Real-World Outcomes of Nivolumab and Cabozantinib in Metastatic Renal Cell Carcinoma: Results from the International Metastatic Renal Cell Carcinoma Database Consortium

Abstract

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.

Another one in the chamber: cabozantinib for patients with metastatic non clear cell renal cell carcinoma

“…This study is for sure the largest evaluation of cabozantinib in nccRCC population and confirmed previous real-world data evaluating the use of cabozantinib in smaller population of nccRCC (15)(16)(17)(18)(19).…”

A multicenter retrospective study of nivolumab monotherapy in previously treated metastatic renal cell carcinoma patients: interim analysis of Japanese real-world data

“…In addition to insufficient clinical trial data, there is little real-world evidence in Japanese patients. While there are several reports from other countries [13][14][15][16] and some analyses of patient groups excluded from CheckMate 025 [17], no similar multicenter or large-scale analyses have been reported in Japan. This clinical study was planned to analyze the treatment patterns of nivolumab for mRCC patients in clinical practice, and the efficacy and safety of nivolumab for these patients, by retrospective analyses of information from medical records.…”

RNA Sequencing of Collecting Duct Renal Cell Carcinoma Suggests an Interaction between miRNA and Target Genes and a Predominance of Deregulated Solute Carrier Genes

“…Promising treatment schemes for metastasized renal cell carcinoma have been reported [9,10], but they mostly concern ccRCC, and there is still no specific therapy for CDC. However, there are treatment suggestions for metastatic CDC, i.e., first-line therapy with a combination of chemotherapy (gemcitabine) plus cisplatin/carboplatin, and second-line therapy as a targeted therapy [2,3].…”