GU Cancers 2021 | CABEYOND: cabozantinib beyond PD and survival outcomes in mRCC

CABEYOND trial was a retrospective clinical trial undertaken in a population affected by advance of the renal cell carcinoma pretreated with tyrosine kinase inhibitors and often with also with PD-1 or PD-L1 inhibitors. The majority of the patients are receiving previous multiple lines of treatment, three or more.

In this clinical trial, we [inaudible] to evaluate the role of cabozantinib beyond progression, so all patients with a progressive disease using cabozantinib, and at the progress of the disease, we decide, due to the lack of therapeutic options, to continue the same.

We analyzed this data, and we compared this data with a cohort of control lab, represented by patient received another option, for example, another multi kinase inhibitors like sunitinib or sorafenib or an mTOR inhibitor like everolimus, or a PD-1 inhibitor like nivolumab. And so, the main hypothesis was to compare the outcome of these two cohorts of patients. Patients that continued the cabozantinib beyond progression, and the patient who started new lines of therapy.

This trial was a multicenter trial undertaken on behalf of the Meet-Uro group in Italy, and, overall, 45 patients were treated with cabozantinib beyond progression, and 44 of them, the rest of the patients, received another lines of treatment.

When we performed the comparison of the people in the outcome of these two groups of patients, we reported that the differences in post-progression overall survival in favor of the cabozantinib beyond progression. So, cabozantinib beyond progression are associated with an improvement in overall survival, and a reduction of risk of death of 34%.

In general, the treatment was safe and feasible. Of course, some patients required a dosing modification and a dose reduction. We need to remind ourselves that these are patients hand selected because the patients are receiving treatment after multiple lines of treatment, so are of course more frail due to a longer treatment exposure, for example, with multi kinase inhibitor. But the treatment with Cabo was safe and no unexpected toxicities were reported. The key message is, for selected patients, cabozantinib beyond the progression would be an option in terms of overall disease control, and improvement in overall survival. So in case they’re without other therapeutic options, we may consider cabozantinib beyond progression.