Axitinib – Uses, Dosage, Side Effects, Interactions

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Drugs (A - Z)

Axitinib is an oral tyrosine kinase inhibitor selective for vascular endothelial growth factor (VEGF) receptors -1, -2, and -3 that is used in the therapy of advanced renal cell carcinoma. Axitinib therapy is commonly associated with transient elevations in serum aminotransferase that are generally mild and asymptomatic. Axitinib has yet to be linked to instances of clinically apparent acute liver injury.

Axitinib is an orally bioavailable tyrosine kinase inhibitor. Axitinib inhibits the proangiogenic cytokines vascular endothelial growth factor (VEGF) and platelet-derived growth factor receptor (PDGF), thereby exerting an anti-angiogenic effect. Axitinib is an oral tyrosine kinase inhibitor selective for vascular endothelial growth factor (VEGF) receptors -1, -2, and -3 that is used in the therapy of advanced renal cell carcinoma. Axitinib therapy is commonly associated with transient elevations in serum aminotransferase that are generally mild and asymptomatic. Axitinib has yet to be linked to instances of clinically apparent acute liver injury.

Axitinib is an indazole substituted at position 3 by a 2-(pyridine-2-yl)vinyl group and at position 6 by a 2-(N-methylaminocarboxy)phenylsulfanyl group. Used for the treatment of advanced renal cell carcinoma after failure of first-line systemic treatment. It has a role as an antineoplastic agent, a tyrosine kinase inhibitor, and a vascular endothelial growth factor receptor antagonist. It is a member of indazoles, a member of pyridines, an aryl sulfide, and a member of benzamides.

Mechanism of Action

Axitinib selectively blocks the tyrosine kinase receptors VEGFR-1 (vascular endothelial growth factor receptor), VEGFR-2, and VEGFR-3. Axitinib is a second-generation tyrosine kinase inhibitor that works by selectively inhibiting vascular endothelial growth factor receptors (VEGFR-1, VEGFR-2, VEGFR-3).7 Through this mechanism of action, axitinib blocks angiogenesis, tumor growth, and metastases. It is reported to exhibit potency that is 50-450 times higher than that of first-generation VEGFR inhibitors.7 Axitinib is an indazole derivative.6 It is most commonly marketed under the name Inlyta® and is available in oral formulations.

Indications

  • Used in kidney cell cancer and investigated for use/treatment in pancreatic and thyroid cancer.
  • Inlyta is indicated for the treatment of adult patients with advanced renal cell carcinoma (RCC) after the failure of prior treatment with sunitinib or a cytokine.
  • Axitinib is an oral VEGFR and kinase inhibitor used for the treatment of advanced renal cell carcinoma after failure of one prior systemic therapy.
  • Used in kidney cell cancer and investigated for use/treatment in pancreatic and thyroid cancer.
  • Advanced Renal Cell Carcinoma (aRCC)
  • Advanced Thyroid cancer

Use in Cancer

Axitinib is approved to treat:

  • Renal cell carcinoma (a type of kidney cancer) is advanced. It is used:
    • With avelumab or pembrolizumab as the first treatment.
    • Alone in patients whose cancer did not get better after one treatment with systemic therapy.

Axitinib is also being studied in the treatment of other types of cancer.

Contraindications

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

  • spread of cancer to the brain
  • a condition with low thyroid hormone levels
  • a blockage of blood vessels in the retina of the eye
  • high blood pressure
  • a heart attack
  • a clot in the lung
  • chronic heart failure
  • a hemorrhage in the brain
  • a transient ischemic attack, a type of stroke that lasts only a few minutes
  • a stroke
  • a localized weakening and ballooning in an artery wall called an arterial aneurysm
  • obstruction of a blood vessel by a blood clot
  • blood clot in a deep vein of the extremities
  • a gastrointestinal tract fistula
  • severe liver disease
  • bleeding of the stomach or intestines
  • elevation of proteins in the urine
  • abnormal liver function tests
  • impaired wound healing
  • pregnancy
  • a patient who is producing milk and breastfeeding
  • a rupture in the wall of the stomach or intestine
  • a type of brain disorder called posterior reversible encephalopathy syndrome
  • dissection of artery

Dosage

Strengths: 1 mg; 5 mg

Renal Cell Carcinoma

  • Initial dose: 5 mg orally twice a day
  • Maintenance dose: Increase or decrease dose based on individual safety and tolerability
  • Dose range: 2 to 10 mg twice a day

Dose Adjustments

Dose increases or dose reductions should be made based on individual patient safety and tolerability.

