METEOR Trial Follow-up: Quality of Life in Metastatic RCC

Key Points

  • QOL was similar for the cabozantinib and everolimus groups.
  • Cabozantinib was associated with prolonged time to deterioration.

In a study reported in the Journal of Clinical Oncology, Cella et al found little difference in quality-of-life (QOL) outcomes between the cabozantinib (Cabometyx) and everolimus (Afinitor) groups in the phase III METEOR trial. The study investigated these treatments in patients with metastatic renal cell carcinoma (RCC). Cabozantinib was associated with improved time to deterioration.

Study Details

In the METEOR trial, 658 previously treated patients with advanced RCC were randomly assigned to receive cabozantinib or everolimus. Cabozantinib treatment was associated with improved progression-free survival, overall survival, and objective response rate.

QOL was assessed using the 19-item Functional Assessment of Cancer Therapy–Kidney Symptom Index (FKSI-19), the 5-level EuroQol (EQ-5D-5L), and the 9-item FKSI–Disease-Related Symptoms (FKSI-DRS), a subset of FKSI-19. Assessment was performed at baseline, every 4 weeks through week 25, every 8 weeks thereafter for the first year, and every 12 weeks thereafter. Time to deterioration was defined as the earlier of death, radiographic progressive disease, or ≥ 4-point decrease from baseline in FKSI-DRS.

QOL Outcomes

QOL questionnaire completion rates were ≥ 75% through week 48 in both groups. No differences over time between groups were observed for FKSI-19 total, FKSI-DRS, or EQ-5D outcomes.

Among individual FKSI-19 items, cabozantinib was associated with worse diarrhea and nausea, and everolimus was associated with worse shortness of breath. Cabozantinib was associated with improved time to deterioration (median = 5.5 vs 3.7 months, P < .001), with the improvement being most evident in patients with bone metastases (median = 5.6 vs 1.9 months, P < .001).

The investigators concluded, “In patients with advanced renal cell carcinoma, relative to everolimus, cabozantinib generally maintained QOL to a similar extent. Compared with everolimus, cabozantinib extended time to deterioration overall and markedly improved time to deterioration in patients with bone metastases.”

The study was supported by Exelixis.

David Cella, PhD, of the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, is the corresponding author for the Journal of Clinical Oncology article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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