2 The technology

2.1 Axitinib (Inlyta, Pfizer) is an oral multi‑targeted tyrosine kinase inhibitor with anti‑tumour activity. Axitinib selectively inhibits vascular endothelial growth factor receptors 1, 2 and 3, platelet‑derived growth factor receptor, and c‑kit, which may inhibit angiogenesis in tumours. Axitinib has a marketing authorisation for 'the treatment of adult patients with advanced renal cell carcinoma, after failure of prior treatment with sunitinib or a cytokine'.

2.2 The summary of product characteristics lists the following adverse reactions for axitinib: diarrhoea, hypertension, fatigue, dysphonia, nausea, decreased appetite, palmar–plantar erythrodysaesthesia (hand–foot syndrome), hypothyroidism, headache, dysgeusia, haemorrhage, vomiting, stomatitis, constipation, rash, dry skin, proteinuria, asthaenia and mucosal inflammation. For full details of adverse reactions and contraindications, see the summary of product characteristics.

2.3 Axitinib is available in 1‑mg and 5‑mg film‑coated tablets at net prices of £703.40 and £3517 per 56‑tablet pack respectively (excluding VAT, 'British national formulary' [BNF] November 2014). Axitinib is administered orally at a recommended starting dose of 5 mg twice daily. This dose may be increased to 7 mg and then up to 10 mg, or decreased to 3 mg and then down to 2 mg, depending on individual safety and tolerability. The company has agreed a patient access scheme with the Department of Health. The size of the discount is commercial in confidence. The Department of Health considered that this patient access scheme does not constitute an excessive administrative burden on the NHS.

  • National Institute for Health and Care Excellence (NICE)