Effect 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

Giandomenico Roviello, Elisabetta Gambale, Roberta Giorgione, Daniele Santini, Marco Stellato, Giuseppe Fornarini, Sara Elena Rebuzzi, Umberto Basso, Davide Bimbatti, Laura Doni, Gabriella Nesi, Melissa Bersanelli, Sebastiano Buti, Ugo De Giorgi, Luca Galli, Andrea Sbrana, Raffaele Conca, Claudia Carella, Emanuele Naglieri, Sandro PignataGiuseppe Procopio, Lorenzo Antonuzzo

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalCancer Medicine
DOIs
Publication statusAccepted/In press - 2022

Keywords

  • fourth-line therapy
  • immune checkpoint inhibitors
  • metastatic renal cell carcinoma
  • targeted therapy
  • tyrosine kinase inhibitors
  • vascular endothelial growth factor receptor

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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