Evidence map›Paper›PMID 40295487›Full record

ArticleNature communications2025

Angiogenic and immune predictors of neoadjuvant axitinib response in renal cell carcinoma with venous tumour thrombus.

Rebecca Wray, Hania Paverd, Ines Machado, Johanna Barbieri, Farhana Easita, Abigail R Edwards, Ferdia A Gallagher, Iosif A Mendichovszky, Thomas J Mitchell, Maike de la Roche and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature communications, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

  1. Article
  2. Review
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  4. Review
  5. Article
  6. Review
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  8. Article
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

19 authors.

Rebecca Wray *Early Cancer Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0009-0003-5595-5170
Hania Paverd *Early Cancer Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0009-0004-5317-9080
Ines MachadoEarly Cancer Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-4160-9624
Johanna BarbieriCancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK.
Farhana EasitaCancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.
Abigail R EdwardsCancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-0273-9549
Ferdia A GallagherCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Iosif A MendichovszkyCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Thomas J MitchellEarly Cancer Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-0761-9503
Maike de la RocheCancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-0558-4119
Jacqueline D ShieldsTranslational Medical Sciences, School of Medicine, University of Nottingham Biodiscovery Institute, Nottingham, UK.ORCID http://orcid.org/0000-0003-2153-9710
Stephan UrsprungCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Lauren WallisWarwick Medical School, University of Warwick, Coventry, UK.
Anne Y WarrenCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID http://orcid.org/0000-0002-1170-7867
Sarah J WelshRoyal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
Mireia Crispin-OrtuzarEarly Cancer Institute, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-4351-3709
Grant D StewartCancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0003-3188-9140
James O JonesDepartment of Oncology, University of Cambridge, Cambridge, UK. joj21@cam.ac.uk.
NAXIVA Study Group

Funding

Wellcome Trust
6 · The paper itself

Abstract

Venous tumour thrombus (VTT), where the primary tumour invades the renal vein and inferior vena cava, affects 10-15% of renal cell carcinoma (RCC) patients. Curative surgery for VTT is high-risk, but neoadjuvant therapy may improve outcomes. The NAXIVA trial demonstrated a 35% VTT response rate after 8 weeks of neoadjuvant axitinib, a VEGFR-directed therapy. However, understanding non-response is critical for better treatment. Here we show that response to axitinib in this setting is characterised by a distinct and predictable set of features. We conduct a multiparametric investigation of samples collected during NAXIVA using digital pathology, flow cytometry, plasma cytokine profiling and RNA sequencing. Responders have higher baseline microvessel density and increased induction of VEGF-A and PlGF during treatment. A multi-modal machine learning model integrating features predict response with an AUC of 0.868, improving to 0.945 when using features from week 3. Key predictive features include plasma CCL17 and IL-12. These findings may guide future treatment strategies for VTT, improving the clinical management of this challenging scenario.

Indexed as

AxitinibCarcinoma, Renal CellKidney NeoplasmsVenous ThrombosisAgedFemaleHumansMaleMiddle AgedNeoadjuvant TherapyNeovascularization, PathologicTreatment OutcomeVascular Endothelial Growth Factor AAxitinibVascular Endothelial Growth Factor A

Identifiers

PMID40295487
PMCPMC12037771

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Registered trials

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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.