Numakura K, Muto Y, Naito S, et al. - Researchers compared axitinib and sunitinib (two tyrosine kinase inhibitors) for efficacy in treating patients suffering from metastatic renal cell carcinoma (mRCC). From 8 Japanese institutes, 703 mRCC patients were enrolled from January 2008 to October 2018. Of these, 408 patients were administered axitinib or sunitinib as the first-line therapy. A total 274 and 134 patients received axitinib and sunitinib, respectively. Nivolumab sequence therapy was received by more than 25% of the patients. The axitinib group exhibited significantly better objective response rate, progression-free survival, cause-specific survival, and overall survival (OS), relative to the sunitinib group. In addition, nivolumab-treated patients in the axitinib group experienced better OS. Findings demonstrated higher efficacy of as well as greater survival benefits with axitinib, vs sunitinib, when given as first-line treatment in mRCC patients. Therefore, among vascular endothelial growth factor receptor-tyrosine kinase inhibitors, axitinib might represent a likely choice for application in the middle of immuno-oncology drug-based treatment sequences.