Cabozantinib real‐world effectiveness in the first‐through fourth‐line settings for the treatment of metastatic renal cell carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium

Background Cabozantinib is approved for metastatic renal cell carcinoma (mRCC) based on the METEOR and CABOSUN trials. However, real‐world effectiveness and dosing patterns of cabozantinib are not well characterized. Methods Patients with mRCC treated with cabozantinib between 2011 and 2019 were ide...

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Published in:Cancer medicine (Malden, MA) MA), 2021-02, Vol.10 (4), p.1212-1221
Main Authors: Gan, Chun Loo, Dudani, Shaan, Wells, J. Connor, Donskov, Frede, Pal, Sumanta K., Dizman, Nazli, Rathi, Nityam, Beuselinck, Benoit, Yan, Flora, Lalani, Aly‐Khan A., Hansen, Aaron, Szabados, Bernadett, Velasco, Guillermo, Tran, Ben, Lee, Jae Lyun, Vaishampayan, Ulka N., Bjarnason, Georg A., Subasri, Mathushan, Choueiri, Toni K., Heng, Daniel Y. C.
Format: Article
Language:English
Subjects:
cabozantinib
Cancer immunotherapy
Clinical Cancer Research
Clinical trials
Confidence intervals
Dosage
Drug dosages
FDA approval
first line
fourth line
Hemoglobin
Histology
IMDC
Inhibitor drugs
Kidney cancer
Metastases
Metastasis
Neutrophils
Oncology
Original Research
Patients
real‐world
Renal cell carcinoma
response rates
Risk factors
Risk groups
second line
Software
survival
Targeted cancer therapy
third line
Toxicity
Vascular endothelial growth factor
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Summary:Background Cabozantinib is approved for metastatic renal cell carcinoma (mRCC) based on the METEOR and CABOSUN trials. However, real‐world effectiveness and dosing patterns of cabozantinib are not well characterized. Methods Patients with mRCC treated with cabozantinib between 2011 and 2019 were identified and stratified using the International mRCC Database Consortium (IMDC) risk groups. First‐ (1L), second‐ (2L), third‐ (3L), and fourth‐line (4L) overall response rate (ORR), time to treatment failure (TTF), and overall survival (OS) were analyzed. Dose reduction rates and their association with TTF and OS were determined. Results A total of 413 patients were identified. The ORRs across 1L to 4L were 32%, 26%, 25%, and 29%, respectively, and the median TTF rates were 8.3, 7.3, 7.0, and 8.0 months, respectively. The median OS (mOS) rates in 1L to 4L were 30.7, 17.8, 12.6, and 14.9 months, respectively. For patients treated with 1L PD(L)1 combination agent (n = 31), 2L cabozantinib had ORR of 22%, median TTF of 5.4 months, and mOS of 17.4 months. About 50% (129/258) of patients required dose reductions. The TTF and mOS were significantly longer for patients who required dose reduction vs. patients who did not, with an adjusted hazard ratio of 0.37 (95% CI 0.202–0.672, p 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.3717