Cabozantinib is a safe and effective treatment option for patients with relapsed renal cell carcinoma (RCC) in every clinical practice, according to a study published in Clinical Genitourinary Cancer.1
The phase 3 METEOR study previously demonstrated that cabozantinib significantly improved survival outcomes among patients with relapsed metastatic RCC compared with everolimus, but whether these results would be sustained outside of clinical study in an unselected population requires further study.
For this retrospective study, researchers assessed the outcomes of 96 patients with metastatic RCC whose disease had progressed after 1 or more previous systemic therapies. Patients were treated with a reduced oral dose of cabozantinib 40 mg once daily with a dose escalation to 60 mg if well-tolerated.
Cabozantinib was administered as second-, third-, or further-line therapy in 28 (29%), 18 (19%), and 50 (52%) patients, respectively. Of study participants, 66 patients began treatment with the full dose of 60 mg, 29 patients began at the reduced dose of 40 mg, and 1 patient initiated treatment at 20 mg.
At the time of analysis, the median progression-free survival (PFS) was 8.0 months. Median overall survival (OS) was not evaluable, but the 1-year OS rate was 65%.
The overall response rate was 36%; 36% (35) and 34% (33) of patients achieved partial response and stable disease, respectively. No patients had a complete response. The remaining 30% (28) of patients had progressive disease.
Grade 3 to 4 adverse effects were observed in 35 (36%) patients, and included diarrhea, asthenia, and hypertension. Only 5 patients discontinued therapy due to treatment-related toxicity.
The authors concluded that “cabozantinib was effective in everyday clinical practice in a large unselected population of mRCC patients who experienced disease progression after prior treatment. Cabozantinib was also safe, and its toxicity profile was feasible and manageable.”
- Procopio G, Prisciandaro M, Iacovelli R, et al. Safety and efficacy of cabozantinib in metastatic renal-cell carcinoma: real-world data from an Italian managed access program [published online April 19, 2018]. Clin Genitourin Cancer. doi: 10.1016/j.clgc.2018.03.014