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Is Cabozantinib Effective After Progression of Metastatic Renal Cell Carcinoma?

By: Gavin Calabretta, BS
Posted: Friday, January 14, 2022

According to the CABEYOND (Meet-URO 21) trial published in Expert Review of Anticancer Therapy, the tyrosine kinase inhibitor cabozantinib exhibited the potential to sustain control of tumor growth in metastatic renal cell carcinoma (RCC) after disease progression. Sebastiano Buti, MD, PhD, of University Hospital of Parma, Italy, and colleagues reported that patients maintaining cabozantinib after disease progression seemed to have better survival outcomes than those who changed therapy.

“The choice to change therapy after first radiological progression or to continue in combination with locoregional approach on metastatic progressive sites is not yet supported by literature evidence,” the study authors commented. “We aimed at investigating the potential benefit of continuing treatment with cabozantinib beyond the first radiological disease progression.”

The retrospective study enrolled 89 patients across 11 institutions in Italy, all of whom received cabozantinib from 2014 to 2020. Participants were divided into two groups: one included 45 patients who continued cabozantinib beyond disease progression, and a control group included 44 patients who received another therapy after disease progression. At the start of cabozantinib treatment, 84.3% of patients had intermediate-poor risk scores, according to International Metastatic RCC Database Consortium criteria. The most common metastatic sites were the lungs (76.4%), lymph nodes (69.7%), bone (56.2%), liver (30.3%), and brain (14.8%). Of the 44 patients who discontinued cabozantinib after disease progression, other treatments included nivolumab, everolimus, and sorafenib.

After a median follow-up of 11.2 months, the group of patients continuing cabozantinib after disease progression had a higher objective response rate than before disease progression (46.7% vs. 25.0%, P = .03), indicating that resistance is a concern. However, continuing cabozantinib beyond disease progression was also associated with a significantly higher survival after disease progression compared with receiving a subsequent therapy (16.9 vs. 13.2 months, hazard ratio = 0.66, 95% confidence interval 0.48–0.92, P = .011).

Disclosure: For full disclosures of the study authors, visit tandfonline.com.


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