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Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis

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A Correction to this article was published on 28 August 2020

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Abstract

Background

Angiogenesis has been recognized as the most important factor for tumor invasion, proliferation, and progression in metastatic renal cell carcinoma (mRCC). However, few clinical data are available regarding the efficacy of cabozantinib following immunotherapy.

Objective

To describe the outcome of cabozantinib in patients previously treated with immunotherapy.

Patients and methods

Patients with mRCC who received cabozantinib immediately after nivolumab were included. The primary endpoint was to assess the outcome in terms of efficacy and activity.

Results

Eighty-four mRCC patients met the criteria to be included in the final analysis. After a median follow-up of 9.4 months, median overall survival was 17.3 months. According to the IMDC criteria, the rates of patients alive at 12 months in the good, intermediate, and poor prognostic groups were 100%, 74%, and 33%, respectively (p < 0.001). The median progression-free survival (PFS) was 11.5 months (95% CI 8.3–14.7); no difference was found based on duration of previous first-line therapy or nivolumab PFS. The overall response rate was 52%, stable disease was found as the best response in 25.3% and progressive disease in 22.7% of patients. Among the 35 patients with progressive disease on nivolumab, 26 (74.3%) patients showed complete/partial response or stable disease with cabozantinib as best response after nivolumab. The major limitations of this study are the retrospective nature and the short follow-up.

Conclusions

Cabozantinib was shown to be effective and active in patients previously receiving immune checkpoint inhibitors. Therefore, cabozantinib can be considered a valid therapeutic option for previously treated mRCC patients, irrespective of the type and duration of prior therapies.

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Data availability

Availability of data and material available after request to the corresponding authors.

Change history

  • 28 August 2020

    While typesetting the article the Table 3 column/row entries are interchanged. Please find below the updated Table

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Acknowledgements

The authors would like to thank Dr. Franziska Michaela Lohmeyer for help with language editing of the manuscript.

Author information

Author notes

  1. Giampaolo Tortora and Giuseppe Procopio share the co-last authorship.

Authors and Affiliations

  1. Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00158, Rome, Italy

    Roberto Iacovelli, Chiara Ciccarese & Giampaolo Tortora

  2. Oncologia Medica, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, Rome, Italy

    Chiara Ciccarese & Giampaolo Tortora

  3. Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione G. Pascale, Naples, Italy

    Gaetano Facchini & Sabrina Rossetti

  4. Oncologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy

    Michele Milella

  5. Oncology Unit, Department of Radiology, Oncology and Human Pathology, Sapienza University of Rome, Rome, Italy

    Federica Urbano & Enrico Cortesi

  6. Medical Oncology Unit 1, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy

    Umberto Basso & Marco Maruzzo

  7. Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy

    Ugo De Giorgi

  8. Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy

    Roberto Sabbatini

  9. Oncologia Medica, Campus Bio-Medico University of Rome, Rome, Italy

    Daniele Santini

  10. Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, Ancona, Italy

    Rossana Berardi

  11. Oncologia Medica, Ospedale di Macerata, Via Santa Lucia 2, 62100, Macerata, Italy

    Matteo Santoni

  12. S.C. Medical Oncology, Azienda Ospedaliera S. Maria, Terni, Italy

    Sergio Bracarda

  13. Dipartimento di Oncologia Medica, Ospedale Sant’Orsola-Malpighi, Bologna, Italy

    Francesco Massari

  14. Medical Oncology Unit, AUSL-IRCCS di Reggio Emilia, Reggio Emilia, Italy

    Cristina Masini

  15. Dipartimento di Scienze Orali e Mediche, Sezione di Oncologia, Università G. D’Annunzio, Chieti, Italy

    Michele De Tursi

  16. Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Riccardo Ricotta

  17. Unità Operativa di Oncologia Medica, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy

    Sebastiano Buti

  18. Oncologia Medica, San Martino Hospital, Belluno, Italy

    Fable Zustovich

  19. Genitourinary Cancer Unit, Dipartimento di Oncologia Medica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Pierangela Sepe & Giuseppe Procopio

Authors
  1. Roberto Iacovelli
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  2. Chiara Ciccarese
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  3. Gaetano Facchini
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  8. Roberto Sabbatini
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  13. Francesco Massari
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  14. Cristina Masini
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  15. Michele De Tursi
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  16. Riccardo Ricotta
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  17. Sebastiano Buti
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  19. Pierangela Sepe
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  20. Sabrina Rossetti
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  21. Marco Maruzzo
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  22. Enrico Cortesi
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  23. Giampaolo Tortora
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Corresponding author

Correspondence to Roberto Iacovelli.

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Funding

No external funding was used in the preparation of this article.

Conflict of interest

R. Iacovelli served as consultant for Ipsen; Pfizer; Novartis; BMS, MSD, Janssen. G. Procopio served as consultant for Bayer, BMS, Ipsen, Janssen, MSD, Novartis, Pfizer. Conflict of interest/Competing interests: Roberto Iacovelli served as consultant for Ipsen; Pfizer; Novartis; BMS, MSD, Janssen. Giuseppe Procopio served as consultant for Bayer, BMS, Ipsen, Janssen, MSD, Novartis, Pfizer. Chiara Ciccarese, Gaetano Facchini, Michele Milella, Federica Urbano, Umberto Basso, Ugo De Giorgi, Roberto Sabbatini, Daniele Santini, Rossana Berardi, Matteo Santoni, Sergio Bracarda, Francesco Massari, Cristina Masini, Michele De Tursi, Riccardo Ricotta, Sebastiano Buti, Fable Zustovich, Pierangela Sepe, Sabrina Rossetti, Marco Maruzzo, Enrico Cortesi, and Giampaolo Tortora declare that they have no conflicts of interest that might be relevant to the contents of this article.

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Iacovelli, R., Ciccarese, C., Facchini, G. et al. Cabozantinib After a Previous Immune Checkpoint Inhibitor in Metastatic Renal Cell Carcinoma: A Retrospective Multi-Institutional Analysis. Targ Oncol 15, 495–501 (2020). https://doi.org/10.1007/s11523-020-00732-y

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  • DOI: https://doi.org/10.1007/s11523-020-00732-y

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