Cabozantinib is a tyrosine kinase inhibitor that is used as a second treatment for advanced kidney cancer after the first treatment has stopped working. The METEOR study compared the effectiveness and safety of cabozantinib with everolimus, an mTOR inhibitor, in patients with advanced kidney cancer as a second treatment.658 advanced kidney cancer patients were enrolled in the study and randomly allocated to be treated with either cabozantinib (330 patients) or everolimus (328 patients). Patients were followed-up for an average of just over 18 months. Enrolment in the study has finished and patients continue to be follow-up for side effects to treatment.

The average overall survival time was just over 21 months for the patients on cabozantinib and 16·5 months for the patients on everolimus. The time to when the treatment stopped working and the cancer started growing again was longer for the patients on cabozantinib and more patients responded to treatment with cabozantinib than everolimus (17% compared to 3 % respectively).

The most common serious or life-threatening side effects were high blood pressure, diarrhoea, extreme tiredness, hand-foot syndrome, anaemia, and high blood sugar levels. Most of these side effects were reported more frequently by patients on cabozantinib. Serious or life-threatening side effects occurred in 4 in 10 patients on cabozantinib and 4 in 10 patients on everolimus. Unfortunately, one patient died during the study and the death was considered to be caused by cabozantinib. Two patients in the everolimus group died, and the deaths were not considered related to treatment.

In conclusion, treatment with cabozantinib increased survival, delayed the progression of the cancer, and improved response to treatment compared with everolimus. Based on these results, cabozantinib should be considered as a new standard-of-care treatment option for previously treated patients with advanced kidney cancer. Patients should be monitored for side effects that might need a change in the dose of cabozantinib.

Read more in UroToday here