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Real-world data on cabozantinib in previously treated patients with metastatic renal cell carcinoma: Focus on sequences and prognostic factors

Real-world data on cabozantinib in previously treated patients with metastatic renal cell carcinoma: Focus on sequences and prognostic factors
Real-world data on cabozantinib in previously treated patients with metastatic renal cell carcinoma: Focus on sequences and prognostic factors

Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second-or third-line cabozantinib. A multicenter retrospective real-world study was conducted, involving 32 worldwide centers. A total of 237 patients with histologically confirmed clear-cell and non-clear-cell RCC who received cabozantinib as second-or third-line therapy for metastatic disease were included. We analyzed overall survival (OS), progression-free survival (PFS) and time-to-strategy failure (TTSF) using Kaplan–Meier curves. Cox proportional models were used at univariate and multivariate analyses.The median PFS and OS of cabozantinib were 7.76 months (95% CI 6.51–10.88) and 11.57 months (95% CI 10.90–not reached (NR)) as second-line and 11.38 months (95% CI 5.79–NR) and NR (95% CI 11.51–NR) as third-line therapy. The median TTSF and OS were 11.57 and 15.52 months with the sequence of cabozantinib–nivolumab and 25.64 months and NR with nivolumab–cabozantinib, respectively. The difference between these two sequences was statistically significant only in good-risk patients. In the second-line setting, hemoglobin (Hb) levels (HR= 2.39; 95% CI 1.24–4.60, p = 0.009) and IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) group (HR = 1.72, 95% CI 1.04–2.87, p = 0.037) were associated with PFS while ECOG-PS (HR = 2.33; 95%CI, 1.16–4.69, p = 0.018) and Hb levels (HR = 3.12; 95%CI 1.18–8.26, p = 0.023) correlated with OS at multivariate analysis, while in the third-line setting, only Hb levels (HR = 2.72; 95%CI 1.04–7.09, p = 0.042) were associated with OS. Results are limited by the retrospective nature of the study.This real-world study provides evidence on the presence of prognostic factors in RCC patients receiving cabozantinib.

Cabozantinib, Nivolumab, Prognosis, Real-world data, Renal cell carcinoma, Targeted therapy
2072-6694
Santoni, Matteo
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Heng, Daniel Y.
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Scarpelli, Marina
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Paolucci, Vittorio
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Battelli, Nicola
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Santoni, Matteo
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Heng, Daniel Y.
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Bracarda, Sergio
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Procopio, Giuseppe
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Milella, Michele
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Porta, Camillo
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Matrana, Marc R.
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Cartenì, Giacomo
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Crabb, Simon J.
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De Giorgi, Ugo
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Basso, Umberto
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Masini, Cristina
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Santini, Daniele
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Massari, Francesco
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Galli, Luca
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Ricotta, Riccardo
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Buti, Sebastiano
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Zucali, Paolo
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Caffo, Orazio
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Morelli, Franco
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Martignetti, Angelo
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Gelibter, Alain
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Atzori, Francesco
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Vau, Nuno
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Incorvaia, Lorena
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Ortega, Cinzia
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Scarpelli, Marina
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Lopez-Beltran, Antonio
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Cheng, Liang
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Paolucci, Vittorio
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Graham, Jeffrey
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Pierce, Erin
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Scagliarini, Sarah
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Sepe, Pierangela
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Verzoni, Elena
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Merler, Sara
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Rizzo, Mimma
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Sorgentoni, Giulia
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Conti, Alessandro
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Piva, Francesco
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Cimadamore, Alessia
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Montironi, Rodolfo
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Battelli, Nicola
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Santoni, Matteo, Heng, Daniel Y., Bracarda, Sergio, Procopio, Giuseppe, Milella, Michele, Porta, Camillo, Matrana, Marc R., Cartenì, Giacomo, Crabb, Simon J., De Giorgi, Ugo, Basso, Umberto, Masini, Cristina, Calabrò, Fabio, Vitale, Maria Giuseppa, Santini, Daniele, Massari, Francesco, Galli, Luca, Fornarini, Giuseppe, Ricotta, Riccardo, Buti, Sebastiano, Zucali, Paolo, Caffo, Orazio, Morelli, Franco, Carrozza, Francesco, Martignetti, Angelo, Gelibter, Alain, Iacovelli, Roberto, Mosca, Alessandra, Atzori, Francesco, Vau, Nuno, Incorvaia, Lorena, Ortega, Cinzia, Scarpelli, Marina, Lopez-Beltran, Antonio, Cheng, Liang, Paolucci, Vittorio, Graham, Jeffrey, Pierce, Erin, Scagliarini, Sarah, Sepe, Pierangela, Verzoni, Elena, Merler, Sara, Rizzo, Mimma, Sorgentoni, Giulia, Conti, Alessandro, Piva, Francesco, Cimadamore, Alessia, Montironi, Rodolfo and Battelli, Nicola (2019) Real-world data on cabozantinib in previously treated patients with metastatic renal cell carcinoma: Focus on sequences and prognostic factors. Cancers, 12 (1), [84]. (doi:10.3390/cancers12010084).

