Open AccessReal-World Outcomes of Nivolumab and Cabozantinib in Metastatic Renal Cell Carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium
Author(s) -
Igor Stukalin,
J. Connor Wells,
Jeffrey Graham,
Takeshi Yuasa,
Benoît Beuselinck,
Christian K. Kollmansberger,
D. Scott Ernst,
Neeraj Agarwal,
Thanh Le,
Frede Donskov,
Shao Hui Huang,
Georg A. Bjarnason,
Sandy Srinivas,
Lori Wood,
Ajjai Alva,
Ravindran Kanesvaran,
Simon Fu,
Ian D. Davis,
Toni K. Choueiri,
Daniel Y.C. Heng
Publication year - 2019
Publication title -
current oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.053
H-Index - 51
eISSN - 1718-7729
pISSN - 1198-0052
DOI - 10.3747/co.26.4595
Subject(s) - cabozantinib , nivolumab , medicine , renal cell carcinoma , hazard ratio , oncology , tyrosine kinase inhibitor , urology , kidney cancer , proportional hazards model , response evaluation criteria in solid tumors , confidence interval , cancer , clinical trial , phases of clinical research , immunotherapy
Objectives: In the present study, we explored the real-world efficacy of the immuno-oncology checkpoint inhibitor nivolumab and the tyrosine kinase inhibitor cabozantinib in the second-line setting. Methods: Using the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) dataset, a retrospective analysis of patients with metastatic renal cell carcinoma (MRCC) treated with nivolumab or cabozantinib in the second line after prior therapy targeted to the vascular endothelial growth factor receptor (VEGFR) was performed. Baseline characteristics and imdc risk factors were collected. Overall survival (OS) and time to treatment failure (TTF) were calculated using Kaplan–Meier curves. Overall response rates (ORRS) were determined for each therapy. Multivariable Cox regression analysis was performed to determine survival differences between cabozantinib and nivolumab treatment. Results: The analysis included 225 patients treated with nivolumab and 53 treated with cabozantinib. No significant difference in median OS was observed: 22.10 months [95% confidence interval (CI): 17.18 months to not reached] with nivolumab and 23.70 months (95% CI: 15.52 months to not reached) with cabozantinib (p = 0.61). The TTF was also similar at 6.90 months (95% CI: 4.60 months to 9.20 months) with nivolumab and 7.39 months (95% CI: 5.52 months to 12.85 months) with cabozantinib (p = 0.20). The adjusted hazard ratio (HR) for nivolumab compared with cabozantinib was 1.30 (95% CI: 0.73 to 2.3), p = 0.38. When adjusted by IMDC criteria and age, the HR was 1.32 (95% CI: 0.74 to 2.38), p = 0.35. Conclusions: Real-world IMDC data indicate comparable OS and TTF for nivolumab and cabozantinib. Both agents are reasonable therapeutic options for patients progressing after initial first-line VEGFR-targeted therapy.