As reported in the Journal of Clinical Oncology by Barata et al, the final overall survival results of the phase II SWOG 1500 trial indicated no significant benefit with cabozantinib vs sunitinib in patients with advanced papillary renal cell carcinoma.
Study Details
In the open-label multicenter trial, 147 eligible patients who had received up to one previous therapy (excluding vascular endothelial growth factor–directed agents) were randomly assigned 1:1:1:1 to receive sunitinib (n = 46), cabozantinib (n = 44), crizotinib (n = 28), or savolitinib (n = 29); the crizotinib and savolitinib arms were closed early due to futility. In the primary analysis, cabozantinib significantly improved progression-free survival (9.0 vs 5.6 months), as well as objective response rate (23% vs 4%), compared with sunitinib.
Key Findings
Median follow-up for the current analysis was 17.5 months. Subsequent anticancer therapy was received by 39% of the cabozantinib group and 43% of the sunitinib group. Median overall survival was 21.5 months (95% confidence interval [CI] = 12.0–28.1 months) in the cabozantinib group vs 17.3 months (95% CI = 12.8–21.8 months) in the sunitinib group (hazard ratio = 0.83; 95% CI = 0.51–1.36, P = .46). Overall survival rates at 24 and 36 months were 50% vs 39% and 32% vs 28%. In the closed arms, median overall survival was 19.9 months in the crizotinib group and 11.7 months in the savolitinib group.
The investigators concluded: “[W]e observed no significant difference in [overall survival] across treatment arms. Although cabozantinib represents a well-supported option for advanced [papillary renal cell carcinoma], the lack of survival benefit underscores the need to develop novel therapies for this disease.”
Sumanta K. Pal, MD, of the City of Hope Comprehensive Cancer Center, Duarte, California, is the corresponding author for the Journal of Clinical Oncology article.
DISCLOSURE: The study was supported by grants from the National Cancer Institute. For full disclosures of the authors, visit ascopubs.org.