Dose Increases:

  • Patients who tolerate this drug for at least 2 consecutive weeks with no adverse reactions greater than grade 2, are normotensive, and are not receiving antihypertensive medication may increase the dose.
  • Dose increases should step from 5 mg twice a day to 7 mg twice a day to 10 mg twice a day based on the same criteria.

Dose Reductions:

  • Some adverse reactions including hypertension, proteinuria, and hepatic impairment should be managed by dose reduction; if dose reduction is necessary decrease to 3 mg twice a day, then 2 mg twice a day if further reduction is necessary.

Discontinuation or Temporary Interruption:

  • Some adverse reactions should be managed by temporary interruption or permanent discontinuation of therapy; these include persistent hypertension despite treatment, hypertensive crisis, cardiac failure, and reversible posterior leukoencephalopathy syndrome.

Strong CYP450 3A4/5 Inhibitors and Inducers:

  • Strong CYP450 3A4/5 inhibitors may increase axitinib exposure
  • Strong CYP450 3A4/5 inducers may decrease axitinib exposure

Recommendations:

  • Select an alternative concomitant medication with no or minimal CYP450 3A4/5 inhibition or induction.
  • If coadministration with strong CYP450 3A4/5 inhibitors is necessary, consider reducing the axitinib starting dose by one-half; subsequent doses can be increased or decreased based on safety and tolerability.
  • If coadministration of the strong inhibitor is discontinued, the axitinib dose should be returned (after 3 to 5 half-lives of the inhibitor) to the recommended dose.
  • Coadministration with strong and moderate CYP450 3A4/5 inducers should be avoided; maximal induction has been reported to occur within 1 week.

Side Effects

The most common

  • diarrhea
  • decrease in appetite or ability to taste things
  • weight loss
  • nausea
  • vomiting
  • constipation
  • tiredness
  • weakness
  • change in the sound of your voice
  • redness, pain, numbness, tingling, itching or peeling of the skin on your hands and feet
  • cough
  • joint or muscle pain
  • mouth sores
  • stomach pain
  • heartburn
  • headache
  • dizziness
  • rash
  • itching
  • dry skin
  • feeling hot or cold
  • pale skin
  • fast heartbeat
  • hair loss
  • ringing in the ears
  • thirst
  • hemorrhoids
  • wound or cut that will not heal

More Common

  • severe stomach pain
  • shortness of breath
  • swelling in hands or feet
  • unusual bleeding or bruising
  • black and tarry stools
  • red blood in stools
  • bloody vomit
  • vomiting material that looks like coffee grounds
  • chest pain or pressure
  • pain in the arms, back, neck, or jaw
  • swelling, tenderness, warmth, or redness of a leg
  • sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
  • sudden confusion, trouble speaking or understanding
  • sudden trouble seeing in one or both eyes
  • sudden trouble walking, dizziness, loss of balance or coordination
  • sudden severe headache with no known cause
  • seizure
  • loss of vision

Rare

  • high blood pressure
  • rash, redness, itching, peeling or burning of your skin (hand-foot syndrome)
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of a blood clot (e.g., sudden chest pain, shortness of breath, sudden leg pain, leg swelling, or leg redness)
  • signs of decreased thyroid function (e.g., tiredness, constipation, dry skin, weight gain)
  • signs of overactive thyroid (e.g., rapid weight loss, sweating, fast heartbeat)
  • signs of heart problems (e.g., fast, irregular heartbeat or pulse; chest pain; sudden weight gain; difficulty breathing; leg swelling)
  • signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine)
  • signs of changes in liver function (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
  • symptoms of a neurological problem (e.g., headache, seizures, lethargy, confusion, blindness, and other visual disturbances)
  • symptoms of a tear in the intestinal wall (perforation of the bowel; such as severe abdominal pain, fever, rectal bleeding, nausea, vomiting)
  • transient stroke-like episodes (e.g., sudden headache, dizziness, trouble speaking, trouble walking, numbness, or weakness)
  • unexplained bleeding (e.g., nosebleeds, darkened urine or stools, coughing up blood)
  • unexplained muscle aches or weakness or dark-colored urine
  • vision changes
  • signs of a serious allergic reaction (e.g., swelling of face or throat, hives, or difficulty breathing)
  • signs of heart attack (e.g., sudden chest pain or pain radiating to back, down arm, jaw; sensation of fullness of the chest; nausea; vomiting; sweating; anxiety)
  • signs of a rare neurological disorder called reversible posterior leukoencephalopathy syndrome (RPLS; e.g., confusion, dizziness, headache, high blood pressure, seizures, vision problems or blindness)
  • signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
  • sudden severe pain in the back, chest, or abdomen

