In the last decade, the U.S. Food and Drug Administration (FDA) has approved a variety of kinase inhibitors, including sorafenib, temsirolimus, everolimus, sunitinib, pazopanib, and axitinib—all angiogenesis inhibitor— for the treatment of patients with advanced renal cell carcinoma (RCC). Two additional immunotherapeutic agents; bevacizumab, which is another antiangiogenic agent; and nivolumab are also indicated for advanced RCC.
Cabozantinib is an oral, small-molecular tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor (VEGFR), like the angiogenesis inhibitors, as well as MET and AXL. An open-label, phase 3 trial comparing the efficacy of cabozantinib to that of everolimus in patients with RCC that had progressed after VEGFR-targeted therapy demonstrated a 42% lower rate of progression or death with cabozantinib.1
“Cabozantinib is very interesting. Data published in The New England Journal of Medicine in September 2015 and an update presented at the 2016 Genitourinary Cancers Symposium showed that the drug beat the second-line standard everolimus in terms of progression-free survival,” said Dr Choueiri, who also serves on the National Comprehensive Cancer Network Kidney & Testicular Cancers Panel and is chairman of the Medical and Scientific Steering Committee of the Kidney Cancer Association…
A new drug is proven more effective than standard therapies for advanced kidney cancer in patients with demonstrated drug resistance.A study trial, led by researchers from the Dana-Farber Cancer Institute, compared the effectiveness of a new drug, cabozantinib, with the accepted second-line treatment, everolimus (Affinitor).
The trial enrolled 658 patients with clear cell renal carcinoma; all participants had advanced or metastatic renal cell carcinoma and their disease had worsened following first-line therapy.
Initial therapy for these patients had targeted the vascular endothelial growth factor receptor (VEGFR). Cabozantinib proved to be more effective than everolimus in slowing the growth of cancer in these patients and there were early indications that it may have improved their overall survival as well (progression-free survival was a median of 7.4 months vs 3.8 for those using everolimus).
Toni K. Choueiri, MD, clinical director of the Genitourinary Cancer Treatment Center at Dana-Farber Cancer Institute, and first author of the report, feels that cabozantinib may also have potential as a first-line treatment for kidney cancer.Cabozantinib has received breakthrough therapy designation from the Food and Drug Administration. Report data were published online in the New England Journal of Medicine.