1Department of Oncology, Soroka Medical Center, Beer Sheva, Israel
2Department of Oncology, Rabin Medical Center, Petah Tikva, Israel
3Department of Oncology, Rambam Medical Center, Haifa, Israel
4Department of Oncology, Sourasky Medical Center, Tel Aviv, Israel
5Department of Oncology, Sheba Medical Center, Petah Tikva, Israel
6Ben-Gurion University of the Negev, Beer Sheva, Israel
7Department of Oncology, Lin Medical Center, Haifa, Israel
8Medison Pharma, Israel
9Department of Oncology, Shaare Zedek Medical Center, Israel
#, ##These Authors Contributed Equally to this Work
Corresponding Author*: Keren Rouvinov, Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel
Received Date: 02 August, 2021
Accepted Date: 10 August, 2021
Published Date: 14 August, 2021
Background: The Phase III METEOR trial showed a survival benefit of cabozantinib over everolimus in patients with metastatic renal cell carcinoma who progressed after a VEGF targeted therapy. However, there is limited data about the real world activity of cabozantinib after present standard of care as immunotherapy. Herein we report real world national multicenter experience with cabozantinib therapy as advance treatment line.
Methods: Records from metastatic renal cell carcinoma patients treated with cabozantinib as advanced treatment line, in 6 medical centers, were reviewed. Outcomes and associated clinico-pathologic factors were analyzed.
Results: Sixty patients were included in the study. Median age was 64 years, 80% (n=48) were male, and 83% (n=50) had a prior nephrectomy. Heng score at metastases diagnosis was favorable in 8% (n=5), intermediate in 68% (n=41), and poor in 23% (n=14). Sixteen patients were treated as second line, 29 as third line, and 15 as ≥4th line. 50 patients were treated with immunotherapy before cabozantinib (30 with nivolumab, 18 with ipilimumab plus nivolumab, and 2 with avelumab plus axininib). 68% had a clinical benefit (partial response 28%, stable disease 40%) while 30% were refractory to therapy. Median duration of treatment was 8.6 months. Median overall survival was 17.6 months. Analyzed factors that may be associated with survival were a prior nephrectomy, bulky disease, and the Heng risk.
Conclusions: The present study real world multicenter analysis revealed the activity of cabozantinib as advanced treatment line of metastatic renal cell carcinoma. Outcome associated factors may aid in treatment selection.
Keywords: Cabozantinib; Renal cell cancer; Metastatic disease; Outcome; Real world