No improvement seen in disease progression or death, and increase seen in serious adverse events with atezolizumab + cabozantinib
By Elana Gotkine HealthDay Reporter
FRIDAY, June 9, 2023 (HealthDay News) — For patients with locally advanced or metastatic renal cell carcinoma with disease progression on or after immune checkpoint inhibitor treatment, the addition of atezolizumab to cabozantinib does not improve clinical outcomes, according to a study published online June 5 in The Lancet to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.
Sumanta Kumar Pal, M.D., from the City of Hope Comprehensive Cancer Center in Duarte, California, and colleagues conducted a randomized, open-label, phase 3 trial at 135 study sites in 15 countries involving patients with locally advanced or metastatic renal cell carcinoma whose disease had progressed with immune checkpoint inhibitors. Participants, aged 18 years or older, were randomly assigned to atezolizumab plus cabozantinib or cabozantinib alone (263 and 259, respectively) from July 28, 2020, to Dec. 27, 2021.
The researchers found that at data cutoff (Jan. 3, 2023), with a median follow-up of 15.2 months, 65 and 64 percent of patients receiving atezolizumab-cabozantinib and cabozantinib, respectively, had disease progression per central review or died. The median progression-free survival was 10.6 and 10.8 months with atezolizumab-cabozantinib and cabozantinib, respectively. Thirty-four percent of patients in each group died. Serious adverse events occurred in 48 and 33 percent of patients treated with atezolizumab-cabozantinib and cabozantinib, respectively; adverse events leading to death occurred in 6 and 4 percent, respectively.
“Our data do not support the addition of atezolizumab to targeted therapy beyond progression on previous checkpoint inhibition in patients with renal cell carcinoma, despite encouraging phase 2 data supporting this approach,” the authors write.
The study was funded by F. Hoffmann-La Roche (Roche is the parent company of Genentech, which manufactures atezolizumab) and Exelixis, which manufactures cabozantinib.
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