Cabozantinib beyond progression improves survival in advanced renal cell carcinoma patients: the CABEYOND study (Meet-URO 21).

Cabozantinib kidney cancer treatment metastatic renal cell carcinoma post-progression survival treatment beyond progression

Journal

Expert review of anticancer therapy
ISSN: 1744-8328
Titre abrégé: Expert Rev Anticancer Ther
Pays: England
ID NLM: 101123358

Informations de publication

Date de publication:
Jan 2022
Historique:
pubmed: 6 11 2021
medline: 27 4 2022
entrez: 5 11 2021
Statut: ppublish

Résumé

Cabozantinib improves survival in metastatic renal cell carcinoma (mRCC) after prior antiangiogenics. 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 postprogression 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, 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 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.

Sections du résumé

BACKGROUND BACKGROUND
Cabozantinib improves survival in metastatic renal cell carcinoma (mRCC) after prior antiangiogenics. 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.
RESEARCH DESIGN AND METHODS METHODS
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 postprogression survival (PPS) of both was our primary endpoint.
RESULTS RESULTS
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, 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 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).
CONCLUSIONS CONCLUSIONS
We observed longer PPS in patients continuing cabozantinib beyond PD, suggesting that this could be an effective option.

Identifiants

pubmed: 34738499
doi: 10.1080/14737140.2022.2002688
doi:

Substances chimiques

Anilides 0
Pyridines 0
cabozantinib 1C39JW444G

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

115-121

Auteurs

Alessia Mennitto (A)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Emma Zattarin (E)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Massimo Di Maio (M)

Department of Oncology, University of Turin, Ordine Mauriziano Hospital, Turin, Italy.

Davide Bimbatti (D)

Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto Iov Irccs, Padua, Italy.

Ugo De Giorgi (U)

Department of Medical Oncology, Istituto Scientifico Romagnolo per Lo Studio E La Cura Dei Tumori (Irst), Irccs, Meldola, Italy.

Sebastiano Buti (S)

Medical Oncology Unit, University Hospital of Parma, Parma, Italy.

Daniele Santini (D)

Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.

Chiara Casadei (C)

Department of Medical Oncology, Istituto Scientifico Romagnolo per Lo Studio E La Cura Dei Tumori (Irst), Irccs, Meldola, Italy.

Mariella Sorarù (M)

Medical Oncology, Camposampiero Hospital, Camposampiero (Padua), Italy.

Carlo Messina (C)

Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy.

Claudia Mucciarini (C)

Medical Oncology Unit, Ramazzini Hospital, Carpi, Italy.

Giuseppe Di Lorenzo (G)

Oncology Unit, Andrea Tortora Hospital, ASL Salerno, Pagani, Italy.
Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy.

Giandomenico Roviello (G)

Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy.

Consuelo Buttigliero (C)

Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy.

Marco Stellato (M)

Department of Medical Oncology, Campus Bio-Medico University of Rome, Rome, Italy.

Pierangela Sepe (P)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Melanie Claps (M)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Valentina Guadalupi (V)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Arianna Ottini (A)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Sandro Pignata (S)

Department of Urology and Gynecology, Istituto Nazionale Tumori Irccs Fondazione "G. Pascale", Naples, Italy.

Filippo G De Braud (FG)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.
Oncology and Hemato-Oncology Department, University of Milan, Milan, Italy.

Elena Verzoni (E)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

Giuseppe Procopio (G)

Department of Medical Oncology, Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy.

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Classifications MeSH