Open AccessEffect of systemic therapies or best supportive care after disease progression to both nivolumab and cabozantinib in metastatic renal cell carcinoma: The Meet‐Uro 19BEYOND study
Author(s) -
Roviello Giandomenico,
Gambale Elisabetta,
Giorgione Roberta,
Santini Daniele,
Stellato Marco,
Fornarini Giuseppe,
Rebuzzi Sara Elena,
Basso Umberto,
Bimbatti Davide,
Doni Laura,
Nesi Gabriella,
Bersanelli Melissa,
Buti Sebastiano,
De Giorgi Ugo,
Galli Luca,
Sbrana Andrea,
Conca Raffaele,
Carella Claudia,
Naglieri Emanuele,
Pignata Sandro,
Procopio Giuseppe,
Antonuzzo Lorenzo
Publication year - 2022
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.4681
Subject(s) - cabozantinib , medicine , nivolumab , renal cell carcinoma , sorafenib , everolimus , oncology , clinical endpoint , progression free survival , sunitinib , rash , clinical trial , overall survival , hepatocellular carcinoma , cancer , immunotherapy
Background Nivolumab and cabozantinib are currently approved agents in metastatic renal cell carcinoma (mRCC) but there are no data available for patients progressing to both treatments. The aim of this study was to compare active therapeutic options and best supportive care (BSC) after progression to nivolumab and cabozantinib in mRCC. Methods In this retrospective study, we selected 50 patients from eight Italian centers. The primary endpoint of the study was the overall survival (OS) of patients on active treatment versus BSC. Secondary endpoints were the progression‐free survival (PFS) and objective response rate (ORR). The efficacy of active therapy was also investigated. Results After progression to both nivolumab and cabozantinib, 57.1% of patients were given active treatment (mainly everolimus and sorafenib) while 42.9% received BSC. The median OS was 13 months (95% CI: 4‐NR) in actively treated patients and 3 months (95% CI: 2–4) in BSC patients ( p = 0.001). Patients treated with sorafenib had better disease control than those treated with everolimus (stable disease: 71.4% vs. 16.7%, progression disease: 14.3% vs. 58.3%; p = 0.03), with no significant differences in PFS (5 and 3 months, 95% CI: 1–6 vs. 2–5; p = 0.6) and OS (12 and 4 months, 95% CI: 3‐NR vs. 2‐NR; p = 0.2). Conclusion After treatment with both nivolumab and cabozantinib, the choice of a safe active systemic therapy offered better outcomes than BSC.