Nav: Home

Cabozantinib improves progression-free survival in metastatic renal cell carcinoma

October 10, 2016

LUGANO-COPENHAGEN, Oct. 10, 2016 - Cabozantinib significantly improves progression-free survival and response rate in patients with metastatic renal cell carcinoma compared to sunitinib, according to research presented today at the ESMO 2016 Congress in Copenhagen1.

Cabozantinib targets a class of enzymes called tyrosine kinases but, unlike sunitinib which targets the vascular endothelial growth factor receptors (VEGFR), cabozantinib additionally inhibits the action of MET and AXL.

"Both MET and AXL seem to be associated with tumour progression but more importantly, animal models showed that the development of resistance to VEGFR inhibitors like sunitinib can be mediated through AXL and MET," said principal investigator Dr. Toni Choueiri, director of the Lank Center for Genitourinary Oncology at the Dana-Farber Cancer Institute in Boston, US.

In this phase II multicenter trial, 157 patients with untreated clear-cell metastatic renal cell carcinoma of intermediate or poor risk, were randomized either to oral cabozantinib (60mg once daily) or sunitinib (50mg once daily, 4 weeks on, 2 weeks off).

Patients treated with cabozantinib showed a 31% reduction in the median rate of progression or death compared to those treated with sunitinib (8.2 months vs. 5.6 months, p = 0.012). The objective response rate was also significantly higher in the cabozantinib arm compared to the sunitinib arm (46% vs.18%).

Researchers observed a similar rate of adverse events between the two arms of the study, with the incidence of grade 3 or higher adverse events being 70.5% in the cabozantinib arm and 72.2% in the sunitinib arm. The most common adverse events for both treatments included diarrhoea, fatigue, hypertension, palmar-plantar erythrodysesthesia, hematological events, and 16 patients in each arm terminated their treatment early due to toxicity.

The study did not include good-risk patients, but Choueiri said there was no biological or clinical rationale to think that cabozantinib would not be equally effective in that population.

"Cabozantinib is currently approved for second or later lines of therapies, after patients have progressed on a VEGFR tyrosine kinase inhibitor, but this data shows that cabozantinib has the potential to become a first-line standard treatment," Choueiri said.

Commenting on the study, Dr Bernard Escudier, chairman of the renal cancer unit at Institut Gustave-Roussy, France, said, "For many years, sunitinib has been the most commonly used standard of care for first line metastatic renal cell carcinoma, and recently, cabozantinib was proven to be active in second line, especially after sunitinib failure."

"Obviously, this study will raise a lot of questions, such as whether these results are expandable to all metastatic renal cell carcinoma patients, including the good prognosis group; whether cabozantinib should become a new standard of care in the first line setting; and how we should interprete all the ongoing phase III first-line studies which selected sunitinib as the control arm."

"While more mature data and additional studies using cabozantinib in the first line setting will be required, this study raises a lot of new expectations for the treatment of metastatic renal cell carcinoma," Escudier concluded.

European Society for Medical Oncology

Related Sunitinib Articles:

Nivolumab with ipilimumab: Combination has added benefit in advanced renal cell carcinoma
There are advantages in overall survival, which are not offset by any disadvantages of similar importance.
Drug combination may become new standard treatment for advanced kidney cancer
A combination of two drugs -- one of them an immunotherapy agent -- could become a new standard, first-line treatment for patients with metastatic kidney cancer, says an investigator from Dana-Farber Cancer Institute, reporting results from a phase 3 clinical trial.
Financial relationships and prescribing practices between physicians and drug companies
In a study published in The Oncologist, physicians treating certain cancers who consistently received payments from a cancer drug's manufacturer were more likely to prescribe that drug over alternative treatments.
Avelumab plus axitinib significantly improve PFS in untreated renal cell carcinoma
A combination of the immune checkpoint blocker, avelumab, plus the tyrosine kinase inhibitor (TKI), axitinib, significantly improves progression-free survival (PFS) in previously untreated patients with advanced renal cell carcinoma (RCC) in a phase 3 study, according to results presented at ESMO 2018 Congress.
FDA approves new standard of care for kidney cancer
The US Food and Drug Administration granted approval to the combination of two immunotherapy drugs, ipilimumab and nivolumab, for the treatment of metastatic kidney cancer.
More Sunitinib News and Sunitinib Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...