Effectiveness of Second-Line Cabozantinib in Metastatic Clear Cell Renal Cell Carcinoma Patients After First-Line Treatment with Immune Checkpoint Inhibitor-based Combinations.
Kidney Cancer
; 8(1): 135-142, 2024.
Article
em En
| MEDLINE
| ID: mdl-39263256
ABSTRACT
Background:
Cabozantinib, a tyrosine kinase inhibitor (TKI), is a prevalent second-line (2âL) therapy and was approved for use after progression on TKIs. However, the 1âL treatment setting has changed since the approval of cabozantinib monotherapy in salvage therapy settings.Objective:
To assess the differential effectiveness of cabozantinib after prior progression on 1âL ipilimumab with nivolumab (IPIâ+âNIVO) compared to programmed death receptor-1 (PD-1) or PD-1 ligand (PD-L1) inhibitors (PD1/L1i) with TKIs.Methods:
Utilizing a nationwide electronic health record (EHR)-derived de-identified database, we included patients with metastatic clear cell renal cell carcinoma (mccRCC) who received 1âL treatment with an immune checkpoint inhibitor (ICI)-based combination and 2âL treatment with cabozantinib monotherapy. These patients were categorized based on the type of 1âL ICI-based combination received IPIâ+âNIVO vs. PD1/L1i with TKI. Real-world time to next therapy (rwTTNT) and real-world overall survival (rwOS) were summarized using Kaplan-Meier curves and compared using Cox-proportional hazard models adjusted for International mRCC Database Consortium (IMDC) risk groups.Results:
Among 12,285 patients with metastatic renal cell carcinoma, 237 were eligible and included. Median rwTTNT was 8 months for the IPIâ+âNIVO subgroup and 7.5 months for the PD1/L1iâ+âTKI subgroup (HR 1.05, 95% CI 0.74-1.49, pâ=â0.8). Median rwOS was 17 months for IPIâ+âNIVO and 16 months for PD1/L1iâ+âTKI subgroup (HR 0.79, 95% CI 0.52-1.20, pâ=â0.3).Conclusions:
Cabozantinib remains effective as a 2âL therapy for mccRCC independent of the type of prior 1âL ICI-based combination. Further research is needed to validate these findings and explore the ideal sequencing of therapies.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
Kidney Cancer
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Estados Unidos