Nivolumab and cabozantinib are currently approved agents in metastatic renal cell carcinoma (mRCC) but there are no data available for patients progressing to both treatments. The aim of this study was to compare active therapeutic options and best supportive care (BSC) after progression to nivolumab and cabozantinib in mRCC.
In this retrospective study, we selected 50 patients from eight Italian centers. The primary endpoint of the study was the overall survival (OS) of patients on active treatment versus BSC. Secondary endpoints were the progression-free survival (PFS) and objective response rate (ORR). The efficacy of active therapy was also investigated.
After progression to both nivolumab and cabozantinib, 57.1% of patients were given active treatment (mainly everolimus and sorafenib) while 42.9% received BSC. The median OS was 13 months (95% CI: 4-NR) in actively treated patients and 3 months (95% CI: 2-4) in BSC patients (p = 0.001). Patients treated with sorafenib had better disease control than those treated with everolimus (stable disease: 71.4% vs. 16.7%, progression disease: 14.3% vs. 58.3%; p = 0.03), with no significant differences in PFS (5 and 3 months, 95% CI: 1-6 vs. 2-5; p = 0.6) and OS (12 and 4 months, 95% CI: 3-NR vs. 2-NR; p = 0.2).
After treatment with both nivolumab and cabozantinib, the choice of a safe active systemic therapy offered better outcomes than BSC.
Cancer medicine. 2022 Mar 20 [Epub ahead of print]
Giandomenico Roviello, Elisabetta Gambale, Roberta Giorgione, Daniele Santini, Marco Stellato, Giuseppe Fornarini, Sara Elena Rebuzzi, Umberto Basso, Davide Bimbatti, Laura Doni, Gabriella Nesi, Melissa Bersanelli, Sebastiano Buti, Ugo De Giorgi, Luca Galli, Andrea Sbrana, Raffaele Conca, Claudia Carella, Emanuele Naglieri, Sandro Pignata, Giuseppe Procopio, Lorenzo Antonuzzo
Department of Health Sciences, University of Florence, Florence, Italy., Medical Oncology Unit, Careggi University Hospital, Florence, Italy., Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy., Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy., Medical Oncology Unit, San Paolo General Hospital, Savona, Italy., MedicalOncology Unit 1, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy., Medical Oncology Unit, University Hospital of Parma, Parma, Italy., IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Italy., Medical Oncology Unit 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy., Division of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, Rionero in Vulture, Italy., Istituto Oncologico Giovanni Paolo II, Bari, Italy., Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy., Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy.