In the present study, we explored the real-world efficacy of the immuno-oncology checkpoint inhibitor nivolumab and the tyrosine kinase inhibitor cabozantinib in the second-line setting.
Using the International Metastatic Renal Cell Carcinoma Database Consortium (imdc) dataset, a retrospective analysis of patients with metastatic renal cell carcinoma (mrcc) treated with nivolumab or cabozantinib in the second line after prior therapy targeted to the vascular endothelial growth factor receptor (vegfr) was performed. Baseline characteristics and imdc risk factors were collected. Overall survival (os) and time to treatment failure (ttf) were calculated using Kaplan-Meier curves. Overall response rates (orrs) were determined for each therapy. Multivariable Cox regression analysis was performed to determine survival differences between cabozantinib and nivolumab treatment.
The analysis included 225 patients treated with nivolumab and 53 treated with cabozantinib. No significant difference in median os was observed: 22.10 months [95% confidence interval (ci): 17.18 months to not reached] with nivolumab and 23.70 months (95% ci: 15.52 months to not reached) with cabozantinib (p = 0.61). The ttf was also similar at 6.90 months (95% ci: 4.60 months to 9.20 months) with nivolumab and 7.39 months (95% ci: 5.52 months to 12.85 months) with cabozantinib (p = 0.20). The adjusted hazard ratio (hr) for nivolumab compared with cabozantinib was 1.30 (95% ci: 0.73 to 2.3), p = 0.38. When adjusted by imdc criteria and age, the hr was 1.32 (95% ci: 0.74 to 2.38), p = 0.35.
Real-world imdc data indicate comparable os and ttf for nivolumab and cabozantinib. Both agents are reasonable therapeutic options for patients progressing after initial first-line vegfr-targeted therapy.
Current oncology (Toronto, Ont.). 2019 Apr 01 [Epub]
I Stukalin, J C Wells, J Graham, T Yuasa, B Beuselinck, C Kollmansberger, D S Ernst, N Agarwal, T Le, F Donskov, A R Hansen, G A Bjarnason, S Srinivas, L A Wood, A S Alva, R Kanesvaran, S Y F Fu, I D Davis, T K Choueiri, D Y C Heng
Alberta: Tom Baker Cancer Center, University of Calgary, Calgary (Stukalin, Wells, Heng)., non-United States international: Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan (Yuasa); University Hospitals Leuven, Leuven, Belgium (Beuselinck); Aarhus University Hospital, Aarhus, Denmark (Donskov); National Cancer Centre Singapore, Singapore (Kanesvaran); Auckland City Hospital, Auckland, New Zealand (Fu); Monash University Eastern Health Clinical School, Melbourne, Australia (Davis)., British Columbia: BC Cancer, Vancouver (Kollmansberger)., Ontario: Queen's University, Kingston (Wells); London Health Sciences Centre, London (Ernst); Princess Margaret Cancer Centre, University Health Network, Toronto (Hansen); Sunnybrook Odette Cancer Centre, Toronto (Bjarnason)., United States: University of Utah Huntsman Cancer Institute, Salt Lake City, UT (Agarwal); University of Texas Southwestern Medical Center, Dallas, TX (Le); Stanford Medical Center, Stanford, CA (Srinivas); University of Michigan, Ann Arbor, MI (Alva); Dana-Farber Cancer Institute, Boston, MA (Choueiri)., Nova Scotia: Queen Elizabeth II Health Sciences Centre, Halifax (Wood).