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In a European study of second-line treatments for metastatic kidney cancer that does not respond to first-line treatment, or becomes resistant to first-line treatment (refractory kidney cancer), cabozantinib was the most commonly used treatment and results in good outcomes for patients.
The study looked at 356 patients with metastatic kidney cancer that did not respond to first-line treatment with immunotherapy and were receiving a second-line treatment. Patients were on first-line treatment for an average of just over 2 and a half months. The average time from stopping first-line treatment to starting second-line treatment was 3 weeks.
Nearly 4 in 10 patients were treated with cabozantinib in the second-line, about a third were treated with sunitinib, and 1 in 10 patients received pazopanib. A quarter of patients had poor-risk disease. Patients were followed for about one and a half years.
For all patients in the study, average overall survival time was 14.5 months, with an average time to treatment failure of 5.5 months. However, results varied by treatment type.
For the patients who were on cabozantinib as a second-line treatment, average overall survival time was 13.5 months for those on immunotherapy plus a TKI as a first-line treatment and 15.1 months for those on a combination of immunotherapies. For patients on sunitinib as a second-line treatment, overall survival time was 10.7 months, and for pazopanib, overall survival time was 15.3 months.
For the patients on cabozantinib, the time to treatment failure was more than 6 and a half months. For sunitinib and pazopanib, time to treatment failure was just over 4 months and nearly 3 months, respectively.
More patients responded to cabozantinib (2 in 10 patients) in the second-line, than sunitinib (1 in 10 patients) and pazopanib (1.5 in 10 patients).
The researchers concluded that cabozantinib, the most common second-line treatment for patients with refractory metastatic kidney cancer, showed favourable clinical outcomes compared with sunitinib or pazopanib. Further research is needed to explore biomarkers of refractory disease and find new treatments for these patients.
