Abstract 3793
Background
Cabo is approved for mccRCC based on trials in which the vast majority of patients were ICB-naive. We analyzed the activity of cabo in mccRCC patients who had progressed on ICB.
Methods
We included 69 patients with mccRCC who received cabo after progression on ICB alone or in combination with VEGF or other therapies. Baseline characteristics, best response (BR, investigator-assessed), time to treatment failure (TTF) and overall survival (OS) were analyzed.
Results
Median age was 62 years (range 37-78). Median number of prior therapies was 2 (range 1-10). Median time on prior ICB was 3.9 months (range 0.5-38). Type of prior therapy was ICB single agent (54%) or in combination with a VEGF inhibitor (35%) or other therapies (12%). At time of cabo initiation, IMDC risk groups were 6% good, 67% intermediate and 27% poor. BR was 33% PR, 46% SD, 17% PD, 3% unevaluable. Median follow up after cabo initiation was 12 months. At time of analysis, 35% (n = 24) remained on cabo and median TTF was 6.6 (95%CI: 5.3-8.5) months. Of those discontinuing cabo, 58% (n = 26) received additional therapy. At time of analysis, 62% (n = 43) were alive with 1-year OS rate of 53% (95%CI: 37%-66%).Table: 879P
| Best Response to Cabo | |||||
|---|---|---|---|---|---|
| N | PR | SD | PD | Unevaluable | |
| All patients | 69 | 23(33%) | 32(46%) | 12(17%) | 2(3%) |
| By prior ICB type | |||||
| ICB alone | 37 | 16(43%) | 15(41%) | 5(14%) | 1(3%) |
| ICB+VEGF | 24 | 6(25%) | 12(50%) | 5(21%) | 1(4%) |
| ICB+Other | 8 | 1(13%) | 5(63%) | 2(25%) | |
| By prior ICB duration | |||||
| <6mos | 42 | 12(29%) | 22(52%) | 8(19%) | |
| >6mos | 27 | 11(41%) | 10(37%) | 4(15%) | 2(7%) |
Conclusions
Cabo is active in patients treated after PD-1/PD-L1 based ICB independent of prior combination therapy with VEGF inhibitors, with 79% achieving disease control at minimum. These results support the continued use of cabo irrespective of ICB timing. Equal contribution: BAM, AAL.
Clinical trial identification
Legal entity responsible for the study
Dana Farber Cancer institute.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
B.A. McGregor: Consulting: Exelixis, Genentech, Astellas, Seattle-Genetics, Bayer, Jannsen, AstraZeneca, Pfizer Institutional research: Bristol-Myers-Squibb. L.C. Harshman: Advisory: Bayer, Genentech, Dendreon, Pfizer, Medivation/ Astellas, Kew Group, Theragene, Corvus, Merck, Exelixis; Novartis; Research to the institution: Bayer, Sotio, Bristol-Myers Squib, Merck, Takeda, Dendreon/Valient, Jannsen, Medivation/Astellas, Genentech, Pfizer. M.A. Bilen: Consulting: Exelixis. T.K. Choueiri: Research funding: AstraZeneca, B Bristol-Myers-Squibb MS, Exelixis, Genentech, GSK, Merck, Novartis, Peloton, Pfizer, Roche, Tracon, Eisai; Consulting and Advisory role: AstraZeneca, Bayer, Bristol-Myers-Squibb, Cerulean, Eisai, Foundation Medicine Inc., Exelixis, Genentech, Roche, GlaxoSmithKline, Merck, Novartis, Peloton, Pfizer, Prometheus Labs, Corvus, Ipsen. All other authors have declared no conflicts of interest.