Abstract 4020
Background
Cabozantinib (CABO) is currently a standard of care as 2nd or 3rd line in metastatic renal cell carcinoma (mRCC). Previous studies showed that sarcopenia is generally linked with worse survival and/or higher toxicity in oncology. The aim is to evaluate its impact in mRCC patients (pt) treated with CABO.
Methods
Unicentric study of consecutive pt treated with CABO for mRCC from January 2014 to December 2018 and with available computed tomography images (CT). CT were centrally reviewed and axial L3 sections were used to measure the total muscle area and calculate skeletal muscle index (SMI, cm²/m²). Sarcopenia was defined as SMI lower than a sex-based threshold. Sarcopenic event-free survival was estimated from CABO start. Treatment-related toxicity (TRT), defined as dose reduction and/or treatment stop, was evaluated.
Results
Overall, 95 pts with median-follow-up of 15.4 months (mo) from CABO start were included. The median age was 61 (range 28-75) years, 71 (74.7%) pts had clear cell histology. IMDC group distribution: 11.7% good, 62.8% intermediate and 25.5% poor. CABO was administered in 1rd (3.2%), 2nd (30.5%), 3rd line (26.3%) and beyond (40.0%). At CABO start, median BMI was 24.7kg/m², median SMI was 46.6 with 61 (64.2%) sarcopenic pt. For non-sarcopenic pt at baseline (n = 34), 18 (52.9%) developed sarcopenia during treatment with a median sarcopenic event-free survival of 6.7 mo (95%CI 3.5-27.4). Overall, 79 (83.2%) pt experienced muscle mass loss during the treatment: the relative variation of muscle loss between baseline and worst value was ≤5% in 22.1%, ]5-10%] in 26.3%, ]10-20%] in 24.2% and >20% in 10.5%. The best response was CR (1.1%), PR (35.5%), SD (54.8%) and PD (8.6%). Median time-to-TRT was 2.5 mo (95%CI 2.1-3.3; 74.7% events) and median overall survival was 20.1 mo (95%CI 18.0-NE; 35.8% deaths). Both endpoints were not associated to sarcopenia at CABO start.
Conclusions
We reported the first cohort assessing sarcopenia in pt treated with CABO for mRCC. Baseline sarcopenia is underestimated in this setting. Furthermore, half of non-sarcopenic patients at baseline develop sarcopenia during treatment requiring physician awareness and interventional studies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Onco-urology department of Gustave Roussy.
Disclosure
E. Colomba: Travel / Accommodation / Expenses: BMS; Travel / Accommodation / Expenses: Ipsen; Travel / Accommodation / Expenses: PFIZER; Travel / Accommodation / Expenses: SANOFI. B. Escudier: Honoraria (self), Advisory / Consultancy: Pfizer; Honoraria (self), Advisory / Consultancy: BMS; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Ipsen; Honoraria (self), Advisory / Consultancy: Roche; Honoraria (self), Advisory / Consultancy: Oncorena. L. Albiges: Honoraria (institution), Advisory / Consultancy: Novartis; Honoraria (institution), Advisory / Consultancy: Bristol‐Myers Squibb; Honoraria (institution), Advisory / Consultancy: Merck; Honoraria (institution), Advisory / Consultancy: Roche; Honoraria (institution), Advisory / Consultancy: Pfizer; Honoraria (institution), Advisory / Consultancy: Amgen; Honoraria (institution), Advisory / Consultancy: Ipsen; Honoraria (institution), Advisory / Consultancy: Astellas Pharma. All other authors have declared no conflicts of interest.
Resources from the same session
5529 - Safety and efficacy of Ac-225-PSMA-617 in metastatic castration resistant prostate cancer (mCRPC) after failure of Lu-177-PSMA
Presenter: Robert Tauber
Session: Poster Display session 3
Resources:
Abstract
3611 - Phase II trial of SM 88 in Non-Metastatic Biochemical Recurrent Prostate Cancer.
Presenter: Benjamin Gartrell
Session: Poster Display session 3
Resources:
Abstract
2492 - A phase 1 study of Ad5 PSA/MUC-1/Brachyury Vaccine in Patients with Metastatic Castration Resistant Prostate Cancer (mCRPC)
Presenter: Marijo Bilusic
Session: Poster Display session 3
Resources:
Abstract
3142 - Multicenter Phase I Trial of a DNA Vaccine Encoding the Androgen Receptor Ligand Binding Domain (pTVG-AR, MVI-118) in Patients with Metastatic Prostate Cancer
Presenter: Douglas McNeel
Session: Poster Display session 3
Resources:
Abstract
4327 - Impact of germline mutations in Homologous Recombination (HR) genes on the response to Radium-223 for metastatic castration resistant prostate cancer (mCRPC)
Presenter: Elena Castro
Session: Poster Display session 3
Resources:
Abstract
3600 - Serum biomarkers of bone metabolism in metastatic castration-resistant prostate cancer (mCRPC) patients (pts) treated with Radium-223 (Ra223): Results from a prospective multicentre study
Presenter: Nuria Romero Laorden
Session: Poster Display session 3
Resources:
Abstract
3742 - Prognostic value of tumor suppression genes (TP53, PTEN, Rb) in metastatic hormone sensitive prostate cancer
Presenter: Miguel Gonzalez Velez
Session: Poster Display session 3
Resources:
Abstract
2643 - Germline sequencing of advanced prostate cancer patients in the BARCODE2 trial
Presenter: Sarah Benafif
Session: Poster Display session 3
Resources:
Abstract
4349 - Impact of treatment sequence in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): data from the prospective PROREPAIR-B study.
Presenter: Carlo Cattrini
Session: Poster Display session 3
Resources:
Abstract
3301 - Implications of Single Nucleotide Polymorphisms (SNPs) in Androgen Related-Genes in Outcome of metastatic castration-resistant prostate cancer (mCRPC) patients treated with Abiraterone (Abi) and Enzalutamide (Enza)
Presenter: Isabel Aragon
Session: Poster Display session 3
Resources:
Abstract