Cabozantinib as first-line treatment in advanced renal cell carcinoma: a profile of its use
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Oral cabozantinib tablets (Cabometyx®) are an important option for the treatment of advanced renal cell carcinoma (RCC). Cabozantinib is an anti-angiogenic agent and potently inhibits multiple tyrosine kinases, including those implicated in the development of RCC. The previously approved indication of cabozantinib tablets (i.e. treatment of advanced RCC following prior VEGF-targeted therapy) has been extended to include the first-line treatment of advanced RCC in treatment-naïve adults with intermediate or poor risk (EU) and all patients with advanced RCC (USA). These label extensions are based on the results of a randomized, open-label phase 2 trial, in which adults with metastatic RCC of poor or intermediate risk received targeted first-line treatment with cabozantinib or standard-of-care sunitinib. Relative to sunitinib, cabozantinib significantly prolonged median progression-free survival (primary endpoint; investigator and independent assessments), and increased the objective response rate (investigator assessment). The tolerability profile of cabozantinib is comparable to those of other tyrosine kinase inhibitors, with adverse events being manageable with medical intervention, dosage reductions, treatment interruption and/or permanent discontinuation.
The manuscript was reviewed by: E. Gallardo, Medical Oncology Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació ParcTaulí I3P, Universitat Autònoma de Barcelona, Sabadell, Spain; B. Maughan, Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA. During the peer review process, Ipsen Pharma (EU) and Exelixis, Inc. (USA), the marketing-authorization holders of cabozantinib, were also offered an opportunity to provide a scientific accuracy review of their data. Changes resulting from comments received were made on the basis of scientific and editorial merit.
Compliance with ethical standards
The preparation of this review was not supported by any external funding.
Conflicts of interest
K. A. Lyseng-Williamson is an employee of Adis/Springer, is responsible for the article content and declares no conflicts of interest.
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