Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors
Author:
Santoni Matteo, Heng Daniel Y., Bracarda Sergio, Procopio Giuseppe, Milella Michele, Porta CamilloORCID, Matrana Marc R., Cartenì Giacomo, Crabb Simon J.ORCID, De Giorgi UgoORCID, Basso Umberto, Masini Cristina, Calabrò Fabio, Vitale Maria Giuseppa, Santini Daniele, Massari FrancescoORCID, Galli Luca, Fornarini Giuseppe, Ricotta Riccardo, Buti SebastianoORCID, Zucali PaoloORCID, Caffo OrazioORCID, Morelli Franco, Carrozza Francesco, Martignetti Angelo, Gelibter Alain, Iacovelli RobertoORCID, Mosca Alessandra, Atzori Francesco, Vau Nuno, Incorvaia Lorena, Ortega Cinzia, Scarpelli Marina, Lopez-Beltran AntonioORCID, Cheng LiangORCID, Paolucci Vittorio, Graham Jeffrey, Pierce Erin, Scagliarini Sarah, Sepe Pierangela, Verzoni Elena, Merler SaraORCID, Rizzo Mimma, Sorgentoni Giulia, Conti Alessandro, Piva Francesco, Cimadamore AlessiaORCID, Montironi RodolfoORCID, Battelli Nicola
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.
Subject
Cancer Research,Oncology
Cited by
24 articles.
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