Evidence map›Paper›PMID 24627641›Full record

ArticleOncoTargets and therapy2014

Axitinib for preoperative downstaging of renal cell carcinoma with sarcomatoid differentiation and direct invasion of the duodenum and inferior vena cava: a case report.

Hideo Yuki, Takao Kamai, Keiichi Kubota, Hideyuki Abe, Daisaku Nishihara, Tomoya Mizuno, Akinori Masuda, Hironori Betsunoh, Masahiro Yashi, Yoshitatsu Fukabori and 1 more

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In one paragraph

Article in OncoTargets and therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hideo YukiDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Takao KamaiDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Keiichi KubotaDepartment of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
Hideyuki AbeDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Daisaku NishiharaDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Tomoya MizunoDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Akinori MasudaDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Hironori BetsunohDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Masahiro YashiDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Yoshitatsu FukaboriDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.
Ken-Ichiro YoshidaDepartment of Urology, Dokkyo Medical University, Mibu, Tochigi, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal cell carcinoma (RCC) with sarcomatoid differentiation is invasive, refractory to treatment, and has a higher mortality. Therefore, systemic therapy is still challenging, and the curative resection of localized or locally advanced RCC with sarcomatoid differentiation is very important. Axitinib is a potent and selective second-generation vascular endothelial growth factor receptor tyrosine kinase inhibitor with improved safety and tolerability. Axitinib is generally recommended as second-line therapy for advanced RCC because the phase III axitinib versus sorafenib in advanced RCC (AXIS) trial demonstrated that it achieved longer progression-free survival than sorafenib in patients with metastatic RCC after failure of an approved first-line regimen.

methodsWe present a 73-year-old man who had a large (13 cm in diameter) right RCC with sarcomatoid differentiation that directly invaded the duodenum and inferior vena cava. The patient presented with gastrointestinal bleeding, was unable to eat solid food, and had become emaciated. Thus, his classification was poor risk with anemia, hypercalcemia, and poor performance status, according to the Memorial Sloan-Kettering Cancer Center criteria. He seemed unlikely to survive if radical nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed. To reduce the tumor burden and potential operative complications, we administered axitinib as first-line neoadjuvant therapy.

resultsSix weeks of treatment reduced the tumor burden without causing severe toxicities. Subsequently, radical right nephrectomy, cavotomy with thrombectomy, and pancreatoduodenectomy were performed successfully. The pathological treatment effect of axitinib was grade 2 (two-thirds necrosis). The resected tumor showed a heterogeneous reaction for phosphorylated Akt (Ser-473) by Western blotting and immunohistochemistry, indicating that parts of the tumor were sensitive to axitinib and other parts were not.

conclusionAxitinib might be promising as preoperative or neoadjuvant therapy for locally advanced RCC (>cT3b or >cTanyN1).

Indexed as

axitinibphosphorylated Aktrenal cell carcinomasarcomatoid differentiationtyrosine kinase inhibitors

Identifiers

PMID24627641
PMCPMC3931632

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.