The agent Cabometyx™ (cabozantinib) improves anti-cancer responses and time to cancer progression compared to Sutent® (sunitinib) when used as initial therapy for advanced kidney cancer. These results were recently published in the Journal of Clinical Oncology.
The kidneys are a pair of organs with multiple functions. Renal cell carcinoma is the most common type of kidney cancer. Metastatic renal cell carcinoma (mRCC) refers to cancer that has spread from the kidney to distant sites in the body.
Cabozantinib is an agent that inhibits pathways within cells that are implicated with the growth and spread of cancer. Specifically, cabozantinib is thought to inhibit the VEGF2, MET, and AXL pathways. Cabozantinib is already approved for the treatment of mRCC that has stopped responding to prior standard therapies.
Researchers recently conducted a clinical trial to compare treatment with cabozantinib to sunitinib, an agent that is currently approved as initial therapy for mRCC. The trial included 157 patients with poor- or intermediate-risk (at a high or intermediate risk for a cancer recurrence following therapy) who had not received prior therapy. Patients were divided into two groups: one group was treated with cabozantinib, and the other group was treated with sunitnib.
- Anti-cancer responses were achieved in 46% of patients treated with cabozantinib, compared with 18% for those treated with sunitinib.
- The median time of survival without progression of cancer was 8.2 months for patients treated with cabozantinib, compared with 5.6 months for those treated with sunitinib.
- Overall, patients treated with cabozantinib had a 34% reduction in the rate of cancer progression or death, compared to those treated with sunitinib.
- Severe side effects occurred in 67% of patients treated with cabozantnib, and 68% of patients treated with sunitinib.
The researchers concluded that “Cabozantinib demonstrated a significant clinical benefit in PFS and ORR over standard-of-care sunitinib as first-line therapy in patients with intermediate- or poor-risk mRCC.”
Reference: Choueiri T, Halabi S, Sanford B, et al. Cabozantinib versus sunitinib as initial targeted therapy for patients with metastatic renal cell carcinoma of poor or intermediate risk: The Alliance A031203 CABOSUN Trial. DOI: 10.1200/JCO.2016.70.7398 Journal of Clinical Oncology – published online before print November 14, 2016. Available at: http://ascopubs.org/doi/abs/10.1200/JCO.2016.70.7398.