Outcomes based on age in the phase III METEOR trial of cabozantinib versus everolimus in patients with advanced renal cell carcinoma

Background - Cabozantinib improved progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) compared with everolimus in patients with advanced renal cell carcinoma (RCC) after prior antiangiogenic therapy in the phase III METEOR trial (NCT01865747). Limited data are a...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Donskov, Frede (VerfasserIn) , Grüllich, Carsten (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2020
In: European journal of cancer
Year: 2019, Jahrgang: 126, Pages: 1-10
ISSN:1879-0852
DOI:10.1016/j.ejca.2019.10.032
Online-Zugang:Verlag, Volltext: https://doi.org/10.1016/j.ejca.2019.10.032
Verlag: http://www.sciencedirect.com/science/article/pii/S0959804919308123
Volltext
Verfasserangaben:Frede Donskov, Robert J. Motzer, Eric Voog, Elizabeth Hovey, Carsten Grüllich, Louise M. Nott, Katharine Cuff, Thierry Gil, Niels Viggo Jensen, Christine Chevreau, Sylvie Negrier, Reinhard Depenbusch, Lothar Bergmann, Izzy Cornelio, Anne Champsaur, Bernard Escudier, Sumanta Pal, Thomas Powles, Toni K. Choueiri
Beschreibung
Zusammenfassung:Background - Cabozantinib improved progression-free survival (PFS), overall survival (OS) and objective response rate (ORR) compared with everolimus in patients with advanced renal cell carcinoma (RCC) after prior antiangiogenic therapy in the phase III METEOR trial (NCT01865747). Limited data are available on the use of targeted therapies in older patients with advanced RCC. - Methods - Efficacy and safety in METEOR were retrospectively analysed for three age subgroups: <65 (n = 394), 65-74 (n = 201) and ≥75 years (n = 63). - Results - PFS, OS and ORR were improved with cabozantinib compared with everolimus in all age subgroups. The PFS hazard ratios (HRs) were 0.53 (95% confidence interval [CI]: 0.41-0.68), 0.53 (95% CI: 0.37-0.77) and 0.38 (95% CI: 0.18-0.79) for <65, 65-74 and ≥75 years, respectively, and the OS HRs were 0.72 (95% CI: 0.54-0.95), 0.66 (95% CI: 0.44-0.99) and 0.57 (95% CI: 0.28-1.14). The ORR for cabozantinib versus everolimus was 15% vs 5%, 21% vs 2% and 19% vs 0%, respectively. No significant differences were observed in PFS or OS with age as a categorical or continuous variable. Grade III/IV adverse events (AEs) were generally consistent across subgroups, although fatigue, hypertension and hyponatraemia occurred more frequently in older patients treated with cabozantinib. Dose reductions to manage AEs were more frequent in patients receiving cabozantinib than in those receiving everolimus. Dose reductions and treatment discontinuation due to AEs were more frequent in older patients in both treatment groups. - Conclusions - Cabozantinib improved PFS, OS and ORR compared with everolimus in previously treated patients with advanced RCC, irrespective of age group, supporting use in all age categories. Proactive dose modification and supportive care may help to mitigate AEs in older patients while maintaining efficacy.
Beschreibung:Available online: 27 December 2019
Gesehen am 12.03.2020
Beschreibung:Online Resource
ISSN:1879-0852
DOI:10.1016/j.ejca.2019.10.032