Cabozantinib Versus Everolimus in Advanced Renal Cell Carcinoma
When compared with everolimus, cabozantinib improved progression-free survival, objective response rate, and overall survival in patients with advanced renal cell carcinoma, regardless of nephrectomy status, based on the randomized phase III METEOR study. These results were presented by Nizar Tannir, MD, of the MD Anderson Cancer Center, at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 4570).
A total of 658 patients with clear cell renal cell carcinoma who had received at least 1 prior vascular endothelial growth factor receptor tyrosine kinase inhibitor were randomized 1:1 to receive cabozantinib at 60 mg/day or everolimus at 10 mg/day. Eighty-five percent of the enrolled patients had prior nephrectomy, of which 7% were partial, and 15% had no prior nephrectomy.
Cabozantinib improved outcomes regardless of nephrectomy status: Median progression-free survival was 7.4 months with cabozantinib and 3.9 months with everolimus in the prior nephrectomy subgroup and 6.6 months and 4.4 months in the no-nephrectomy group. The objective response rate favored cabozantinib over everolimus in both the nephrectomy (17% vs. 4%) and no-nephrectomy (21% vs. 2%) groups. Median overall survival was longer in the nephrectomy subgroup for both treatment arms: 22.0 versus 17.2 months for nephrectomy and 16.3 versus 12.5 months for no nephrectomy.