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Contemporary Oncology/Współczesna Onkologia
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3/2023
vol. 27
 
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abstract:
Original paper

Activity of cabozantinib in further line treatment of metastatic clear cell renal cell carcinoma. Real-world experience in a single-center retrospective study

Piotr Domański
1, 2
,
Jadwiga Jarosińska
1
,
Barbara Kruczyk
1
,
Mateusz Piętak
1
,
Anna Mydlak
2
,
Tomasz Demkow
1
,
Łukasz Kuncman
3, 4
,
Marta Darewicz
1
,
Bożena Sikora-Kupis
1
,
Paulina Dumnicka
5
,
Jakub Kucharz
1

  1. Department of Uro-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  2. Department of Experimental Immunotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  3. Department of Radiotherapy, Medical University of Łódź, Poland
  4. Department of External Beam Radiotherapy, Nicolaus Copernicus Multidisciplinary Center for Oncology and Traumatology, Łódź, Poland
  5. Chair of Medical Biochemistry, Jagiellonian University Medical College, Kraków, Poland
Contemp Oncol (Pozn) 2023; 27 (3): 190–197
DOI: https://doi.org/10.5114/wo.2023.133545
Online publish date: 2023/12/07
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Introduction:
Cabozantinib is an oral inhibitor of MET, AXL, and vascular endothelial growth factor receptors. It has an immunomodulatory effect and may influence the tumor’s microenvironment and make mutated cells more sensitive to immune-mediated killing. These properties have made cabozantinib an effective drug for first-line or subsequent-line treatment after progression of metastatic renal cell carcinoma (mRCC), even after immunotherapy.

Material and methods:
Seventy-one patients with mRCC were treated with second or further lines of cabozantinib at the Department of Genitourinary Oncology, Maria Sklodowska-Curie National Research Institute of Oncology. This study retrospectively evaluated the effectiveness of cabozantinib in subsequent lines of treatment. Progression-free survival (PFS) and overall survival (OS) were the primary endpoints. The best overall response (BOR) to cabozantinib was the secondary endpoint. For this purpose, Cox’s proportional hazard model was used.

Results:
The median PFS was 11 months (5; 23) and the median OS was 16 months (10; 42) and differed significantly in the second and further lines of treatment. Progression in the second and further lines was observed in 28 (93%) and 27 (66%) patients, respectively (p = 0.006). Partial response as the BOR was observed in one patient (3%) in the second line and 13 patients (32%) in the further lines (p = 0.012).

Conclusions:
Cabozantinib has antitumor effects in the second and further lines of treatment. In this study we observed high efficiency of cabozantinib in further lines of treatment.

keywords:

second-line treatment, tyrosine-kinase inhibitors (TKI), metastatic renal cell carcinoma (mRCC), cabozantinib, further line treatment
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