Cabozantinib-nivolumab sequence in metastatic renal cell carcinoma: The CABIR study.

Autor: Vano YA; Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP Centre-Université Paris Cité, Paris, France.; INSERM U970, PARCC, Paris, France.; Centre de Recherche des Cordeliers, INSERM, Université Paris Cité, Sorbonne Université, Paris, France., Phan L; ARTIC-Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France., Gravis G; Medical Oncology, Institut Paoli-Calmettes, Aix-Marseille University, CRCM, Marseille, France., Korakis I; Medical Oncology, Institut Universitaire du Cancer-Toulouse-Oncopole, Toulouse, France., Schlürmann F; Medical Oncology, Centre Hospitalier Intercommunal, Quimper, Quimper, France., Maillet D; Medical Oncology, IMMUCARE, Centre Hospitalier Lyon Sud, Institut de Cancérologie des Hospices de Lyon (IC-HCL), Pierre-Bénite, France., Bennamoun M; Medical Oncology, Institut Mutualiste Montsouris, Paris, France., Houede N; Medical Oncology, Institut de cancérologie du Gard, Nimes, Montpellier University, France., Topart D; Medical Oncology, Hopital Saint-Eloi (CHU de Montpellier), Montpellier, France., Borchiellini D; Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France., Barthelemy P; Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France., Ratta R; Medical Oncology, Hopital Foch, Suresnes, France., Ryckewaert T; Medical Oncology, Centre Oscar Lambret, Lille, France., Hasbini A; Medical Oncology, Clinique Pasteur Lanroze, Brest, France., Hans S; Department of Medical Oncology, Hôpital Henri-Mondor, AP-HP-Université de Paris Est, Créteil, France., Emambux S; Medical Oncology, Centre Hospitalier Universitaire Poitiers, Poitiers, France., Cournier S; ARTIC-Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France., Braychenko E; ARTIC-Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France., Elaidi RT; ARTIC-Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France., Oudard S; Medical Oncology, Hôpital Européen Georges Pompidou, AP-HP Centre-Université Paris Cité, Paris, France.; INSERM U970, PARCC, Paris, France.
Jazyk: angličtina
Zdroj: International journal of cancer [Int J Cancer] 2022 Oct 15; Vol. 151 (8), pp. 1335-1344. Date of Electronic Publication: 2022 Jun 06.
DOI: 10.1002/ijc.34126
Abstrakt: Nivolumab and cabozantinib are approved agents in mRCC patients after sunitinib/pazopanib (TKI) failure. However, the optimal sequence, cabozantinib then nivolumab (CN) or nivolumab then cabozantinib (NC), is still unknown. The CABIR study aimed to identify the optimal sequence between CN and NC after frontline VEGFR-TKI. In this multicenter retrospective study, we collected data from mRCC pts receiving CN or NC, after frontline VEGFR-TKI. A propensity score (PrS) was calculated to manage bias selection, and sequence comparisons were carried out with a cox model on a matched sample 1:1. The primary endpoint was progression-free survival (PFS) from the start of second line to progression in third line (PFS 2-3 ). Key secondary endpoints included overall survival from second line (OS 2 ). Out of 139 included mRCC patients, 38 (27%) and 101 (73%) received CN and NC, respectively. Overlap in PrS allowed 1:1 matching for each CN pts, with characteristics well balanced. For both PFS 2-3 and OS 2 , NC sequence was superior to CN (PFS 2-3 : HR = 0.58 [0.34-0.98], P = .043; OS 2 : 0.66 [0.42-1.05], P = .080). Superior PFS 2-3 was in patients treated between 6 and 18 months with prior VEGFR-TKI (P = .019) and was driven by a higher PFS L3 with cabozantinib when given after nivolumab (P < .001). The CABIR study shows a prolonged PFS of the NC sequence compared to CN in mRCC after first line VEGFR-TKI failure. The data suggest that cabozantinib may be more effective than nivolumab in the third-line setting, possibly related to an ability of cabozantinib to overcome resistance to PD-1 blockade.
(© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)
Databáze: MEDLINE
Externí odkaz: