Upcoming Trials Show Promise With Cabozantinib in RCC

Matthew T. Campbell, MD, MS, assistant professor in the Department of Genitourinary Medical Oncology of the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center, discusses trials investigating cabozantinib (Cabometyx) in patients with renal cell carcinoma (RCC).

For patients with RCC that have aggressive disease, including those with extensive bone disease, especially in their spinal column, or extensive liver disease, physicians sometimes only have one chance to treat them. Campbell thinks the combination of nivolumab (Opdivo) and cabozantinib, which in now approved in advanced RCC, is a good fit for this patient population.

An important question in this space, which may be answered when the CONTACT-03 (NCT04338269) data are published, is how to best treat patients who have already progressed on immune-oncology treatment or pembrolizumab (Keytruda) plus axitinib (Inlyta). Campbell wonders if cabozantinib plus immunotherapy with atezolizumab (Tecentriq) will enhance patient’s long-term disease control versus using cabozantinib alone.

Another study of cabozantinib in RCC is COSMIC-313 (NCT03937219), which is looking at cabozantinib combined with nivolumab and ipilimumab (Yervoy) in previously untreated patients with advanced or metastatic RCC. This trial will show if the combination has the ability to achieve complete responses in patients and if it will improve the durability of response. This is an important study in this setting, according to Campbell.