Drug Interaction

Drug-Food Interactions

  • Avoid grapefruit products. Grapefruit inhibits CYP3A4 metabolism, which may increase the serum concentration of axitinib.
  • Avoid St. John’s Wort. This herb induces CYP3A4 metabolism, which may reduce the serum concentration of axitinib.
  • Take it with a full glass of water.
  • Take it with or without food.

Pregnancy and Lactations

 FDA Pregnancy Category D 

Pregnancy

This medication should not be used during pregnancy. Both men and women should use effective birth control during axitinib treatment. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding

It is not known if axitinib passes into breast milk. If you are a breastfeeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding. No information is available on the use of axitinib during breastfeeding. Because axitinib is more than 99% bound to plasma proteins, the amount in milk is likely to be low. The manufacturer recommends that breastfeeding be discontinued during axitinib therapy and for 2 weeks after the final dose of therapy.

What special precautions should I follow?

Before taking axitinib,

  • tell your doctor and pharmacist if you are allergic to axitinib, any other medications, or any of the ingredients in axitinib tablets. Ask your pharmacist for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: bosentan (Tracleer); carbamazepine (Carbatrol, Epitol, Tegretol); clarithromycin (Biaxin, in Prevpac); itraconazole (Sporanox); ketoconazole (Nizoral); medications to treat HIV/AIDs including atazanavir (Reyataz), efavirenz (Sustiva, in Atripla), etravirine (Intelence), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase); modafinil (Provigil); nafcillin; nefazodone; phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); rifampin (Rifamate, Rifater); rifapentine (Priftin); steroid medications such as dexamethasone (Decadron); telithromycin (Ketek); and voriconazole (Vfend). Many other medications may also interact with axitinib, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
  • tell your doctor what herbal products you are taking, especially St John’s wort.
  • tell your doctor if you have a wound that has not healed, or if you have or have ever had bleeding problems; blood clots; high blood pressure; a heart attack; diabetes; high cholesterol levels; bleeding in the stomach or intestines; brain cancer; a pulmonary embolism (blood clot in your lung); a stroke or ministroke (TIA); or heart; liver; or thyroid disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or if you plan to father a child. If you are female, you will have to take a pregnancy test before starting treatment and use birth control to prevent pregnancy during your treatment and for 1 week after your final dose. If you are male, you and your female partner should use birth control during your treatment and for 1 week after your final dose. Talk to your doctor about birth control methods that will work for you. If you or your partner becomes pregnant while taking axitinib, call your doctor. Axitinib may harm the fetus.
  • tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with axitinib and for 2 weeks after your final dose.
  • you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking axitinib.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking axitinib. Your doctor will tell you to stop taking axitinib at least 2 days before your surgery and when it will be safe for you to start taking axitinib again after your surgery.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bleeding: Axitinib may cause a reduced number of platelets in the blood, which can make it difficult to stop cuts from bleeding and may increase your risk of bleeding. If you experience signs of bleeding (e.g., nosebleeds, blood in the urine or stools, darkened urine or stools), contact your doctor as soon as possible. Your doctor will perform regular blood tests to monitor you while you are taking this medication.

Blood clots: Axitinib may cause the formation of blood clots in the legs (deep vein thrombosis) that can move to the lungs (pulmonary embolism). Blood clots can also cause a heart attack or a stroke. Contact your doctor as soon as possible if you have pain, redness, or swelling in your legs. If you develop chest pain and shortness of breath, seek immediate medical attention. Also seek immediate medical attention if you have a sudden headaches, dizziness, problems speaking, vision problems, or numbness or weakness, even if they are temporary. If you have had a blood clot in the past, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hand-foot skin reaction: A rash on the palms of your hands as well as the soles of your feet may occur with axitinib. It can vary in redness and itchiness, but it is possible that blistering and pain can develop. Speak to your doctor immediately if you develop a rash, pain, or blistering on your hands or feet.

