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Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
Activity of Systemic Treatments After Cabozantinib Failure in Advanced Metastatic Renal Cell Carcinoma
Luigi Cerbone1, Vincenzo Di Nunno2, Lucia Carril Ajuria1
1Department of Cancer Medicine, Gustave Roussy, Villejuif, France.
Background:
Cabozantinib, a potent multityrosine kinases inhibitor (TKI), has demonstrated overall survival (OS) benefit over everolimus in patients previously treated with VEGFR TKI for metastatic Renal Cell Carcinoma (mRCC). The efficacy of systemic treatments after cabozantinib failure has not been investigated.
Materials And Methods:
We conducted a retrospective study on patients receiving systemic treatment after cabozantinib failure in heavily pretreated patient with mRCC. We assessed Time to Treatment Failure (TTF), OS and objective response rate (ORR).
Results:
Among 150 patients treated with cabozantinib in our institution, 56 (37.3%) received subsequent systemic therapy and were eligible for the analysis. IMDC prognostic group was good, intermediate and poor in 11 (19.6%), 24 (42.9%) and 11 (19.6%) patients, respectively. Cabozantinib was administered mainly as a second (41.1%), or third (33.9%) line treatment. axitinib or immune-checkpoint inhibitors were the subsequent treatment in 18 (34.8%) patients for each everolimus (n:16, 28.6%), other angiogenesis inhibitors (n:4, 7.1%) TTF and OS from subsequent systemic therapy after cabozantinib failure were 2.8 months (95%CI 1.9-3.7) and 7.7 months (95%CI 4.4-10.8), respectively. ORR was 8.7% and 2 patients with axitinib and 2 patients treated with Immune checkpoint inhibitors achieved a partial response.
Conclusion:
Overall, activity of systemic therapies after cabozantinib was limited.
Insights
Systemic therapies after cabozantinib failure showed limited efficacy in metastatic renal cell carcinoma (mRCC) patients. Further research is needed to identify effective treatments following cabozantinib progression in heavily pretreated mRCC.
Area of Science:
- Oncology
- Medical Science
Background:
- Cabozantinib (a multityrosine kinase inhibitor) improves overall survival (OS) in metastatic renal cell carcinoma (mRCC) patients over everolimus.
- Efficacy of subsequent treatments after cabozantinib failure in mRCC is not well-established.
Purpose of the Study:
- To evaluate the efficacy of systemic treatments following cabozantinib failure in heavily pretreated mRCC patients.
- To assess Time to Treatment Failure (TTF), OS, and objective response rate (ORR) of subsequent therapies.
Main Methods:
- Retrospective study of 56 mRCC patients who received systemic therapy after cabozantinib failure.
- Analysis included IMDC prognostic groups, treatment lines, and specific subsequent therapies (axitinib, immune-checkpoint inhibitors, everolimus, other angiogenesis inhibitors).
Main Results:
- Subsequent systemic therapies demonstrated limited efficacy, with a TTF of 2.8 months and OS of 7.7 months.
- The overall response rate (ORR) was 8.7%, with partial responses observed in patients treated with axitinib or immune-checkpoint inhibitors.
Conclusions:
- The activity of systemic therapies following cabozantinib failure in mRCC is limited.
- This highlights the need for novel therapeutic strategies in this patient population.
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