ESMO 2017: Cabozantinib Versus Sunitinib as Initial Targeted Therapy in Metastatic Renal Cell Carcinoma
As initial targeted therapy in patients with untreated clear cell metastatic renal cell carcinoma of poor or intermediate risk, cabozantinib improved overall survival compared with sunitinib, according to updated results from the Alliance A031203 trial (CABOSUN). These updated survival data were presented by Toni Choueiri, MD, of Dana-Farber Cancer Institute, Boston, at the 2017 European Society for Medical Oncology (ESMO) Congress (Abstract LBA38).
A total of 157 patients were randomized 1:1 to receive cabozantinib at 60 mg once daily (n=79) or sunitinib at 50 mg once daily (n=78) for 4 weeks on/2 weeks off. Previously reported median progression-free survival was 8.2 months for cabozantinib compared with 5.6 months for sunitinib.
With a median follow-up of 30.8 months, an updated overall survival analysis also favored cabozantinib over sunitinib (with median overall survival of 26.6 months vs. 21.2 months). Grade 3 or 4 adverse events occurred in 68% of patients treated with cabozantinib and 65% of patients treated with sunitinib; these safety profiles were consistent with those previously reported. Treatment discontinuation due to adverse events occurred in 16 patients in each study arm.