Angiogenesis has been recognized as the most important factor for tumor invasion, proliferation, and progression in metastatic renal cell carcinoma (mRCC). However, few clinical data are available regarding the efficacy of cabozantinib following immunotherapy.
To describe the outcome of cabozantinib in patients previously treated with immunotherapy.
Patients with mRCC who received cabozantinib immediately after nivolumab were included. The primary endpoint was to assess the outcome in terms of efficacy and activity.
Eighty-four mRCC patients met the criteria to be included in the final analysis. After a median follow-up of 9.4 months, median overall survival was 17.3 months. According to the IMDC criteria, the rates of patients alive at 12 months in the good, intermediate, and poor prognostic groups were 100%, 74%, and 33%, respectively (p < 0.001). The median progression-free survival (PFS) was 11.5 months (95% CI 8.3-14.7); no difference was found based on duration of previous first-line therapy or nivolumab PFS. The overall response rate was 52%, stable disease was found as the best response in 25.3% and progressive disease in 22.7% of patients. Among the 35 patients with progressive disease on nivolumab, 26 (74.3%) patients showed complete/partial response or stable disease with cabozantinib as best response after nivolumab. The major limitations of this study are the retrospective nature and the short follow-up.
Cabozantinib was shown to be effective and active in patients previously receiving immune checkpoint inhibitors. Therefore, cabozantinib can be considered a valid therapeutic option for previously treated mRCC patients, irrespective of the type and duration of prior therapies.
Targeted oncology. 2020 Jul 15 [Epub ahead of print]
Roberto Iacovelli, Chiara Ciccarese, Gaetano Facchini, Michele Milella, Federica Urbano, Umberto Basso, Ugo De Giorgi, Roberto Sabbatini, Daniele Santini, Rossana Berardi, Matteo Santoni, Sergio Bracarda, Francesco Massari, Cristina Masini, Michele De Tursi, Riccardo Ricotta, Sebastiano Buti, Fable Zustovich, Pierangela Sepe, Sabrina Rossetti, Marco Maruzzo, Enrico Cortesi, Giampaolo Tortora, Giuseppe Procopio
Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy. ., Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy., Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy., Oncologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy., Oncology Unit, Department of Radiology, Oncology and Human Pathology, Sapienza University of Rome, Rome, Italy., Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy., Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy., Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy., Oncologia Medica, Campus Bio-Medico University of Rome, Rome, Italy., Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, Ancona, Italy., Oncologia Medica, Ospedale di Macerata, Via Santa Lucia 2, 62100, Macerata, Italy., S.C. Medical Oncology, Azienda Ospedaliera S. Maria, Terni, Italy., Dipartimento di Oncologia Medica, Ospedale Sant'Orsola-Malpighi, Bologna, Italy., Medical Oncology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy., Dipartimento di Scienze Orali e Mediche, Sezione di Oncologia, Università G. D'Annunzio, Chieti, Italy., Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy., Unità Operativa di Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy., Oncologia Medica, San Martino Hospital, Belluno, Italy., Genitourinary Cancer Unit, Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.