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
485P - LDCT lung cancer screening of never-smokers meta-analysis subgroup analysis: Adenocarcinoma is the highly predictive histology identified in never-smokers
Presenter: Sai-Hong Ou
Session: Poster Display
Resources:
Abstract
486P - Fiscal feasibility and implications of integrating lung cancer screening into Hong Kong’s healthcare system
Presenter: Herbert Ho Fung Loong
Session: Poster Display
Resources:
Abstract
487P - Evaluating the performance of the USPSTF lung cancer screening guidelines in an Asian population of lung cancer patients
Presenter: Jian Wei Tan
Session: Poster Display
Resources:
Abstract
488P - Pulmonary ground glass opacity lesions: Immune ecosystem and its clinical relevances of early-stage lung adenocarcinoma
Presenter: Shensi Shen
Session: Poster Display
Resources:
Abstract
489TiP - BGB-LC-202 (NCT05577702): Phase II Umbrella study of tislelizumab (TIS) monotherapy and TIS-based immunotherapy combinations +/- chemotherapy (CT) as neoadjuvant treatment in Chinese patients (pts) with resectable stage II to IIIA non-small cell lung cancer (NSCLC)
Presenter: Wentao Yu
Session: Poster Display
Resources:
Abstract
491P - Furmonertinib as adjuvant therapy for elderly patients in resected EGFR-mutated non-small cell lung cancer: A double-center, real-world experience
Presenter: Ziheng Wu
Session: Poster Display
Resources:
Abstract
492P - Penpulimab-based combination neoadjuvant/adjuvant therapy for patients with resectable locally advanced non-small cell lung cancer: Preliminary results from a phase II study (ALTER-L043)
Presenter: Changli Wang
Session: Poster Display
Resources:
Abstract
493P - The prognostic value of 4L lymph node dissection in left-sided operable non-small cell lung cancer: A systematic review and meta-analysis
Presenter: Lei Peng
Session: Poster Display
Resources:
Abstract
495P - Intrinsic STING of CD8+T cells regulates self-metabolic reprogramming and exerts anti-tumor effects
Presenter: Qiuli Xu
Session: Poster Display
Resources:
Abstract
496P - Fruquintinib plus sintilimab in patients (pts) with advanced non-small cell lung cancer (NSCLC) with PD-L1-positive expression: A multicenter, single-arm phase II study
Presenter: Shun Lu
Session: Poster Display
Resources:
Abstract