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Cabozantinib Plus Atezolizumab in Advanced Non–Small Cell Lung Cancer

By: Lauren Harrison, MD, MS
Posted: Friday, July 1, 2022

Combining cabozantinib with atezolizumab and using cabozantinib alone both showed clinical activity in patients with advanced non–small cell lung cancer (NSCLC) who had previously been treated with immune checkpoint inhibitors. The multitargeted receptor tyrosine cabozantinib may enhance the activity of the PD-1 inhibitor atezolizumab. Joel W. Neal, MD, PhD, of Stanford University, Palo Alto, California, presented data from cohorts 7 and 20 of the phase Ib COSMIC-021 trial on behalf of his colleagues at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9005).

These cohorts consisted of 112 patients with stage IV nonsquamous NSCLC who did not have mutations in EGFR, ALK, ROS1, or BRAF. Patients had received one prior immune checkpoint inhibitor and two or fewer prior lines of therapy. In cohort 7, a total of 81 patients received both cabozantinib and atezolizumab; in cohort 20, a total of 31 patients received cabozantinib alone.

The median follow-up was 24.7 months in the combination-therapy group and 21.5 months in the monotherapy group. The objective response rate was 19% with the combination therapy, with 15% achieving a partial response and 50% with stable disease. The objective response rate was 6% with cabozantinib alone, including 2% with a partial response and 18% with stable disease. The median duration of response was 5.8 months and 10.6 months with the combination therapy and monotherapy, respectively. The median overall survival was 13.8 months for those who received cabozantinib plus atezolizumab and 9.4 months for those who received cabozantinib alone.

The most common treatment-related adverse events of any grade for the combination and single-therapy groups were diarrhea (40% and 42%, respectively), nausea (22% and 45%), decreased appetite (25% and 26%), vomiting (14% and 23%), and fatigue (28% and 19%). One patient in each cohort suffered from a grade 5 adverse event (pneumonitis in the cabozantinib/atezolizumab group and gastric ulcer hemorrhage in the cabozantinib-alone group).

Disclosure: For a full list of authors’ disclosures, visit coi.asco.org.


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