Bradley McGregor, MD, clinical director, Lank Center for Genitourinary Oncology, senior physician, Dana-Farber Cancer Institute, and instructor of medicine, Harvard Medical School, discusses the future of cabozantinib (Cabometyx) in renal cell carcinoma (RCC).
Cabozantinib is an active drug in RCC as evidenced by the phase III METEOR trial, in which the agent showed an overall survival improvement in the second-line setting over everolimus (Afinitor). The trial was critiqued in that patients who enrolled had progressed on a TKI alone which is no longer the standard of care. As the treatment landscape evolves, it is important to consider whether cabozantinib still has a role, says McGregor.
Therefore, a retrospective review of approximately 100 patients was done by Dana-Farber Cancer Institute and Emory University. Investigators showed that, independent of prior immunotherapy, cabozantinib was an active agent with no increase in toxicity. As such, cabozantinib will continue to have a role in this second-line setting, says McGregor. The agent may also continue to have a role in the frontline setting, particularly for patients who are ineligible for immunotherapy and/or have autoimmune disease, he concludes.