Cabozantinib, a potent multityrosine kinases inhibitor (TKI), has demonstrated overall survival (OS) benefit over everolimus in patients previously treated with VEGFR TKI for metastatic Renal Cell Carcinoma (mRCC). The efficacy of systemic treatments after cabozantinib failure has not been investigated.
We conducted a retrospective study on patients receiving systemic treatment after cabozantinib failure in heavily pretreated patient with mRCC. We assessed Time to Treatment Failure (TTF), OS and objective response rate (ORR).
Among 150 patients treated with cabozantinib in our institution, 56 (37.3%) received subsequent systemic therapy and were eligible for the analysis. IMDC prognostic group was good, intermediate and poor in 11 (19.6%), 24 (42.9%) and 11 (19.6%) patients, respectively. Cabozantinib was administered mainly as a second (41.1%), or third (33.9%) line treatment. axitinib or immune-checkpoint inhibitors were the subsequent treatment in 18 (34.8%) patients for each everolimus (n:16, 28.6%), other angiogenesis inhibitors (n:4, 7.1%) TTF and OS from subsequent systemic therapy after cabozantinib failure were 2.8 months (95%CI 1.9-3.7) and 7.7 months (95%CI 4.4-10.8), respectively. ORR was 8.7% and 2 patients with axitinib and 2 patients treated with Immune checkpoint inhibitors achieved a partial response.
Overall, activity of systemic therapies after cabozantinib was limited.
Clinical genitourinary cancer. 2021 Sep 24 [Epub ahead of print]
Luigi Cerbone, Vincenzo Di Nunno, Lucia Carril Ajuria, Carolina Alves Costa Silva, Emeline Colomba, Annalisa Guida, Flore Salviat, Laure Hirsch, Axelle Benchimol-Zouari, Ronan Flippot, Bernard Escudier, Laurence Albiges
Department of Cancer Medicine, Gustave Roussy, Villejuif, France., Oncologia Medica Ospedale Bellaria Bologna, Bologna, Italy., Medical and Translational Oncology, Ospedale Santa Chiara di Terni, Terni, Italy., Department of Epidemiology, Gustave Roussy, Villejuif, France., Department of Radiology, Gustave Roussy, Villejuif, France., Department of Cancer Medicine, Gustave Roussy, Villejuif, France; University of Paris-Saclay, Le Kremlin-Bicetre, France. Electronic address: .