Can the drugs pazopanib and axitinib cause cholecystitis in cancer patients?
Pazopanib and axitinib are targeted cancer drugs called tyrosine kinase inhibitors (TKIs). They work by blocking proteins that help tumors grow new blood vessels. A case report describes one patient with renal cell carcinoma (kidney cancer) who developed cholecystitis (inflammation of the gallbladder) while taking these drugs 1. The report suggests this side effect is possible but rare, and the evidence comes mainly from a single case plus a literature review 1. Larger studies of these drugs focus on cancer outcomes and do not highlight cholecystitis as a common problem 4.
What the research says
A 74-year-old man with renal cell carcinoma developed cholecystitis symptoms 4 weeks after starting pazopanib and 8 weeks after starting axitinib 1. His symptoms improved after the drugs were stopped, along with anti-infective therapy and supportive care 1. Using the Naranjo Adverse Drug Reaction Probability Scale, the case scored 4 points for pazopanib and 6 points for axitinib, which the authors interpreted as a probable link between the drugs and the gallbladder inflammation 1. The report also reviewed published studies on TKI-induced cholecystitis from 2005 to 2025 and concluded that anti-angiogenic TKIs may rarely cause cholecystitis in certain patients 1. The authors advised doctors to watch for this possibility and adjust treatment if needed 1.
It is important to put this in context. A large network meta-analysis of first-line immunotherapy combinations for advanced renal cell carcinoma, which included 6,193 patients across nine regimens, looked at survival and adverse events but did not flag cholecystitis as a notable concern 4. That analysis focused on pembrolizumab plus axitinib and other combinations, and its main findings were about overall survival and progression-free survival, not gallbladder inflammation 4. This does not mean cholecystitis never happens with axitinib, but it suggests it is not a common or prominent side effect in large trials 4.
Other sources in this set do not directly address whether pazopanib or axitinib cause cholecystitis. One review discusses traditional Tibetan medicine and mentions that some formulas have been used for cholecystitis, but it does not study cancer drugs 2. Another source covers nutrition after gallbladder removal and notes that acute cholecystitis is a complicated scenario requiring special consideration, but it is about postoperative care, not drug causes 3. A study on sarcopenia (muscle loss) found it independently predicted acute cholecystitis in older adults with gallstones, with a 3.56-fold higher risk, but that is about patient factors, not these drugs 8. A meta-analysis on AI-assisted imaging for abdominal infections including cholecystitis is about diagnosis, not drug causes 6. A case report on axitinib in chronic myeloid leukemia discusses drug resistance and does not mention cholecystitis 7. A protocol for a sarcoma review mentions pazopanib as a treatment but does not report cholecystitis as an adverse effect 5.
What to ask your doctor
- Could my cancer treatment (pazopanib or axitinib) be causing gallbladder symptoms like pain, nausea, or fever?
- What signs of cholecystitis should I watch for while on these drugs?
- If I develop gallbladder symptoms, what are the options for managing them without stopping my cancer treatment?
- How common is cholecystitis with these drugs, and is there any monitoring I should have?
- Are there other factors (like gallstones or muscle loss) that might raise my risk of gallbladder problems?
This question is drawn from common patient questions about Oncology and answered using cited medical research. We do not provide individualized advice.