Cancers, Vol. 12, Pages 84: Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors

Cancers, Vol. 12, Pages 84: Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors:

Cancers, Vol. 12, Pages 84: Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors

Cancers doi: 10.3390/cancers12010084

Authors:
Matteo Santoni
Daniel Y. Heng
Sergio Bracarda
Giuseppe Procopio
Michele Milella
Camillo Porta
Marc R. Matrana
Giacomo Cartenì
Simon J. Crabb
Ugo De Giorgi
Umberto Basso
Cristina Masini
Fabio Calabrò
Maria Giuseppa Vitale
Daniele Santini
Francesco Massari
Luca Galli
Giuseppe Fornarini
Riccardo Ricotta
Sebastiano Buti
Paolo Zucali
Orazio Caffo
Franco Morelli
Francesco Carrozza
Angelo Martignetti
Alain Gelibter
Roberto Iacovelli
Alessandra Mosca
Francesco Atzori
Nuno Vau
Lorena Incorvaia
Cinzia Ortega
Marina Scarpelli
Antonio Lopez-Beltran
Liang Cheng
Vittorio Paolucci
Jeffrey Graham
Erin Pierce
Sarah Scagliarini
Pierangela Sepe
Elena Verzoni
Sara Merler
Mimma Rizzo
Giulia Sorgentoni
Alessandro Conti
Francesco Piva
Alessia Cimadamore
Rodolfo Montironi
Nicola Battelli


Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second- or third-line cabozantinib. A multicenter retrospective real-world study was conducted, involving 32 worldwide centers. A total of 237 patients with histologically confirmed clear-cell and non-clear-cell RCC who received cabozantinib as second- or third-line therapy for metastatic disease were included. We analyzed overall survival (OS), progression-free survival (PFS) and time-to-strategy failure (TTSF) using Kaplan–Meier curves. Cox proportional models were used at univariate and multivariate analyses.The median PFS and OS of cabozantinib were 7.76 months (95% CI 6.51–10.88) and 11.57 months (95% CI 10.90–not reached (NR)) as second-line and 11.38 months (95% CI 5.79–NR) and NR (95% CI 11.51–NR) as third-line therapy. The median TTSF and OS were 11.57 and 15.52 months with the sequence of cabozantinib–nivolumab and 25.64 months and NR with nivolumab–cabozantinib, respectively. The difference between these two sequences was statistically significant only in good-risk patients. In the second-line setting, hemoglobin (Hb) levels (HR= 2.39; 95% CI 1.24–4.60, p = 0.009) and IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) group (HR = 1.72, 95% CI 1.04–2.87, p = 0.037) were associated with PFS while ECOG-PS (HR = 2.33; 95%CI, 1.16–4.69, p = 0.018) and Hb levels (HR = 3.12; 95%CI 1.18–8.26, p = 0.023) correlated with OS at multivariate analysis, while in the third-line setting, only Hb levels (HR = 2.72; 95%CI 1.04–7.09, p = 0.042) were associated with OS. Results are limited by the retrospective nature of the study.This real-world study provides evidence on the presence of prognostic factors in RCC patients receiving cabozantinib.