Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis

A Correction to this article was published on 28 August 2020

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Abstract

Background

Angiogenesis has been recognized as the most important factor for tumor invasion, proliferation, and progression in metastatic renal cell carcinoma (mRCC). However, few clinical data are available regarding the efficacy of cabozantinib following immunotherapy.

Objective

To describe the outcome of cabozantinib in patients previously treated with immunotherapy.

Patients and methods

Patients with mRCC who received cabozantinib immediately after nivolumab were included. The primary endpoint was to assess the outcome in terms of efficacy and activity.

Results

Eighty-four mRCC patients met the criteria to be included in the final analysis. After a median follow-up of 9.4 months, median overall survival was 17.3 months. According to the IMDC criteria, the rates of patients alive at 12 months in the good, intermediate, and poor prognostic groups were 100%, 74%, and 33%, respectively (p < 0.001). The median progression-free survival (PFS) was 11.5 months (95% CI 8.3–14.7); no difference was found based on duration of previous first-line therapy or nivolumab PFS. The overall response rate was 52%, stable disease was found as the best response in 25.3% and progressive disease in 22.7% of patients. Among the 35 patients with progressive disease on nivolumab, 26 (74.3%) patients showed complete/partial response or stable disease with cabozantinib as best response after nivolumab. The major limitations of this study are the retrospective nature and the short follow-up.

Conclusions

Cabozantinib was shown to be effective and active in patients previously receiving immune checkpoint inhibitors. Therefore, cabozantinib can be considered a valid therapeutic option for previously treated mRCC patients, irrespective of the type and duration of prior therapies.

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Data availability

Availability of data and material available after request to the corresponding authors.

Change history

  • 28 August 2020

    While typesetting the article the Table 3 column/row entries are interchanged. Please find below the updated Table

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Acknowledgements

The authors would like to thank Dr. Franziska Michaela Lohmeyer for help with language editing of the manuscript.

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Correspondence to Roberto Iacovelli.

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No external funding was used in the preparation of this article.

Conflict of interest

R. Iacovelli served as consultant for Ipsen; Pfizer; Novartis; BMS, MSD, Janssen. G. Procopio served as consultant for Bayer, BMS, Ipsen, Janssen, MSD, Novartis, Pfizer. Conflict of interest/Competing interests: Roberto Iacovelli served as consultant for Ipsen; Pfizer; Novartis; BMS, MSD, Janssen. Giuseppe Procopio served as consultant for Bayer, BMS, Ipsen, Janssen, MSD, Novartis, Pfizer. Chiara Ciccarese, Gaetano Facchini, Michele Milella, Federica Urbano, Umberto Basso, Ugo De Giorgi, Roberto Sabbatini, Daniele Santini, Rossana Berardi, Matteo Santoni, Sergio Bracarda, Francesco Massari, Cristina Masini, Michele De Tursi, Riccardo Ricotta, Sebastiano Buti, Fable Zustovich, Pierangela Sepe, Sabrina Rossetti, Marco Maruzzo, Enrico Cortesi, and Giampaolo Tortora declare that they have no conflicts of interest that might be relevant to the contents of this article.

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Iacovelli, R., Ciccarese, C., Facchini, G. et al. Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis. Targ Oncol 15, 495–501 (2020). https://doi.org/10.1007/s11523-020-00732-y

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