Advanced renal cell carcinoma (aRCC) is a metastatic malignancy with a poor prognosis and limited curative options. First-line treatment strategies have evolved significantly, with targeted therapies and immune checkpoint inhibitors gaining prominence. While sunitinib, a tyrosine kinase inhibitor (TKI), has long been the standard first-line therapy, recent studies suggest that the combination of axitinib, a selective VEGFR inhibitor, with avelumab, an anti–PD-L1 monoclonal antibody, may provide superior efficacy. This systematic review aimed to compare the efficacy and safety of axitinib plus avelumab (A+A) versus sunitinib as first-line treatment for patients with advanced renal cell carcinoma.
Methods
A comprehensive literature search was conducted in April 2025 across PubMed, ScienceDirect, and the Cochrane Central Register of Controlled Trials (CENTRAL). Eligible studies were randomized controlled trials (RCTs), phase III clinical trials, or economic evaluations comparing A+A with sunitinib in adult patients with aRCC. Primary endpoints included progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and treatment-related adverse events.
Results
Out of 3,930 articles screened, nine studies met the inclusion criteria, encompassing a total of 886 patients. Most studies reported that A+A offered superior PFS (13.8–16.6 months vs. 8.4 months), higher ORR (up to 55% vs. 25.5–32%), and favorable OS trends compared to sunitinib. While A+A was associated with more immune-related adverse events, overall safety profiles and discontinuation rates were comparable. One economic analysis supported the cost-effectiveness of A+A despite higher initial costs.
Conclusion
Axitinib plus avelumab appears to offer improved clinical efficacy with manageable toxicity compared to sunitinib, supporting its role as a preferred first-line therapy for aRCC.