Real-World Study Shows Cabozantinib Effective for Pretreated mRCC

According to the largest real-world study to date, cabozantinib proved to be effective in heavily pretreated patients with metastatic renal cell carcinoma (mRCC; Eur J Cancer. 2021;142:102-111).

“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,” wrote Laurence Albiges, MD, PhD, Gustave Roussy, Villejuif, France, and colleagues. 

This was a multi-center, observational, retrospective study that took place across 26 institutions. Eligible patients were those who had mRCC and had received  ≥1 dose of cabozantinib.

The Kaplan-Meier method was used to estimate overall survival (OS)< while subgroups were compared using the log-rank test. A multiple Cox regression model was used to assess predictive factors of OS following cabozantinib initiation. 

A total of 410 recruited patients began treatment between September 2016 and February 2018; 39.3% of patients had an Eastern Cooperative Oncology Group Performance Status ≥2, and 31.7% had poor International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk. The percentage of patients who received 0-1 previous treatment lines was 25.3%, while 33.4% and 41.2% of patients received 2 or ≥3 previous treatment lines, respectively. 55.9% of patients had bone metastases, while 16.8% had brain metastases.

The median average dose was 40.0 mg, 57.0% of patients had dose reduction, and 15.6% an alternative dose schedule. The median treatment duration was 7.6 (0.1-29.1) months, and the median follow-up was 14.4 (0-30) months.
 
The OS was a median of 14.4 months and the 12-month OS rate was 56.6% (95% CI: 51.5-61.2). Body mass index ≥25 kg/m² (P = .0021), prior nephrectomy (p cv    v = .0109), favourable or intermediate IMDC risk (P <.0001) and cabozantinib initiation at 60 mg daily (P = .0486) were identified as the predictive factors associated with a longer OS.

“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,” concluded Dr Albige et al. —Alexandra Graziano