Klin Onkol 2024; 37(1): 57-62. DOI: 10.48095/ccko202457.
Background: Cabozantinib is a tyrosine kinase inhibitor (TKI) that targets vascular endothelial growth factor receptor (VEGFR) as well as MET and AXL. In METEOR study, cabozantinib demonstrated efficacy when compared with everolimus in pacients with metastatic renal cell cancer (mRCC) after previous TKI therapy. Purpose: The determination of efficacy and tolerance of cabozantinib in the second or higher lines of the therapy of mRCC after previous treatment with tyrosinkinase inhibitors. Patients and methods: A total of 45 patients with mRCC were treated in two oncology centers (Regional Hospital Liberec and University Hospital Motol, Prague) in clinical practice. We determined progression free survival (PFS) and overall survival (OS) according to Kaplan-Meier analysis. We performed a multivariate analysis of the risk factors for treatment outcomes (PFS, OS) by Cox regression analysis. All statistics were evaluated at the significance level of α = 0.05. Results: A median of follow-up was 24 months. Median PFS was 8.7 months (95% CI 6.7–19.5), median OS was 21.6 months (95% CI 13.2–not achieved). Parcial remission was described in 42.5% patients, stabilization in 37.8% patients. Progression as the best response was demonstrated in 20% of patients. Regression analysis demonstrated a statistically significant favorable prognostic effect on PFS in patients at older age and patients with longer first-line therapy. The regression analysis demonstrated a statistically significant favorable prognostic effect on OS in patients with Eastern Cooperative Oncology Group (ECOG) performance status 0, patients with longer-first line therapy and patients treated with immunotherapy in the next lines. Grade 3–4 toxicity was described in 37.8% patients. The most common type of toxicity was hypertension. Conclusion: Our analysis demonstrated the efficacy and good tolerance of cabozantinib in with mRCC treated by cabozantinib in second-line therapy.
