In the phase 3 METEOR trial, cabozantinib improved progression-free survival (PFS), objective response rate (ORR), and overall survival (OS) versus everolimus in patients with advanced renal cell carcinoma (RCC), after prior antiangiogenic therapy.
Outcomes were evaluated for subgroups defined by prior therapy with sunitinib or pazopanib as the only prior VEGFR inhibitor, or prior anti-PD-1/PD-L1 therapy.
For the prior sunitinib subgroup (N = 267), median PFS for cabozantinib versus everolimus was 9.1 versus 3.7 months (HR 0.43, 95% CI 0.32-0.59), ORR was 16% versus 3%, and median OS was 21.4 versus 16.5 months (HR 0.66, 95% CI 0.47-0.93). For the prior pazopanib subgroup (N = 171), median PFS for cabozantinib versus everolimus was 7.4 versus 5.1 months (HR 0.67, 95% CI 0.45-0.99), ORR was 19% versus 4%, and median OS was 22.0 versus 17.5 months (HR 0.66, 95% CI 0.42-1.04). For prior anti-PD-1/PD-L1 therapy (N = 32), median PFS was not reached for cabozantinib versus 4.1 months for everolimus (HR 0.22, 95% CI 0.07-0.65), ORR was 22% versus 0%, and median OS was not reached versus 16.3 months (HR 0.56, 95% CI 0.21-1.52).
Cabozantinib was associated with improved clinical outcomes versus everolimus in patients with advanced RCC, irrespective of prior therapy, including checkpoint inhibitor therapy.
British journal of cancer. 2018 Sep 10 [Epub ahead of print]
Thomas Powles, Robert J Motzer, Bernard Escudier, Sumanta Pal, Christian Kollmannsberger, Joanna Pikiel, Howard Gurney, Sun Young Rha, Se Hoon Park, Poul F Geertsen, Marine Gross-Goupil, Enrique Grande, Cristina Suarez, David W Markby, Alan Arroyo, Mark Dean, Toni K Choueiri, Daniel George
Barts Cancer Institute, Cancer Research UK Experimental Cancer Medicine Centre, Queen Mary University of London, Royal Free NHS Trust, Queen Mary, University of London, London, E1 4NS, UK. ., Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA., Gustave Roussy, 94 805, Villejuif Cedex, France., City of Hope National Medical Center, Duarte, CA, 91010, USA., British Columbia Cancer Agency, BCCA Vancouver Cancer Centre, Vancouver, BC, V5Z 4E6, Canada., Wojewodzkie Centrum Onkologii, 80-219, Gdańsk, Poland., Macquarie University and Westmead Hospital, Macquarie University, Sydney, NSW, 2109, Australia., Severance Hospital, Yonsei Cancer Center, Seodaemun-Gu, Seoul, 03722, South Korea., Samsung Medical Center, Seoul, South Korea., Herlev and Gentofte Hospital, Herlev Hospital, Copenhagen University, Herlev, Denmark., Groupe Hospitalier Saint André, 33000, Bordeaux, France., Hospital Universitario Ramón y Cajal, Ctra. Colmenar Viejo, km. 9,100, 28034, Madrid, Spain., Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain., Exelixis, Inc, South San Francisco, CA, 94080, USA., Dana-Farber Cancer Institute, Boston, MA, 02215, USA., Duke University Medical Center, Durham, NC, 27710, USA.