Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Winship Cancer Institute of Emory University, Department of Hematology/Medical Oncology, Atlanta, GA, USA.
Eur J Cancer. 2018 Nov;104:188-194. doi: 10.1016/j.ejca.2018.08.014. Epub 2018 Oct 28.
Cabozantinib prolongs overall survival (OS) and progression-free survival (PFS) in patients with metastatic clear cell renal cell carcinoma (RCC) that progressed on first-line vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI). The role of cabozantinib has not been established in non-clear cell renal cell carcinoma (nccRCC).
This is a retrospective study of 30 patients with nccRCC who received cabozantinib from January 2013 to January 2017. Information collected included baseline characteristics, toxicity, dose reductions, PFS and OS. A fellowship trained abdominal radiologist, blinded to patient history and clinical data, assessed radiographic response using RECIST, v1.1.
With a median follow-up of 20.6 months (95% confidence interval [CI]: 11.4-28.8), median PFS was 8.6 months (95% CI: 6.1-14.7), and median OS was 25.4 months (95% CI: 15.5-35.4). Of the 28 patients with measurable disease, 4 had partial responses (2 papillary, 1 chromophobe and 1 unclassified RCC), 18 had stable disease (64.2%) and 6 had progressive disease (21.4%), resulting in a 14.3% objective response rate and a 78.6% disease control rate. Two patients with papillary RCC who had experienced disease progression on savolitinib achieved durable partial response and stable disease, respectively, following treatment with cabozantinib. Of the 21 patients who started cabozantinib at 60 mg/d, 12 (57.1%) required dose reduction due to toxicity.
In this retrospective study, cabozantinib produced a clinically meaningful benefit in patients with metastatic nccRCC, the majority of whom had disease progression on prior VEGFR-TKIs. Prospective trials of cabozantinib in nccRCC are warranted.
卡博替尼可延长转移性透明细胞肾细胞癌（RCC）患者的总生存期（OS）和无进展生存期（PFS），这些患者在一线血管内皮生长因子受体酪氨酸激酶抑制剂（VEGFR-TKI）治疗后进展。卡博替尼在非透明细胞肾细胞癌（nccRCC）中的作用尚未确定。
这是一项回顾性研究，纳入了 2013 年 1 月至 2017 年 1 月期间接受卡博替尼治疗的 30 例 nccRCC 患者。收集的信息包括基线特征、毒性、剂量减少、PFS 和 OS。一位接受过 fellowship培训的腹部放射科医生，对患者病史和临床数据进行盲法评估，使用 RECIST v1.1 评估放射学反应。
中位随访 20.6 个月（95%置信区间 [CI]：11.4-28.8），中位 PFS 为 8.6 个月（95%CI：6.1-14.7），中位 OS 为 25.4 个月（95%CI：15.5-35.4）。在 28 例可测量疾病患者中，4 例有部分缓解（2 例为乳头状，1 例为嫌色细胞，1 例为未分类 RCC），18 例有稳定疾病（64.2%），6 例有进展性疾病（21.4%），客观缓解率为 14.3%，疾病控制率为 78.6%。2 例接受过索拉非尼治疗的乳头状 RCC 患者，在接受卡博替尼治疗后分别出现持久的部分缓解和稳定疾病。在开始卡博替尼 60mg/d 的 21 例患者中，由于毒性，12 例（57.1%）需要减少剂量。
在这项回顾性研究中，卡博替尼在转移性 nccRCC 患者中产生了有临床意义的获益，其中大多数患者在先前的 VEGFR-TKI 治疗后进展。需要进行卡博替尼治疗 nccRCC 的前瞻性试验。
