Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 278.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\29662541
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Ther+Adv+Urol
2018 ; 10
(3
): 109-123
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Cabozantinib in the treatment of advanced renal cell carcinoma in adults
following prior vascular endothelial growth factor targeted therapy: clinical
trial evidence and experience
#MMPMID29662541
Osanto S
; van der Hulle T
Ther Adv Urol
2018[Mar]; 10
(3
): 109-123
PMID29662541
show ga
Cabozantinib is an oral multitargeted tyrosine kinase inhibitor (TKI) that
potently inhibits MET and AXL, both associated with poor prognosis in renal cell
carcinoma (RCC), next to vascular endothelial growth factor receptor 2, KIT, FLT3
and RET. Chronic treatment with vascular endothelial growth factor receptor
(VEGFR)-targeting sunitinib upregulates MET and AXL in RCC, indicating that
cabozantinib may be particularly effective in patients with advanced RCC whose
disease progressed on prior VEGFR-targeted treatment. Cabozantinib (60 mg once
daily) has been investigated in comparison to everolimus (10 mg once daily) in a
phase III randomized controlled trial (RCT) in 658 patients with advanced RCC of
whom 71% had received one prior and 29% had received at least two prior lines of
VEGR-targeted therapy. This study demonstrated highly significant improved
progression-free survival of 7.4 months versus 3.9 months with a hazard ratio
(HR) of 0.51 [95% confidence interval (CI) 0.41-0.62] in favour of cabozantinib.
Cabozantinib also showed a superior overall survival of 21.4 months versus 16.5
months (HR 0.66; 95% CI 0.53-0.83). Objective response rate was higher in
cabozantinib-treated patients, 17% versus 3%. Clinical benefit was shown in all
subgroups of patients, including in patients with bone or visceral metastases.
The safety profile was acceptable with manageable side effects. Based on this
study, cabozantinib is a highly effective approved second-line treatment option
for patients with advanced RCC with a manageable toxicity profile. Other recently
approved second-line agents include checkpoint inhibitor nivolumab and
VEGF-targeting agent lenvatinib combined with everolimus. In the absence of
predictive markers as well as head-to-head comparisons of these three recently
approved treatments, the choice between these drugs in second-line treatment will
probably be made based on comorbidities, tolerability of previous treatment and
presence of high tumour burden with rapidly progressive disease. Future
pretreatment assessment of MET and AXL tumour aberration may aid clinicians to
make a rational choice between currently approved second-line treatment options.
free
free
free
