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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
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Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
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  1. Home
  2. Final Results From A Phase I Trial And Expansion Cohorts Of Cabozantinib And Nivolumab Alone Or With Ipilimumab For Advanced/metastatic Genitourinary Tumors.
  1. Home
  2. Final Results From A Phase I Trial And Expansion Cohorts Of Cabozantinib And Nivolumab Alone Or With Ipilimumab For Advanced/metastatic Genitourinary Tumors.

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Final Results From a Phase I Trial and Expansion Cohorts of Cabozantinib and Nivolumab Alone or With Ipilimumab for

Andrea B Apolo1, Daniel M Girardi1, Scot A Niglio1

  • 1Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|July 2, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

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Cabozantinib plus nivolumab, with or without ipilimumab, shows efficacy in genitourinary cancers. This combination therapy demonstrated clinical activity and manageable safety in patients with metastatic urothelial carcinoma and renal cell carcinoma.

Area of Science:

  • Genitourinary (GU) oncology
  • Cancer immunotherapy
  • Targeted cancer therapy

Background:

  • Metastatic urothelial carcinoma (mUC) and metastatic renal cell carcinoma (mRCC) have limited treatment options.
  • Cabozantinib and nivolumab (CaboNivo) ± ipilimumab (CaboNivoIpi) are novel treatment strategies.
  • Phase I data suggested promising efficacy and safety in GU malignancies.

Purpose of the Study:

  • To report final safety, overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) from a phase I trial.
  • To evaluate CaboNivo and CaboNivoIpi in mUC, mRCC, and rare GU tumors.
  • To analyze data from phase I patients and seven expansion cohorts.

Main Methods:

  • Investigator-initiated, multicenter, phase I trial.
  • Expansion cohorts for CaboNivo doublet (mUC, mRCC, bladder adenocarcinoma) and CaboNivoIpi triplet (mUC, mRCC, penile cancer, rare GU tumors).
  • Enrollment of 120 patients; median follow-up of 49.2 months.
  • Main Results:

    • Overall Response Rate (ORR) was 38% (11% complete response) with a median duration of response of 20 months.
    • High ORRs observed in specific GU malignancies: mUC (42.4%), mRCC (62.5%), squamous cell carcinoma of the bladder (85.7%), penile cancer (44.4%).
    • Grade ≥ 3 treatment-related adverse events occurred in 84% (CaboNivo) and 80% (CaboNivoIpi) of patients.

    Conclusions:

    • Cabozantinib and nivolumab, alone or with ipilimumab, demonstrate clinical activity and acceptable safety in GU malignancies.
    • The combination therapy is particularly effective in clear cell RCC, urothelial carcinoma, and rare GU tumors.
    • Further investigation in larger trials is warranted for these promising treatment regimens.