: Cabozantinib improves survival in metastatic renal cell carcinoma (mRCC) after prior anti-angiogenics. The best treatment at disease progression (PD) is unknown. Being also a AXL/MET inhibitor, involved in acquired resistance, we hypothesized a prolonged tumor growth control in patients continuing cabozantinib despite PD.
: This retrospective multicenter study enrolled patients receiving cabozantinib after the first line between 2014 and 2020. We compared patients maintaining cabozantinib after first PD due to clinical benefit and good tolerability with those who changed therapy. The post-progression survival (PPS) of both was our primary endpoint.
: We analyzed 89 patients: 45 received cabozantinib beyond PD and 44 switched therapy. 40.4%, 31.5% and 28.1% of patients received 1, 2 or >2 prior treatment lines, respectively. 84.3% were intermediate-poor International Metastatic Renal Cell Carcinoma Database risk. Patients continuing cabozantinib showed a higher response rate to cabozantinib before PD (46.7% vs 25%, p = 0.03) and were more heavily pretreated. Continuing cabozantinib beyond PD showed a significantly longer PPS compared with switching therapy (median PPS 16.9 vs 13.2 months, HR 0.66, 95%CI 0.48 - 0.92, p = 0.011).
: We observed longer PPS in patients continuing cabozantinib beyond PD, suggesting that this could be an effective option.
Expert review of anticancer therapy. 2021 Nov 05 [Epub ahead of print]
Alessia Mennitto, Emma Zattarin, Massimo Di Maio, Davide Bimbatti, Ugo De Giorgi, Sebastiano Buti, Daniele Santini, Chiara Casadei, Mariella Sorarù, Carlo Messina, Claudia Mucciarini, Giuseppe Di Lorenzo, Giandomenico Roviello, Consuelo Buttigliero, Marco Stellato, Pierangela Sepe, Melanie Claps, Valentina Guadalupi, Arianna Ottini, Sandro Pignata, Filippo G De Braud, Elena Verzoni, Giuseppe Procopio
Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy., Medical Oncology 1 Unit, 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., Medical Oncology Unit, University Hospital of Parma, Parma, Italy., Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy., Medical Oncology, Camposampiero Hospital, Camposampiero (Padua), Italy., Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy., Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy., Oncology Unit, Andrea Tortora Hospital, ASL Salerno, Pagani, Italy., Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy., Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy., Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale", Naples, Italy.