Real-world data on cabozantinib in metastatic renal cell carcinoma (mRCC) is limited. This study (CABOREAL) reports treatment patterns and outcomes for patients treated with cabozantinib through the French Early Access Program.
This multicentre (n = 26), observational, retrospective study enrolled patients with mRCC who had received ≥1 dose of cabozantinib. Overall survival (OS) was estimated using the Kaplan-Meier method; subgroups were compared using the log-rank test. A multiple Cox regression model assessed predictive factors of OS after cabozantinib initiation.
Four hundred and ten recruited patients started treatment between September 2016 and February 2018: the Eastern Cooperative Oncology Group Performance Status ≥2, 39.3%; poor International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk, 31.7%; 0-1, 2 and ≥3 previous treatment lines, 25.3%, 33.4% and 41.2%, respectively; bone metastases, 55.9%; brain metastases, 16.8%. Median (min-max) follow-up was 14.4 (0-30) months. Overall, 57.0% of patients had a dose reduction, 15.6% an alternative dose schedule. The median average daily dose was 40.0 mg. Median (quartile [Q]1-Q3) treatment duration was 7.6 (0.1-29.1) months, median OS was 14.4 months, and the 12-month OS rate was 56.5% (95% confidence interval: 51.5-61.2). Most patients (54.4%) received subsequent treatment. Predictive factors associated with longer OS were body mass index ≥25 kg/m2 (p = 0.0021), prior nephrectomy (p = 0.0109), favourable or intermediate IMDC risk (p < 0.0001) and cabozantinib initiation at 60 mg/day (p = 0.0486).
In the largest real-world study to date, cabozantinib was effective in unselected, heavily pretreated patients with mRCC. Initiation at 60 mg/day was associated with improved outcomes. CLINICALTRIALS.
European journal of cancer (Oxford, England : 1990). 2020 Nov 27 [Epub ahead of print]
Laurence Albiges, Aude Fléchon, Christine Chevreau, Delphine Topart, Gwenaëlle Gravis, Stéphane Oudard, Jean M Tourani, Lionnel Geoffrois, Emeline Meriaux, Antoine Thiery-Vuillemin, Philippe Barthélémy, Sylvain Ladoire, Brigitte Laguerre, Valérie Perrot, Anaïs Billard, Bernard Escudier, Marine Gross-Goupil
Gustave Roussy, Villejuif, France. Electronic address: ., Centre Léon Bérard, Lyon, France., IUCT Oncopole Institut Claudius Regaud, Toulouse, France., Centre Hospitalier Universitaire, Montpellier, France., Institut Paoli-Calmettes, Department of Medical Oncology, Aix-Marseille University, Inserm, CNRS, CRCM, Marseille, France., Hôpital Européen Georges Pompidou, Paris, France., Centre Hospitalier Universitaire, Poitiers, France., Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France., Centre François Baclesse, Caen, France., Centre Hospitalier Universitaire Jean Minjoz, Besançon, France., Centre Hospitalier Universitaire, Strasbourg, France., Centre Georges François Leclerc, Dijon, France., Centre Eugène Marquis, Rennes, France., Ipsen, Boulogne-Billancourt, France., Gustave Roussy, Villejuif, France., Centre Hospitalier Universitaire Saint-André, Bordeaux, France.