Abstract 241P
Background
Cabozantinib is approved in first-line metastatic renal cell carcinoma (mRCC), as a single agent and in combination with nivolumab. In real-world setting, only a miniscule proportion of Indian patients with mRCC manage to afford nivolumab, and majority of the patients end up receiving first-line cabozantinib monotherapy. Unfortunately, even though cabozantinib has been approved for long time, there is no published data from India regarding the experience of first-line cabozantinib in mRCC.
Methods
From February 2022 to August 2023, consecutive patients of mRCC who were treated with first-line cabozantinib monotherapy, were prospectively followed. Response rates, survival outcomes and toxicity were analyzed for patients who received at least 3 months of cabozantinib. The adverse events were classified based on the CTCAE v 4.0.
Results
Of the 21 mRCC patients, 18 (86%) were males. Median age at diagnosis was 56 years (range: 35-72); and 20 (95%) patients had clear cell histology. Most common site of metastasis was lungs (n=14) followed by bone (n=12), non-regional lymph nodes (n=6) and liver (n=3). Two patients had favorable risk disease, whereas 15 had intermediate risk and 4 had poor risk disease according to IMDC risk criteria. Dose reductions due to toxicity were required in 8 (38%) patients. At initial evaluation (3 months after treatment initiation), 20 patients had disease control (partial response in 3 and stable disease in 17 patients), while one had progression of disease. At a median follow-up of 11.5 months (range: 3–19); median progression free survival was not reached (total number of progression events = 5) and all patients were surviving. Toxicities of cabozantinib were grade 1 or 2 in 12 patients and grade 3 or 4 in 7 patients. The most frequent grade 3-4 adverse events were diarrhea (n=3, 14.3%), hypertension (n=3, 14.3%), palmar-plantar erythrodysesthesia syndrome (n=2, 9.5%), stomatitis (n=1, 4.8%), and hepatic transaminitis (n=1, 4.8%).
Conclusions
Cabozantinib is a viable first-line option for Indian patients with mRCC. Keeping in mind the toxicity profile and need for dose reduction; starting with 40 mg daily dose and careful tailoring as per tolerance, seems to be practically more feasible in our setting.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
341P - NUP214 gene rearrangements in leukemia patients: Case series from a single institution
Presenter: Yu Jeong Choi
Session: Poster Display
Resources:
Abstract
344P - Venetoclax and azacitidine compared with azacitidine monotherapy for acute myeloid leukemia patients: A systematic review and meta-analysis
Presenter: Azzahra Noersamsjah
Session: Poster Display
Resources:
Abstract
345P - Safety and efficacy of platinum substitution in induction chemotherapy for mantle cell lymphoma
Presenter: Omali Pitiyarachchi
Session: Poster Display
Resources:
Abstract
346P - An assessment of marrow-infiltrating T cells in early relapsed hematologic cancer patients after allogeneic hematopoietic stem cell transplantation
Presenter: Ik-Chan Song
Session: Poster Display
Resources:
Abstract
347P - New targets for adult T cell leukemia/lymphoma (ATLL): A map for ATLL immunotherapy
Presenter: Zahra Rezaei Borojerdi
Session: Poster Display
Resources:
Abstract
348P - In-depth molecular analysis in the diagnosis of lymphomas with lymphoplasmacytic differentiation may provide a more precise diagnosis and rational treatment allocation
Presenter: Ella Willenbacher
Session: Poster Display
Resources:
Abstract
349P - Overall survival and progression-free survival comparison of lenalidomide + standard therapy versus standard therapy only in indolent lymphoma: A meta-analysis
Presenter: Kevin Winston
Session: Poster Display
Resources:
Abstract
350P - Intratumoural CD66b+ to predict treatment response in diffuse large B cell lymphoma (DLBCL)
Presenter: Mita Adriani
Session: Poster Display
Resources:
Abstract
351P - Clinical features and treatment outcomes of Waldenstrom macroglobulinemia patients: A single center study
Presenter: Devi Amelia
Session: Poster Display
Resources:
Abstract
352TiP - Randomized phase III study of daratumumab (D) versus bortezomib plus D as a maintenance therapy after D-MPB for elderly or non-elderly patients refusing transplant with untreated multiple myeloma (JCOG1911, B-DASH study)
Presenter: Tomotaka Suzuki
Session: Poster Display
Resources:
Abstract