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Cabozantinib demonstrates efficacy for advanced kidney cancer
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Treatment with cabozantinib conferred longer PFS than everolimus in patients with advanced renal cell carcinoma, according to the results of a phase 3 trial presented at European Society for Medical Oncology’s European Cancer Congress.
"Cabozantinib [Cometriq, Exelixis] is a new drug that targets possible escape mechanisms of tumor cells, including the tyrosine kinases MET, vascular epidermal growth factor receptor [VEGFR] and AXL,” Toni K. Choueiri, MD, clinical director and kidney cancer center director at The Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, said in a press release. “The results of the METEOR trial indicate that cabozantinib is able to shrink tumors and slow down tumor growth much better than current standard treatment in patients who previously received VEGFR–targeted drugs.”
Toni K. Choueiri
Cabozantinib exhibited encouraging clinical activity in early phase clinical trials, according to study background.
Choueiri and colleagues conducted the randomized, open label phase 3 METEOR trial — the results of which were simultaneously published in The New England Journal of Medicine — to observe the efficacy of cabozantinib compared with standard-of-care everolimus (Afinitor, Novartis) in patients with advanced renal cell carcinoma.
The study included data from 658 participants who the researchers randomly assigned to receive 60 mg daily cabozantinib or 10 mg daily everolimus.
PFS served as the primary endpoint. OS and objective response rate served as secondary endpoints.
Participants assigned cabozantinib achieved as median PFS of 7.4 months, whereas patients assigned everolimus achieved a median PFS of 3.8 months.
Participants in the cabozantinib arm had a 42% lower rate of progression or death than participants in the everolimus arm (HR = 0.58; 95% CI, 0.45-0.75). Further, the cabozantinib arm achieved a significantly higher ORR (21% vs. 5%; P < .001).
In a planned interim analysis, cabozantinib was associated with prolonged OS compared with everolimus (HR = 0.67; 95% CI, 0.51-0.89); however, the difference did not cross the significance boundary for the interim analysis. Median OS figures could not be estimated at the interim analysis.
Sixty percent of patients assigned cabozantinib and 25% of patients assigned everolimus required dose reductions for adverse events. Further, 9% of patients assigned cabozantinib and 10% of patients assigned everolimus discontinued treatment due to adverse events.
“Overall, these results should give new hope to patients diagnosed with advanced kidney cancer as cabozantinib may become a new treatment option,” Choueiri said. “The METEOR results are important from a clinical and scientific point of view. Overcoming mechanisms of tumor escape or resistance to standard therapies is critical for improving long-term outcomes for our patients with advanced kidney cancer.” – by Cameron Kelsall
Reference:
Choueiri T, et al. Abstract 4LBA. Presented at: European Cancer Congress; September 25-29, 2015; Vienna.
Disclosure: Choueiri reports research funding from Exelixis. Please see the abstract for a list of all other researchers’ relevant financial disclosures.
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