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Adverse Events of Cabozantinib as a Potential Prognostic Factor in Metastatic Renal Cell Carcinoma Patients:
Piotr Domański1,2, Mateusz Piętak2, Barbara Kruczyk2
1Department of Experimental Immunotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5, 02-781 Warsaw, Poland.
Abstract:
Cabozantinib, an oral inhibitor targeting MET, AXL, and VEGF receptors, has become a key component of a sequential treatment strategy for clear cell renal cell carcinoma (ccRCC). The purpose of this work is to show that effective management of adverse events (AEs) during cabozantinib treatment and achieving a balance between AEs and treatment efficacy is crucial to achieving therapeutic goals. In this retrospective study, involving seventy-one metastatic RCC (mRCC) patients receiving second or subsequent lines of cabozantinib at the Department of Genitourinary Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, we explored the impact of AEs on overall survival (OS) and progression-free survival (PFS). AEs were observed in 92% of patients. Hypothyroidism during treatment was significantly associated with prolonged OS and PFS (HR: 0.31; p < 0.001 and HR: 0.34; p < 0.001, respectively). The occurrence of hand-foot syndrome (HFS) was also linked to improved OS (HR: 0.46; p = 0.021). Patients experiencing multiple AEs demonstrated superior OS and PFS compared to those with one or no AEs (HR: 0.36; p < 0.001 and HR: 0.30; p < 0.001, respectively). Hypothyroidism and HFS serve as valuable predictive factors during cabozantinib treatment in ccRCC patients, indicating a more favorable prognosis.
Insights
Effective management of adverse events (AEs) in clear cell renal cell carcinoma (ccRCC) patients treated with cabozantinib is crucial. Experiencing AEs like hypothyroidism and hand-foot syndrome may indicate a more favorable prognosis and improved survival outcomes.
Area of Science:
- Oncology
- Pharmacology
- Clinical Research
Background:
- Cabozantinib is a targeted therapy for clear cell renal cell carcinoma (ccRCC).
- Managing adverse events (AEs) is vital for optimizing treatment efficacy.
- Sequential treatment strategies in metastatic RCC (mRCC) require careful AE monitoring.
Purpose of the Study:
- To investigate the impact of AEs on overall survival (OS) and progression-free survival (PFS) in ccRCC patients receiving cabozantinib.
- To determine if specific AEs are predictive of better treatment outcomes.
- To highlight the importance of AE management in cabozantinib therapy.
Main Methods:
- Retrospective study of 71 mRCC patients treated with second or subsequent lines of cabozantinib.
- Analysis of AE occurrence and its correlation with OS and PFS.
- Statistical evaluation using hazard ratios (HR) and p-values.
Main Results:
- 92% of patients experienced AEs during cabozantinib treatment.
- Hypothyroidism was significantly associated with prolonged OS and PFS (HR: 0.31, p < 0.001; HR: 0.34, p < 0.001).
- Hand-foot syndrome (HFS) occurrence was linked to improved OS (HR: 0.46, p = 0.021).
- Patients with multiple AEs showed superior OS and PFS compared to those with fewer or no AEs (HR: 0.36, p < 0.001; HR: 0.30, p < 0.001).
Conclusions:
- Hypothyroidism and HFS are valuable predictive factors for a favorable prognosis in cabozantinib-treated ccRCC patients.
- Effective AE management and balancing AEs with efficacy are crucial for therapeutic success.
- The presence and management of AEs can indicate a more positive treatment response in ccRCC.
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