Cabozantinib and Axitinib After Vascular Endothelial Growth Factor Therapy in Patients with Advanced Renal Cell Carcinoma: A Retrospective Cohort Study from England.

Autor: Brown J; Division of Clinical Medicine, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK. j.e.brown@sheffield.ac.uk., Harrow B; Formerly Ipsen, Boulogne-Billancourt, France., Marciniak A; Formerly Ipsen, Boulogne-Billancourt, France., McCarthy C; Formerly Ipsen, Boulogne-Billancourt, France., Houchard A; Ipsen, Boulogne-Billancourt, France., Cirneanu L; IQVIA, London, UK., Protheroe A; Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Jazyk: angličtina
Zdroj: Drugs - real world outcomes [Drugs Real World Outcomes] 2024 Jun; Vol. 11 (2), pp. 195-207. Date of Electronic Publication: 2024 Jan 24.
DOI: 10.1007/s40801-023-00415-w
Abstrakt: Background and Objective: The tyrosine kinase inhibitors cabozantinib and axitinib have been widely used in England to treat advanced renal cell carcinoma following prior vascular endothelial growth factor-targeted therapy, but data on real-world usage remain limited. Our objective was to describe the real-world treatment patterns and outcomes of patients with advanced renal cell carcinoma who received second-line or later-line (≥ 2L) cabozantinib or axitinib after vascular endothelial growth factor-targeted therapy in clinical practice in England.
Methods: This retrospective cohort study used clinical practice data (collected 2011-20) from the English Cancer Analysis System database. Patient characteristics, treatment sequence and duration, and overall survival (time from initiation of cabozantinib/axitinib treatment to death) were evaluated.
Results: Data from 1485 eligible adults with advanced renal cell carcinoma were analyzed: 440 received ≥  2L cabozantinib (2L for 88.6% of them); 1045 received ≥  2L axitinib (2L for 89.5%). The most common first-line treatments were sunitinib (2L cabozantinib subcohort, 48%; 2L axitinib subcohort, 46%) and pazopanib (46% and 54%, respectively); nivolumab was the most common third-line treatment (18% and 19%, respectively). Median (interquartile range) 2L therapy duration was 5.52 (2.73-11.74) months for cabozantinib and 4.60 (1.45-12.36) months for axitinib. Following adjustment for potential confounders using inverse probability weighting, overall survival (median [interquartile range]) was longer for ≥ 2L cabozantinib (11.2 [5.7-28.0] months) than for ≥  2L axitinib (10.4 [4.7-22.0] months; log-rank p = 0.0034).
Conclusions: The Cancer Analysis System database is a valuable research resource providing extensive real-world clinical data. Real-world overall survival was longer with ≥  2L cabozantinib than with axitinib.
Clinical Trial Registration: ClinicalTrials.gov, NCT04637204; registered November 2020.
(© 2024. The Author(s).)
Databáze: MEDLINE
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