Cabozantinib Versus Everolimus for Bone Metastases From Renal Cell Carcinoma
A subgroup analysis of the phase III METEOR trial showed that cabozantinib was associated with improved outcomes in patients with renal cell carcinoma (RCC) with and without bone metastases. However, given these findings are from unplanned subset investigation, they may require further prospective study to confirm the benefits of cabozantinib in those with RCC who have bone metastases. Bernard Escudier, MD, of the Institut Gustave Roussy, in France, and coauthors published their findings in the Journal of Clinical Oncology.
“Although our study was not powered for statistical testing of the subgroup analyses, the values of the hazard ratios and medians for progression-free survival and overall survival for patients with bone metastases were notable and favored cabozantinib over everolimus,” the investigators wrote.
A total of 658 patients were randomized 1:1 to receive cabozantinib or everolimus. Between the two groups, 22% had bone metastases at baseline. Baseline characteristics for patients with and without bone metastases and between treatment groups were similar.
Those who received cabozantinib versus everolimus demonstrated higher progression-free survival (7.4 vs 2.7 months), median overall survival (20.1 vs 12.1 months), and objective response rate (17% vs 0%). The rate of skeletal-related events was higher with everolimus than cabozantinib (29% v. 23%). Overall safety profiles of both treatments were similar among those patients with and without bone metastases.