Previous Trials Inform Toxicity Profile of Cabozantinib/Atezolizumab in mCRPC

Neeraj Agarwal, MD, a professor of medicine and director of the Genitourinary Oncology Program at the Huntsman Cancer Institute, discusses the possible adverse events (AEs) of the randomized phase 3 CONTACT-02 trial (NCT04446117) of cabozantinib (Cabometyx) plus atezolizumab (Tecentriq) versus a second novel hormonal therapy in patients with metastatic castration-resistant prostate cancer (mCRPC).

Agarwal says one of the most common questions surrounding the CONTACT-02 study is the toxicity profile of combination cabozantinib and atezolizumab in the mCRPC population being enrolled on this trial. Investigators learned from the prostate cohort of the phase 1 COSMIC-021 trial (NCT03170960) of cabozantinib plus atezolizumab that there were no new AEs. Most oncologists have used cabozantinib previously to treat patients in different settings, such as kidney cancers, and have seen the toxicities that are associated with this tyrosine kinase inhibitor.

The AEs were mostly grade 1 and 2 in the COSMIC-021 trial and were driven by cabozantinib for the most part, according to Agarwal. These toxicities included diarrhea, hand-foot syndrome, altered taste, and fatigue. Immune-related AEs were rare in these patients. Overall, this combination was well-tolerated. The median duration of treatment was about 6 months, and the duration of response was about 8 months in the trial. Agarwal feels these data are indicative of the combination being well tolerated in the CONTACT-02 study of patients with mCRPC who have progressed on novel hormonal therapy.