Record type: Article

Abstract

Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second-or third-line cabozantinib. A multicenter retrospective real-world study was conducted, involving 32 worldwide centers. A total of 237 patients with histologically confirmed clear-cell and non-clear-cell RCC who received cabozantinib as second-or third-line therapy for metastatic disease were included. We analyzed overall survival (OS), progression-free survival (PFS) and time-to-strategy failure (TTSF) using Kaplan–Meier curves. Cox proportional models were used at univariate and multivariate analyses.The median PFS and OS of cabozantinib were 7.76 months (95% CI 6.51–10.88) and 11.57 months (95% CI 10.90–not reached (NR)) as second-line and 11.38 months (95% CI 5.79–NR) and NR (95% CI 11.51–NR) as third-line therapy. The median TTSF and OS were 11.57 and 15.52 months with the sequence of cabozantinib–nivolumab and 25.64 months and NR with nivolumab–cabozantinib, respectively. The difference between these two sequences was statistically significant only in good-risk patients. In the second-line setting, hemoglobin (Hb) levels (HR= 2.39; 95% CI 1.24–4.60, p = 0.009) and IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) group (HR = 1.72, 95% CI 1.04–2.87, p = 0.037) were associated with PFS while ECOG-PS (HR = 2.33; 95%CI, 1.16–4.69, p = 0.018) and Hb levels (HR = 3.12; 95%CI 1.18–8.26, p = 0.023) correlated with OS at multivariate analysis, while in the third-line setting, only Hb levels (HR = 2.72; 95%CI 1.04–7.09, p = 0.042) were associated with OS. Results are limited by the retrospective nature of the study.This real-world study provides evidence on the presence of prognostic factors in RCC patients receiving cabozantinib.

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Accepted/In Press date: 23 November 2019
e-pub ahead of print date: 30 December 2019
Published date: 30 December 2019
Keywords: Cabozantinib, Nivolumab, Prognosis, Real-world data, Renal cell carcinoma, Targeted therapy

Identifiers

Local EPrints ID: 437205
URI: http://eprints.soton.ac.uk/id/eprint/437205
ISSN: 2072-6694
PURE UUID: e89dfcfa-8c5e-4b11-9006-f373359c8064
ORCID for Simon J. Crabb: ORCID iD orcid.org/0000-0003-3521-9064

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Date deposited: 21 Jan 2020 17:36
Last modified: 17 Mar 2024 02:57

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Contributors

Author: Matteo Santoni
Author: Daniel Y. Heng
Author: Sergio Bracarda
Author: Giuseppe Procopio
Author: Michele Milella
Author: Camillo Porta
Author: Marc R. Matrana
Author: Giacomo Cartenì
Author: Simon J. Crabb ORCID iD
Author: Ugo De Giorgi
Author: Umberto Basso
Author: Cristina Masini
Author: Fabio Calabrò
Author: Maria Giuseppa Vitale
Author: Daniele Santini
Author: Francesco Massari
Author: Luca Galli
Author: Giuseppe Fornarini
Author: Riccardo Ricotta
Author: Sebastiano Buti
Author: Paolo Zucali
Author: Orazio Caffo
Author: Franco Morelli
Author: Francesco Carrozza
Author: Angelo Martignetti
Author: Alain Gelibter
Author: Roberto Iacovelli
Author: Alessandra Mosca
Author: Francesco Atzori
Author: Nuno Vau
Author: Lorena Incorvaia
Author: Cinzia Ortega
Author: Marina Scarpelli
Author: Antonio Lopez-Beltran
Author: Liang Cheng
Author: Vittorio Paolucci
Author: Jeffrey Graham
Author: Erin Pierce
Author: Sarah Scagliarini
Author: Pierangela Sepe
Author: Elena Verzoni
Author: Sara Merler
Author: Mimma Rizzo
Author: Giulia Sorgentoni
Author: Alessandro Conti
Author: Francesco Piva
Author: Alessia Cimadamore
Author: Rodolfo Montironi
Author: Nicola Battelli

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