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At the American Society of Clinical Oncology Genitourinary Cancers Conference (ASCO GU) last week, updated results from the phase 3 clinical trial, CheckMate-9ER, with the cabozantinib (a VEGFR TKI tablet) plus nivolumab (an immunotherapy infusion) combination were presented.
After more than three years of follow-up, the combination of cabozantinib plus nivolumab continues to improve survival, control the cancer, and shrink the cancer on scans compared with sunitinib.
The time to when the treatment stopped working and the cancer started growing again was doubled with the combination treatment compared with sunitinib (16.6 months versus 8.4 months, respectively). Average overall survival was just over 4 years with the cabozantinib plus nivolumab combination, compared with nearly 3 years for sunitinib. Additionally, the number of patients who responded to treatment doubled with the combination (56%) compared with sunitinib (28%) and 12% of patients had a complete response compared with 5% for sunitinib. Also, the average duration of the response was longer for the patients on the combination (23.1 months compared to 15.2 months for sunitinib).
Slightly more patients experience side-effects with the combination (97% versus 93%), and the side effects were more severe. This was similar to previous studies of this combination. However, only 7% of patients stopped combination treatment because of side effects.
After more than 3 years follow-up, patients continued to benefit from the cabozantinib plus nivolumab combination. Average overall survival has improved by nearly a year since last year, and patients continue to respond to treatment, regardless of the severity of their disease.
During this study the researchers also looked for natural substances or genes that could identify or predict a person’s response to treatment (also called biomarkers). The researchers looked for biomarkers in people with advanced kidney cancer CD8 T cells and PD-L1, as well as the genes of people with advanced kidney cancer taking the combination treatment.
Unfortunately, none of the biomarkers tested were able to predict the effectiveness of nivolumab plus cabozantinib in patients with advanced kidney cancer.