876P - Efficacy of cabozantinib (C) after PD-1/PD-L1 checkpoint inhibitors in metastatic Renal Cell Carcinoma (mRCC): the Gustave Roussy experience.

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Renal Cell Cancer
Cancer Immunology and Immunotherapy
Genitourinary Cancers
Presenter Lisa Derosa
Citation Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371
Authors L. Derosa1, J.A. Rouche1, E. Colomba1, G. Baciarello1, B. Routy1, L. Albiges2, B. Escudier1
  • 1Medical Oncology, Gustave Roussy, 94800 - Villejuif  /FR
  • 2Medical Oncology, Gustave Roussy, Villejuif  /FR

Abstract

Background

Optimal treatment sequence in mRCC remains unclear, although PD-1/PD-L1 inhibitors are becoming standard of care in second or third-line. There is little evidence about the efficacy of antiangiogenic therapies after immune checkpoint inhibitors (ICI), especially of C, which was recently approved for mRCC. We report our initial experience of C efficacy after prior ICI.

Methods

We conducted a retrospective analysis of mRCC patients (pts) enrolled on clinical trials at Gustave Roussy with ICI with a special focus on C as subsequent therapy. Clinical outcome during C treatment, including Time to Treatment Failure (TTF), Objective Response Rate (ORR), Overall Survival (OS) and safety are reported.

Results

After a median follow-up of 60 months (mo), among 127 pts treated with ICI (n: 107; nivolumab), 44 (35%) were still on-treatment and 5 pts had stable disease after treatment interruption. Among the 78 pts who progressed after ICI, 22 pts (28%) never received further treatment. 56 pts (72%) received further therapies: 18 (32%) C, 25 (44%) Axitinib (A) and 13 (24%) other (O). C was given as third-line or beyond in 27% and 73% of pts, respectively. Before starting C, pts were only intermediate or poor prognosis by IMDC criteria. Considering all evaluable pts, ORR was 33%, median TTF was 7.99 mo and median OS was 12.33 mo. Focusing on C, ORR was 42% and no pts presented progressive disease as best response versus 37% for A with 2% progressive disease. Currently, median TTF and OS on C are not yet estimable (0.92-not reached); update on clinical outcome will be presented. Moreover, C demonstrated acceptable safety profile and the rate of treatment discontinuation because of adverse events was 11%.

Conclusions

In mRCC pts previously treated by ICI, treatment with C seems to be very active, irrespective of number of prior treatments or IMDC risk group. Prior PD-1/PD-L1 exposure did not influence safety of subsequent C therapy. Interestingly, activity of A also appears excellent, raising the hypothesis of enhanced efficacy of TKI after ICI.

Clinical trial identification

Not applicable

Legal entity responsible for the study

Not applicable

Funding

None

Disclosure

B. Escudier: Honorarium received from: Bristol-Myers Squib, Novartis, Pfizer, Ipsen, Roche, Bayer, Calithera, Acceleron, EUSA, Eisai. All other authors have declared no conflicts of interest.