Subgroup Analyses Show Cabozantinib Improves PFS, ORR in Advanced RCC

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New study data indicates that patients with previously treated advanced kidney cancer may benefit more from cabozantinib than from everolimus.
New study data indicates that patients with previously treated advanced kidney cancer may benefit more from cabozantinib than from everolimus.

SAN FRANCISCO – Patients with previously treated advanced kidney cancer experience more benefit from cabozantinib than from everolimus regardless of metastatic sites, the number of prior treatments, and the type of treatments administered, according to a study that will be presented this week at the 2016 Genitourinary Cancers Symposium.1

“Current treatments can provide some benefit to patients with advanced kidney cancer, but we need treatments that are more effective,” said lead study author Bernard Escudier, MD, Chair of the Genitourinary Oncology Committee at the Institut Gustave Roussy in France. “Our preliminary results suggest that cabozantinib may help overcome treatment resistance and provide new hope to patients with this aggressive cancer.”

The phase 3 METEOR trial included 658 patients with advanced renal cell carcinoma (RCC) who had previously received VEGFR inhibitor therapy. Participants were randomly assigned to receive cabozantinib or everolimus. Initially, results from the first 375 patients showed that cabozantinib improved median progression-free survival by 3.6 months compared with everolimus (7.4 months vs 3.8 months).

The new analysis of all 658 patients showed that median progression-free survival was 7.4 months (95% CI: 6.6-9.1) for cabozantinib vs 3.9 months (95% CI: 3.7-5.1) for everolimus (HR, 0.52; 95% CI: 0.43-0.64; P < .001). Researchers also found that 75% of patients who received cabozantinib experienced tumor shrinkage compared with 48% of everolimus-treated patients. Investigators also observed a trend for improved overall survival for patients receiving cabozantinib.

Subgroup analyses showed that improvements in progression-free survival associated with cabozantinib compared with everolimus were consistent across patient subgroups. Of note, the investigators found that patients with liver metastases or a combination of visceral and bone metastases also benefited more from cabozantinib than everolimus.

“This is one more example of how precision medicine is paying off for patients,” said Sumanta Pal, MD, ASCO spokesperson. “By fine-tuning the way we target molecular pathways that tumors rely on to grow, we're seeing greater benefits for patients with advanced kidney cancer. As we await longer-term survival data, these are striking early signs of success.”

Cabozantinib is currently approved by the U.S. Food and Drug Administration for the treatment of patients with medullary thyroid cancer.

Reference

  1. Escudier BJ, Motzer RJ, Powles T, et al. Subgroup analyses of METEOR, a randomized phase 3 trial of cabozantinib versus everolimus in patients (pts) with advanced renal cell carcinoma (RCC). J Clin Oncol. 2015;34:(suppl 2S; abstr 499).

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