Cancers (Dec 2019)
Real-World Data on Cabozantinib in Previously Treated Patients with Metastatic Renal Cell Carcinoma: Focus on Sequences and Prognostic Factors
- Matteo Santoni,
- Daniel Y. Heng,
- Sergio Bracarda,
- Giuseppe Procopio,
- Michele Milella,
- Camillo Porta,
- Marc R. Matrana,
- Giacomo Cartenì,
- Simon J. Crabb,
- Ugo De Giorgi,
- Umberto Basso,
- Cristina Masini,
- Fabio Calabrò,
- Maria Giuseppa Vitale,
- Daniele Santini,
- Francesco Massari,
- Luca Galli,
- Giuseppe Fornarini,
- Riccardo Ricotta,
- Sebastiano Buti,
- Paolo Zucali,
- Orazio Caffo,
- Franco Morelli,
- Francesco Carrozza,
- Angelo Martignetti,
- Alain Gelibter,
- Roberto Iacovelli,
- Alessandra Mosca,
- Francesco Atzori,
- Nuno Vau,
- Lorena Incorvaia,
- Cinzia Ortega,
- Marina Scarpelli,
- Antonio Lopez-Beltran,
- Liang Cheng,
- Vittorio Paolucci,
- Jeffrey Graham,
- Erin Pierce,
- Sarah Scagliarini,
- Pierangela Sepe,
- Elena Verzoni,
- Sara Merler,
- Mimma Rizzo,
- Giulia Sorgentoni,
- Alessandro Conti,
- Francesco Piva,
- Alessia Cimadamore,
- Rodolfo Montironi,
- Nicola Battelli
Affiliations
- Matteo Santoni
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy
- Daniel Y. Heng
- Division of Medical Oncology, Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
- Sergio Bracarda
- Medical Oncology, Department of Oncology, AziendaOspedaliera S. Maria, 05100 Terni, Italy
- Giuseppe Procopio
- Department of Medical Oncology, Istituto Nazionale deiTumori IRCCS, 20133 Milan, Italy
- Michele Milella
- U.O.C. Oncology, AziendaOspedalieraUniversitariaIntegrata, University and Hospital Trust of Verona, 37126 Verona, Italy
- Camillo Porta
- Department of Internal Medicine and Therapeutics, University of Pavia and Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy
- Marc R. Matrana
- Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA 70121, USA
- Giacomo Cartenì
- Department of Medical Oncology, AO “A. Cardarelli”, 80131 Naples, Italy
- Simon J. Crabb
- Cancer Sciences Unit, University of Southampton, Southampton SO171BJ, UK
- Ugo De Giorgi
- Department of Medical Oncology, IstitutoScientifico Romagnolo per lo Studio e la CuradeiTumori (IRST) IRCCS, 47014 Meldola, Italy
- Umberto Basso
- Department of Medical Oncology, IstitutoOncologico Veneto (IOV) IRCCS, 35128 Padova, Italy
- Cristina Masini
- Medical Oncology Unit, Arcispedale Santa Maria Nuova, IRCCS Reggio Emilia, 42123 Reggio Emilia, Italy
- Fabio Calabrò
- San Camillo-Forlanini Hospital, 00128 Rome, Italy
- Maria Giuseppa Vitale
- Department of Oncology and Haematology and Respiratory Disease, University Hospital, 41125 Modena, Italy
- Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, 00128 Rome, Italy
- Francesco Massari
- Division of Oncology, S. Orsola-Malpighi Hospital, 40138 Bologna, Italy
- Luca Galli
- Medical Oncology Unit, Department of Translational Research and New Technologies in Medicine, University of Pisa, 56126 Pisa, Italy
- Giuseppe Fornarini
- Department of Medical Oncology, Ospedale “S. Martino”, 16132 Genova, Italy
- Riccardo Ricotta
- Niguarda Cancer Center, Grande OspedaleMetropolitano Niguarda, 20162 Milan, Italy
- Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy
- Paolo Zucali
- Humanitas Clinical and Research Center, Humanitas Cancer Center, Rozzano, 20089 Milano, Italy
- Orazio Caffo
- Medical Oncology Department, Santa Chiara Hospital, Largo Medaglied’Oro, 38122 Trento, Italy
- Franco Morelli
- Medical Oncology Department, Casa SollievodellaSofferenza, VialeCappuccini 1, 71013 San Giovanni Rotondo, Italy
- Francesco Carrozza
- Oncology Unit, City Hospital, 48018 Faenza, Italy
- Angelo Martignetti
- Dipartimentooncologicouslsud-esttoscana-area senese, LocalitàCampostaggias.n.c., 53036 Poggibonsi, Italy
- Alain Gelibter
- Medical Oncology (B), Policlinico Umberto I, “Sapienza” University of Rome, 00128 Rome, Italy
- Roberto Iacovelli
- Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
- Alessandra Mosca
- Medical Oncology Unit, Maggiore dellaCarità University Hospital, University of Eastern Piedmont, 28100 Novara, Italy
- Francesco Atzori
- Medical Oncology Unit, AziendaOspedalieroUniversitaria of Cagliari, 09124 Cagliari, Italy
- Nuno Vau
