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
APA StyleSantoni, M., Heng, D. Y., Bracarda, S., Procopio, G., Milella, M., Porta, C., Matrana, M. R., Cartenì, G., Crabb, S. J., De Giorgi, U., Basso, U., Masini, C., Calabrò, F., Vitale, M. G., Santini, D., Massari, F., Galli, L., Fornarini, G., Ricotta, R., ... Battelli, N. (2020). Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors. Cancers, 12(1), 84. https://doi.org/10.3390/cancers12010084