Journal of Oncology Research and Therapy (ISSN: 2574-710X)

Research Article

Cabozantinib as Advanced Treatment Line for Metastatic Renal Cell Carcinoma: Real World Outcomes and Associated Factors

Keren Rouvinov1*#, Victoria Neiman2#, Noa Shani Shrem1, Avivit Peer3, David Sarid4, Moran Gadot5, Wilmosh Mermershtain1, Michael Friger6, Meital Levartovsky5, Eduard Grikshtas7, Eli Rosenbaum2, Niv Mazkereth8, Ana Iavko1, Amir Abramovich9, Hadas Dresler9, Walid Shalata1##, Daniel Keizman4##, Raanan Berger5##

1Department of Oncology, Soroka Medical Center, Beer Sheva, Israel

2Department of Oncology, Rabin Medical Center, Petah Tikva, Israel

3Department of Oncology, Rambam Medical Center, Haifa, Israel

4Department of Oncology, Sourasky Medical Center, Tel Aviv, Israel

5Department of Oncology, Sheba Medical Center, Petah Tikva, Israel

6Ben-Gurion University of the Negev, Beer Sheva, Israel

7Department of Oncology, Lin Medical Center, Haifa, Israel

8Medison Pharma, Israel

9Department of Oncology, Shaare Zedek Medical Center, Israel

#, ##These Authors Contributed Equally to this Work

Corresponding Author*: Keren Rouvinov, Department of Oncology, Soroka University Medical Center, Beer Sheva, Israel

Received Date: 02 August, 2021

Accepted Date: 10 August, 2021

Published Date: 14 August, 2021

Abstract

Background: The Phase III METEOR trial showed a survival benefit of cabozantinib over everolimus in patients with metastatic renal cell carcinoma who progressed after a VEGF targeted therapy. However, there is limited data about the real world activity of cabozantinib after present standard of care as immunotherapy. Herein we report real world national multicenter experience with cabozantinib therapy as advance treatment line.

Methods: Records from metastatic renal cell carcinoma patients treated with cabozantinib as advanced treatment line, in 6 medical centers, were reviewed. Outcomes and associated clinico-pathologic factors were analyzed.

Results: Sixty patients were included in the study. Median age was 64 years, 80% (n=48) were male, and 83% (n=50) had a prior nephrectomy. Heng score at metastases diagnosis was favorable in 8% (n=5), intermediate in 68% (n=41), and poor in 23% (n=14). Sixteen patients were treated as second line, 29 as third line, and 15 as ≥4th line. 50 patients were treated with immunotherapy before cabozantinib (30 with nivolumab, 18 with ipilimumab plus nivolumab, and 2 with avelumab plus axininib). 68% had a clinical benefit (partial response 28%, stable disease 40%) while 30% were refractory to therapy. Median duration of treatment was 8.6 months. Median overall survival was 17.6 months. Analyzed factors that may be associated with survival were a prior nephrectomy, bulky disease, and the Heng risk.

Conclusions: The present study real world multicenter analysis revealed the activity of cabozantinib as advanced treatment line of metastatic renal cell carcinoma. Outcome associated factors may aid in treatment selection.

Keywords: Cabozantinib; Renal cell cancer; Metastatic disease; Outcome; Real world