Heart problems: This medication can decrease heart function, which may lead to heart failure. If you experience symptoms of heart failure such as unusual tiredness, shortness of breath, or swelling of the feet and ankles, contact your doctor.

This medication may also cause an abnormal heart rhythm, which often has no symptoms, or a decreased heart rate. If you experience fainting or chest pain while taking this medication, get immediate medical attention.

If you have a history of heart problems (e.g., heart arrhythmias, congestive heart failure, heart attack, heart bypass surgery), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

High blood pressure: Your doctor may check your blood pressure before starting axitinib and then ask you to measure your blood pressure regularly while taking axitinib. Some people taking axitinib to develop very high blood pressure that requires adding blood pressure medications, changing the dose, or even stopping the medication for a period of time. Talk to your doctor if you have any concerns.

Lactose intolerance: This medication contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take this medication.

Liver function: People taking axitinib may have changes in liver function that produce abnormal liver test results or liver damage. Your doctor will recommend regular liver tests while you are taking this medication. If you have severe changes in liver function, your doctor may recommend that you take a lower dose of this medication or stop taking it altogether.

Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain, or swelling and itchy skin, contact your doctor immediately.

Neurological problems: Rarely, patients may experience symptoms of a neurological disorder is known as reversible posterior leukoencephalopathy syndrome (RPLS). If you have had this disorder before, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. RPLS can present with headache, seizure, lethargy, confusion, blindness, and other visual and neurologic disturbances. Tell your doctor if you experience any of these symptoms.

Tear in the intestines: Axitinib is associated with intestinal perforation (tear in the intestinal wall). If you have symptoms of an intestinal tear such as abdominal pain, nausea, vomiting, or fever and chills, go see your doctor.

Thyroid problems: Axitinib may cause changes to the levels of thyroid hormone in the body. Your doctor will monitor your thyroid function with blood tests before and during treatment with axitinib. If you have symptoms of low thyroid such as dry skin, constipation, weight gain, or fatigue, or symptoms of overactive thyroids, such as increased sweating, fast heartbeat, or rapid weight loss, go see your doctor.

Wound healing complications: Axitinib may decrease your ability for wound healing. Talk to your doctor if you have an unhealed wound following surgery or if you have surgery scheduled.

