Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors
Abstract
:1. Introduction
2. Results
2.1. Overall Population
2.2. Progression-Free Survival of Cabozantinib as Second-Line Therapy
2.3. Overall Survival of Cabozantinib as Second-Line Therapy
2.4. Progression-Free Survival of Cabozantinib as Third-Line Therapy
2.5. Overall Survival of Cabozantinib as Third-Line Therapy
2.6. Time to Strategy Failure and Sequencing: Cabozantinib vs. Nivolumab
3. Discussion
4. Patients and Methods
4.1. Study Population
4.2. Treatment Regimens and Statistical Analysis
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Clinicopathological Features | N. of Patients (%) |
---|---|
Age | |
Median | 62.56y |
Range | 24.55–85.76y |
Gender | |
Male | 174 (73.42) |
Female | 63 (26.58) |
T-Stage at Diagnosis | |
T1 | 37 (15.61) |
T2 | 35 (14.77) |
T3 | 97 (40.93) |
T4 | 26 (10.97) |
Unknown | 42 (17.72) |
Histology | |
Clear-cell RCC | 182 (76.79) |
Non-clear-cell RCC | 55 (23.21) |
Fuhrman or WHO/ISUP Grade | |
Grade 1 | 4 (1.69) |
Grade 2 | 62 (26.16) |
Grade 3 | 86 (36.39) |
Grade 4 | 32 (13.50) |
Unknown | 59 (22.36) |
N. of Metastatic Sites at Recurrence | |
1 site | 77 (32.49) |
≥2 sites | 160 (67.51) |
Site of Metastasis | |
Lung | 154 (64.98) |
Lymph nodes | 133 (56.12) |
Bone | 80 (34.04) |
Liver | 53 (22.36) |
Brain | 20 (8.44) |
IMDC Risk Group | |
Good | 57 (24.05) |
Intermediate | 146 (61.60) |
Poor | 34 (14.35) |
First-Line Therapy | |
Sunitinib | 141 (59.49) |
Pazopanib | 81 (34.18) |
Immunotherapy combinations | 9 (3.80) |
Other | 6 (2.53) |
Second-Line Therapy | 237 (100) |
Cabozantinib | 112 (47.26) |
Nivolumab | 89 (37.55) |
Axitinib | 19 (8.01) |
Everolimus | 14 (5.91) |
Other | 3 (1.27) |
Third-Line Therapy | 178 (100) |
Cabozantinib | 125 (70.22) |
Nivolumab | 29 (16.29) |
Other | 24 (13.49) |
IMDC Criteria | N of Patients (%) |
---|---|
<1 y from Diagnosis to Systemic Therapy | |
Yes | 120 (50.63) |
No | 117 (49.37) |
Performance Status < 80% (Karnofsky) | |
Yes | 19 (8.02) |
No | 214 (91.98) |
Hb Level < LLN | |
Yes | 88 (37.13) |
No | 149 (62.87) |
Calcium Level > ULN | |
Yes | 21 (8.86) |
No | 216 (91.14) |
Neutrophil > ULN | |
Yes | 29 (12.24) |
No | 208 (87.76) |
Platelets > ULN | |
Yes | 31 (13.08) |
No | 206 (86.92) |
Groups | Second-Line Cabozantinib | Third-Line Cabozantinib | ||
---|---|---|---|---|
All Patients | PFS [Median (95% CI)] | OS [Median (95% CI)] | PFS [Median (95% CI)] | OS [Median (95% CI)] |
7.76 (6.51–10.88) | 11.57 (10.90–NR) | 11.38 (5.79–NR) | NR (11.5–NR) | |
Second-line Cabozantinib (29 patients, 25.9%) | Third-line Cabozantinib (28 patients, 22.4%) | |||
Favourable Group | PFS [Median (95% CI)] | OS [Median (95% CI)] | PFS [Median (95% CI)] | OS [Median (95% CI)] |
11.28 (7.89–NR) | 12.53 (11.57–NR) | 11.38 (4.24–NR) | NR (7.40–NR) | |
Second-line Cabozantinib (64 patients, 57.1%) | Third-line Cabozantinib (78 patients, 68.4%) | |||
Intermediate Group | PFS [Median (95% CI)] | OS [Median (95% CI)] | PFS [Median (95% CI)] | OS [Median (95% CI)] |
7.59 (5.52–NR) | 10.95 (9.11–NR) | 7.63 (5.56–NR) | NR (11.51–NR) | |
Second-line Cabozantinib (19 patients, 17.0%) | Third-line Cabozantinib (19 patients, 9.2%) | |||
Poor-Risk Group | PFS [Median (95% CI)] | OS [Median (95% CI)] | PFS [Median (95% CI)] | OS [Median (95% CI)] |
7.13 (2.66–NR) | 11.05 (7.46–NR) | 5.75 (3.19–NR) | NR (4.01–NR) |
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Share and Cite
Santoni, M.; Heng, D.Y.; Bracarda, S.; Procopio, G.; Milella, M.; Porta, C.; Matrana, M.R.; Cartenì, G.; Crabb, S.J.; De Giorgi, U.; et al. Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors. Cancers 2020, 12, 84. https://doi.org/10.3390/cancers12010084
Santoni M, Heng DY, Bracarda S, Procopio G, Milella M, Porta C, Matrana MR, Cartenì G, Crabb SJ, De Giorgi U, et al. Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors. Cancers. 2020; 12(1):84. https://doi.org/10.3390/cancers12010084
Chicago/Turabian StyleSantoni, Matteo, Daniel Y. Heng, Sergio Bracarda, Giuseppe Procopio, Michele Milella, Camillo Porta, Marc R. Matrana, Giacomo Cartenì, Simon J. Crabb, Ugo De Giorgi, and et al. 2020. "Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors" Cancers 12, no. 1: 84. https://doi.org/10.3390/cancers12010084