Cabozantinib prolonged PFS and improved ORR compared to sunitinib among renal cell carcinoma patients, especially in those with MET alteration


With the growing number of therapies for first-line advanced renal cell carcinoma (RCC), there is a need to find out optimal choices for patients. Information on efficacy based on patient characteritics could help select patients for better choice. The phase II CABOSUN trial compared cabozantinib with sunitinib as initial systemic therapy in patients with RCC. The results showed that cabozantinib imporved both progression-free survival (PFS), overall response rate (ORR), overall survival (OS), and safety compared wth sunitinib. The study further analyzed the results based on MET status. Tumor MET status was determined in 131 patients, of these, 47% were MET positive. In 62 MET-positive patients, PFS was 13.8 months with cabozantinib versus 3 months (HR 0.32 [95% CI, 0.16–0.63]) with sunitinib. For MET-negative patients, PFS was 6.9 months with cabozantinib versus 6.1 months (HR, 0.67 [95% CI 0.37–1.23]) with sunitinib. The highest ORR was seen in MET-positive patients treated with cabozantinib. This study demonstrates that MET status could help select optimal first-line treatments for advanced RCC patients. 

Oncologist. 2019 Nov;24(11):1497-1501.