- Urologic Oncology, Champalimaud Clinical Center, 1400-038 Lisbon, Portugal
- Lorena Incorvaia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, 90127 Palermo, Italy
- Cinzia Ortega
- Department of Medical Oncology, Ospedale S. Lazzaro ASL CN2 Alba-Bra, 12051 Cuneo, Italy
- Marina Scarpelli
- United Hospitals, School of Medicine, Section of Pathological Anatomy, Polytechnic University of the Marche Region, Via Conca 71, I-60126 Ancona, Italy
- Antonio Lopez-Beltran
- Department of Pathology and Surgery, Faculty of Medicine, 14004 Cordoba, Spain
- Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Vittorio Paolucci
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy
- Jeffrey Graham
- Division of Medical Oncology, Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada
- Erin Pierce
- Department of Internal Medicine, Hematology/Oncology, Ochsner Medical Center, New Orleans, LA 70121, USA
- Sarah Scagliarini
- Department of Medical Oncology, AO “A. Cardarelli”, 80131 Naples, Italy
- Pierangela Sepe
- Department of Medical Oncology, Istituto Nazionale deiTumori IRCCS, 20133 Milan, Italy
- Elena Verzoni
- Department of Medical Oncology, Istituto Nazionale deiTumori IRCCS, 20133 Milan, Italy
- Sara Merler
- U.O.C. Oncology, AziendaOspedalieraUniversitariaIntegrata, University and Hospital Trust of Verona, 37126 Verona, Italy
- Mimma Rizzo
- Department of Internal Medicine and Therapeutics, University of Pavia and Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, 27100 Pavia, Italy
- Giulia Sorgentoni
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy
- Alessandro Conti
- Department of Urology, Bressanone/Brixen hospital, via Dante 51, 39042 Bressanone BZ, Italy
- Francesco Piva
- Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
- Alessia Cimadamore
- United Hospitals, School of Medicine, Section of Pathological Anatomy, Polytechnic University of the Marche Region, Via Conca 71, I-60126 Ancona, Italy
- Rodolfo Montironi
- United Hospitals, School of Medicine, Section of Pathological Anatomy, Polytechnic University of the Marche Region, Via Conca 71, I-60126 Ancona, Italy
- Nicola Battelli
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, 62100 Macerata, Italy
- DOI
- https://doi.org/10.3390/cancers12010084
- Journal volume & issue
-
Vol. 12,
no. 1
p. 84
Abstract
Cabozantinib is approved for the treatment of renal cell carcinoma (RCC). However, prognostic factors are still lacking in this context. The aim of this study was to evaluate prognostic factors in RCC patients treated with second- or third-line cabozantinib. A multicenter retrospective real-world study was conducted, involving 32 worldwide centers. A total of 237 patients with histologically confirmed clear-cell and non-clear-cell RCC who received cabozantinib as second- or third-line therapy for metastatic disease were included. We analyzed overall survival (OS), progression-free survival (PFS) and time-to-strategy failure (TTSF) using Kaplan−Meier curves. Cox proportional models were used at univariate and multivariate analyses.The median PFS and OS of cabozantinib were 7.76 months (95% CI 6.51−10.88) and 11.57 months (95% CI 10.90−not reached (NR)) as second-line and 11.38 months (95% CI 5.79−NR) and NR (95% CI 11.51−NR) as third-line therapy. The median TTSF and OS were 11.57 and 15.52 months with the sequence of cabozantinib−nivolumab and 25.64 months and NR with nivolumab−cabozantinib, respectively. The difference between these two sequences was statistically significant only in good-risk patients. In the second-line setting, hemoglobin (Hb) levels (HR= 2.39; 95% CI 1.24−4.60, p = 0.009) and IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) group (HR = 1.72, 95% CI 1.04−2.87, p = 0.037) were associated with PFS while ECOG-PS (HR = 2.33; 95%CI, 1.16−4.69, p = 0.018) and Hb levels (HR = 3.12; 95%CI 1.18−8.26, p = 0.023) correlated with OS at multivariate analysis, while in the third-line setting, only Hb levels (HR = 2.72; 95%CI 1.04−7.09, p = 0.042) were associated with OS. Results are limited by the retrospective nature of the study.This real-world study provides evidence on the presence of prognostic factors in RCC patients receiving cabozantinib.
Keywords