References

  1. https://pubchem.ncbi.nlm.nih.gov/compound/Axitinib
  2. https://pubchem.ncbi.nlm.nih.gov/compound/Axitinib-13CD3
  3. https://pubchem.ncbi.nlm.nih.gov/compound/Axitinib-sulfoxide
  4. https://www.drugs.com/mtm/axitinib.html
  5. https://go.drugbank.com/drugs/DB06626
  6. https://en.wikipedia.org/wiki/Axitinib
  7. https://medlineplus.gov/druginfo/meds/a612017.html
  8. https://www.webmd.com/drugs/2/drug-159383/axitinib-oral/details/list-contraindications
  9. https://www.medbroadcast.com/drug/getdrug/inlyta
  10. ChEMBL
    http://www.ebi.ac.uk/Information/termsofuse.html
    https://www.ebi.ac.uk/chembl/compound_report_card/CHEMBL1289926/
    ChEMBL Protein Target Tree
    https://www.ebi.ac.uk/chembl/g/#browse/targets
  11. Comparative Toxicogenomics Database (CTD)
    http://ctdbase.org/about/legal.jsp
    https://ctdbase.org/detail.go?type=chem&acc=D000077784
  12. Drug Gene Interaction database (DGIdb)
    http://www.dgidb.org/downloads
    https://www.dgidb.org/drugs/AXITINIB
  13. DrugBank
    https://www.drugbank.ca/legal/terms_of_use
    Axitinib
    https://www.drugbank.ca/drugs/DB06626
  14. IUPHAR/BPS Guide to PHARMACOLOGY
    https://www.guidetopharmacology.org/about.jsp#license
    https://www.guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=5659
    Guide to Pharmacology Target Classification
    https://www.guidetopharmacology.org/targets.jsp
  15. Therapeutic Target Database (TTD)
    Axitinib
    http://idrblab.net/ttd/data/drug/details/D01ZRI
    Indazole derivative 5
    http://idrblab.net/ttd/data/drug/details/D0MX5B
  16. CAS Common Chemistry
    LICENSE
    The data from CAS Common Chemistry is provided under a CC-BY-NC 4.0 license, unless otherwise stated.
    https://creativecommons.org/licenses/by-nc/4.0/
    Axitinib
    https://commonchemistry.cas.org/detail?cas_rn=319460-85-0
  17. ChemIDplus
    LICENSE
    https://www.nlm.nih.gov/copyright.html
    Axitinib [USAN:INN:JAN]
    https://chem.nlm.nih.gov/chemidplus/sid/0319460850
    ChemIDplus Chemical Information Classification
    https://chem.nlm.nih.gov/chemidplus/
  18. DTP/NCI
    https://www.cancer.gov/policies/copyright-reuse
    Axitinib
    https://dtp.cancer.gov/dtpstandard/servlet/dwindex?searchtype=NSC&outputformat=html&searchlist=757441
  19. EPA DSSTox
    LICENSE
    https://www.epa.gov/privacy/privacy-act-laws-policies-and-resources
    Axitinib
    https://comptox.epa.gov/dashboard/DTXSID3049049
    CompTox Chemicals Dashboard Chemical Lists
    https://comptox.epa.gov/dashboard/chemical-lists/
  20. European Chemicals Agency (ECHA)
    https://echa.europa.eu/web/guest/legal-notice
    N-methyl-2-({3-[(E)-2-(pyridin-2-yl)ethenyl]-1H-indazol-6-yl}sulfanyl)benzamide
    https://echa.europa.eu/information-on-chemicals
    N-methyl-2-({3-[(E)-2-(pyridin-2-yl)ethenyl]-1H-indazol-6-yl}sulfanyl)benzamide
    https://echa.europa.eu/information-on-chemicals/cl-inventory-database/-/discli/details/171215
  21. FDA Global Substance Registration System (GSRS)
    https://www.fda.gov/about-fda/about-website/website-policies#linking
    AXITINIB
    https://gsrs.ncats.nih.gov/ginas/app/beta/substances/C9LVQ0YUXG
  22. ChEBI
    Axitinib
    http://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:66910
    ChEBI Ontology
    http://www.ebi.ac.uk/chebi/userManualForward.do#ChEBI%20Ontology
  23. FDA Pharm Classes
    https://www.fda.gov/about-fda/about-website/website-policies#linking
    AXITINIB
    https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm
    FDA Pharmacological Classification
    https://www.fda.gov/ForIndustry/DataStandards/StructuredProductLabeling/ucm162549.htm
  24. LiverTox
    LICENSE
    https://www.nlm.nih.gov/copyright.html
    Axitinib
    https://www.ncbi.nlm.nih.gov/books/n/livertox/Axitinib/
  25. NCI Thesaurus (NCIt)
    https://www.cancer.gov/policies/copyright-reuse
    https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C38718
    NCI Thesaurus Tree
    https://ncit.nci.nih.gov
  26. ClinicalTrials.gov
    https://clinicaltrials.gov/ct2/about-site/terms-conditions#Use
    https://clinicaltrials.gov/
  27. DailyMed
    LICENSE
    https://www.nlm.nih.gov/copyright.html
    AXITINIB
    https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=AXITINIB
  28. European Medicines Agency (EMA)
    https://www.ema.europa.eu/en/about-us/legal-notice
    Inlyta (EMEA/H/C/002406)
    https://www.ema.europa.eu/en/medicines/human/EPAR/inlyta
