The tyrosine kinase inhibitor (TKI) cabozantinib was found to be used more frequently than other TKIs after checkpoint inhibitor therapy in routine care for patients with metastatic renal cell carcinoma (RCC) in the United States. Results from the retrospective observational cohort study (NCT04353765), which examined outcomes associated with cabozantinib or axitinib, lenvatinib, pazopanib, sorafenib, and sunitinib, were presented at the 2021 Genitourinary Cancers Symposium.

Data on the efficacy of targeted therapies after initial checkpoint inhibition are limited.

In this study, Florence Marteau, MSc, and colleagues evaluated 247 patient the US Oncology Network iKnowMed electronic health record database. Eligible patients had received a diagnosis of metastatic RCC, initiated treatment with a TKI between May 1, 2016 and September 31, 2019, and received a checkpoint inhibitor as their last systemic treatment prior to TKI therapy.

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Of the 247 patients, more than three-quarters (75.7%) received cabozantinib while the remaining 24.3% received another TKI. More poor-risk patients received cabozantinib vs other TKIs (28.9% vs. 20.0%).

Use of cabozantinib was associated with significantly higher 6-month response rate (50.8% vs 33.3%; P <.0001) and overall response rate (53.5% vs 38.3%; adjusted P =.0002) compared with the other TKIs. Additionally, time to treatment discontinuation was twice as long for cabozantinib (6.2 months vs 3.1 months; adjusted P =.0052).

Although it was not statistically significant, the rate of discontinuation due to adverse events was more frequent with other TKIs than with cabozantinib, the researchers noted.

“Cabozantinib was an effective and well tolerated option post-[checkpoint inhibitor], with a high response rate in the real-world setting,” Marteau et al concluded.

Disclosures: Some of the study authors disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the original study. This clinical trial was supported by Ipsen.


Marteau F, Harrow B, McCarthy C, et al. Cabozantinib versus other TKIs after CPI treatment in the real-world management of patients with metastatic renal cell carcinoma (mRCC). Presented at: 2021 Genitourinary Cancers Symposium; February 11-13, 2021. Abstract 293.

This article originally appeared on Cancer Therapy Advisor