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
426P - Characterization of a novel comprehensive genomic profiling test with better detection of heterozygous deletions and gene fusions
Presenter: ryouta kakuta
Session: Poster Display
Resources:
Abstract
427P - Real-world performance of a comprehensive next-generation sequencing (NGS) panel for patients (pts) with solid tumors from Asia and the Middle East (AME)
Presenter: Nitesh Rohatgi
Session: Poster Display
Resources:
Abstract
428P - What do women want to see in a personalized breast cancer risk report? A qualitative study of Asian women of two countries
Presenter: Faustina Audrey Agatha
Session: Poster Display
Resources:
Abstract
429P - Clinical utility and outcomes of liquid biopsy-based next generation sequencing in identification of actionable genomic mutations in solid malignancy: A single center retrospective study in the Philippines
Presenter: Omar Maaño
Session: Poster Display
Resources:
Abstract
436P - Chemotherapy-induced hand-foot syndrome, comparative efficacy and safety of pharmacological prophylaxis: Systematic review and network meta-analysis
Presenter: Anand Srinivasan
Session: Poster Display
Resources:
Abstract
437P - A randomized single blinded phase II trial comparing efficacy and quality of life of topical aloe vera gel plus urea cream versus urea cream alone for prevention of hand-foot syndrome in cancer patients receiving capecitabine
Presenter: Lucksika Wanichtanom
Session: Poster Display
Resources:
Abstract
438P - A novel treatment for immune checkpoint inhibitor-related myocarditis
Presenter: Takahiro Niimura
Session: Poster Display
Resources:
Abstract
439P - Randomized controlled trial evaluating efficacy of topical urea-based cream for capecitabine-associated hand-foot syndrome prevention
Presenter: Concord Wongkraisri
Session: Poster Display
Resources:
Abstract
440P - Real-world adverse events of targeted therapy reported by pharmacist in oncology clinic
Presenter: TIKUMPORN PORNWISETSIRIKUL
Session: Poster Display
Resources:
Abstract
441P - The prophylactic efficacy of telpegfilgrastim, a Y-shape branched pegylated G-CSF in patient with chemotherapy-induced neutropenia: A multicenter, randomized phase III study
Presenter: Xinshuai Wang
Session: Poster Display
Resources:
Abstract