  29. Drugs and Lactation Database (LactMed)
    LICENSE
    https://www.nlm.nih.gov/copyright.html
    Axitinib
    https://www.ncbi.nlm.nih.gov/books/NBK500845/
  30. EU Clinical Trials Register
    https://www.clinicaltrialsregister.eu/
  31. FDA Orange Book
    https://www.fda.gov/about-fda/about-website/website-policies#linking
    https://www.fda.gov/drugs/drug-approvals-and-databases/approved-drug-products-therapeutic-equivalence-evaluations-orange-book
  32. NORMAN Suspect List Exchange
    LICENSE
    Data: CC-BY 4.0; Code (hosted by ECI, LCSB): Artistic-2.0
    https://creativecommons.org/licenses/by/4.0/
    NORMAN Suspect List Exchange Classification
    https://www.norman-network.com/nds/SLE/
  33. WHO Anatomical Therapeutic Chemical (ATC) Classification
    https://www.whocc.no/copyright_disclaimer/
    https://www.whocc.no/atc/
    ATC Code
    https://www.whocc.no/atc_ddd_index/
  34. National Drug Code (NDC) Directory
    https://www.fda.gov/about-fda/about-website/website-policies#linking
    AXITINIB
    https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory
  35. MassBank of North America (MoNA)
    LICENSE
    The content of the MoNA database is licensed under CC BY 4.0.
    https://mona.fiehnlab.ucdavis.edu/documentation/license
    Axitinib
    https://mona.fiehnlab.ucdavis.edu/spectra/browse?query=compound.metaData%3Dq%3D%27name%3D%3D%22InChIKey%22%20and%20value%3D%3D%22RITAVMQDGBJQJZ-FMIVXFBMSA-N%22%27
  36. NCI Cancer Drugs
    LICENSE
    https://www.cancer.gov/policies/copyright-reuse
    Axitinib
    https://www.cancer.gov/about-cancer/treatment/drugs/axitinib
  37. NIPH Clinical Trials Search of Japan
    https://rctportal.niph.go.jp/en/
  38. NLM RxNorm Terminology
    https://www.nlm.nih.gov/research/umls/rxnorm/docs/termsofservice.html
    https://rxnav.nlm.nih.gov/id/rxnorm/1242999
  39. Protein Data Bank in Europe (PDBe)
    http://www.ebi.ac.uk/pdbe-srv/pdbechem/chemicalCompound/show/AXI
  40. PubChem
    https://pubchem.ncbi.nlm.nih.gov
  41. RCSB Protein Data Bank (RCSB PDB)
    https://www.rcsb.org/pages/policies
    https://www.rcsb.org/
  42. Springer Nature
    https://pubchem.ncbi.nlm.nih.gov/substance/?source=15745&sourceid=28055765-143911711
  43. The Cambridge Structural Database
    https://www.ccdc.cam.ac.uk/structures/Search?Ccdcid=773991
    https://www.ccdc.cam.ac.uk/structures/Search?Ccdcid=773992
    https://www.ccdc.cam.ac.uk/structures/Search?Ccdcid=773993
    https://www.ccdc.cam.ac.uk/structures/Search?Ccdcid=773994
    https://www.ccdc.cam.ac.uk/structures/Search?Ccdcid=773995
  44. Thieme Chemistry
    LICENSE
    The Thieme Chemistry contribution within PubChem is provided under a CC-BY-NC-ND 4.0 license, unless otherwise stated.
    https://creativecommons.org/licenses/by-nc-nd/4.0/
    https://pubchem.ncbi.nlm.nih.gov/substance/?source=22163&sourceid=28055765-143911711
  45. Wikidata
    LICENSE
    CCZero
    https://creativecommons.org/publicdomain/zero/1.0/
    Axitinib
    https://www.wikidata.org/wiki/Q4830631
  46. Medical Subject Headings (MeSH)
    LICENSE
    https://www.nlm.nih.gov/copyright.html
    Axitinib
    https://www.ncbi.nlm.nih.gov/mesh/2028146
    MeSH Tree
    http://www.nlm.nih.gov/mesh/meshhome.html
    Antineoplastic Agents
    https://www.ncbi.nlm.nih.gov/mesh/68000970
    Protein Kinase Inhibitors
    https://www.ncbi.nlm.nih.gov/mesh/68047428
  47. KEGG
    LICENSE
    Academic users may freely use the KEGG website. Non-academic use of KEGG generally requires a commercial license
    https://www.kegg.jp/kegg/legal.html
    Therapeutic category of drugs in Japan
    http://www.genome.jp/kegg-bin/get_htext?br08301.keg
    USP drug classification
    http://www.genome.jp/kegg-bin/get_htext?br08302.keg
    Anatomical Therapeutic Chemical (ATC) classification
    http://www.genome.jp/kegg-bin/get_htext?br08303.keg
    Target-based classification of drugs
    http://www.genome.jp/kegg-bin/get_htext?br08310.keg
    Drug Groups
    http://www.genome.jp/kegg-bin/get_htext?br08330.keg
  48. UN Globally Harmonized System of Classification and Labelling of Chemicals (GHS)
    GHS Classification Tree
    http://www.unece.org/trans/danger/publi/ghs/ghs_welcome_e.html
  49. PATENTSCOPE (WIPO)
    SID 404047723
    https://pubchem.ncbi.nlm.nih.gov/substance/404047723
  50. NCBI
    https://www.ncbi.nlm.nih.gov/projects/linkout

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