Published 2022
| Version v1
Journal article
Cabozantinib-nivolumab sequence in metastatic renal cell carcinoma: The CABIR study
Creators
- Vano, Yann-Alexandre
- Phan, Letuan
- Gravis, Gwenaelle
- Korakis, Iphigenie
- Schlurmann, Friederike
- Maillet, Denis
- Bennamoun, Mostefa
- Houede, Nadine
- Topart, Delphine
- Borchiellini, Delphine
- Barthelemy, Philippe
- Ratta, Raffaele
- Ryckewaert, Thomas
- Hasbini, Ali
- Hans, Sophie
- Emambux, Sheik
- Cournier, Sandra
- Braychenko, Elena
- Elaidi, Reza-Thierry
- Oudard, Stephane
Contributors
Others:
- Cancer Research and Personalized Medicine - CARPEM [Paris] ; Hôpital Européen Georges Pompidou [APHP] (HEGP) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP] ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
- Institut Paoli-Calmettes ; Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)
- Centre de Recherche en Cancérologie de Marseille (CRCM) ; Aix Marseille Université (AMU)-Institut Paoli-Calmettes ; Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Service d'Oncologie Médicale [Centre hospitalier Lyon Sud - HCL] ; Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS) ; Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)
- Institut Mutualiste de Montsouris (IMM)
- Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
- CHU Montpellier ; Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
- Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL) ; UNICANCER-Université Côte d'Azur (UCA)
- ChemBioPharm ; Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille) ; Université de Lille-UNICANCER
- Département de Radio-Oncologie [Brest] (Clinique Pasteur) ; Clinique Pasteur [Brest]
- Institut Gustave Roussy (IGR)
- Département de radiologie ; Institut Gustave Roussy (IGR)
- Centre hospitalier universitaire de Poitiers (CHU Poitiers)
- Hôpital Européen Georges Pompidou [APHP] (HEGP) ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Description
Nivolumab and cabozantinib are approved agents in mRCC patients after sunitinib/pazopanib (TKI) failure. However, the optimal sequence, cabozantinib then nivolumab (CN) or nivolumab then cabozantinib (NC), is still unknown. The CABIR study aimed to identify the optimal sequence between CN and NC after frontline VEGFR-TKI. In this multicenter retrospective study, we collected data from mRCC pts receiving CN or NC, after frontline VEGFR-TKI. A propensity score (PrS) was calculated to manage bias selection, and sequence comparisons were carried out with a cox model on a matched sample 1:1. The primary endpoint was progression-free survival (PFS) from the start of second line to progression in third line (PFS2-3). Key secondary endpoints included overall survival from second line (OS2). Out of 139 included mRCC patients, 38 (27%) and 101 (73%) received CN and NC, respectively. Overlap in PrS allowed 1:1 matching for each CN pts, with characteristics well balanced. For both PFS2-3 and OS2, NC sequence was superior to CN (PFS2-3: HR = 0.58 [0.34-0.98], P = .043; OS2: 0.66 [0.42-1.05], P = .080). Superior PFS2-3 was in patients treated between 6 and 18 months with prior VEGFR-TKI (P = .019) and was driven by a higher PFSL3 with cabozantinib when given after nivolumab (P < .001). The CABIR study shows a prolonged PFS of the NC sequence compared to CN in mRCC after first line VEGFR-TKI failure. The data suggest that cabozantinib may be more effective than nivolumab in the third-line setting, possibly related to an ability of cabozantinib to overcome resistance to PD-1 blockade.
Additional details
Identifiers
- URL
- https://hal-amu.archives-ouvertes.fr/hal-04084994
- URN
- urn:oai:HAL:hal-04084994v1
Origin repository
- Origin repository
- UNICA