UP-48 Real world evidence of patient compliance to cabozantinib for metastatic renal cell carcinoma: a single Canadian center experience
Thursday June 27, 2019 from

Jaehoon Kim, Canada

McMaster University


Real world evidence of patient compliance to cabozantinib for metastatic renal cell carcinoma: A single Canadian center experience

Jaehoon Kim1, Camilla Tajzler2, Anil Kapoor2.

1Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; 2Department of Urology, McMaster University, Hamilton, ON, Canada

Introduction: The diagnosis of kidney cancer is often incidental, with 17% of renal cell carcinomas (RCCs) presenting with distant metastases. Multicentre clinical trials, such as CABOSUN and METEOR, demonstrated efficacy of cabozantinib in metastatic RCC patients.[1][2] The associated toxicities of cabozantinib often limit patient adherence, which result in suboptimal antitumour activity. This study aimed to evaluate patient adherence to cabozantinib and outline the associated toxicities in daily clinical practice at a single cancer centre.

Method: A retrospective chart review of metastatic RCC patients at McMaster University between 2018 and 2020 that received cabozantinib at any-line therapy with at least 3 month follow-up. Outcomes included time to discontinuation, time to dose reduction, progression-free survival, and overall toxicity profile of cabozantinib.

Results: A total of 28 patients were evaluated (Fig. 1; mean ± SD; age = 59.4 ± 8.3 years) and the median time of exposure to cabozantinib was 8.1 months (IQR: 3.3 – 12.9). Cabozantinib was usually started at the full standard dose of 60 mg (82%) and half of the (54%) patients required dose reductions with the median time to first dose reduction at 6.1 months (Fig. 2; IQR: 3.5 - not yet reached). Seven (25%) patients required treatment discontinuations, with toxicity-induced causes including hypertension (n=2), PPES and thromboembolic event. Median progression-free survival was 12.8 months (Fig. 2; IQR: 9.1 – not yet reached). The incidences of previously seen toxicities were lower than clinical trials, except for higher incidences of asymptomatic transaminitis and hypothyroidism.

Conclusion: This study aimed to evaluate the role of cabozantinib-induced toxicities that predispose unwanted dose reductions. These findings provide a benchmark for clinicians to anticipate toxicities and manage them by responding to reversible adverse events in the real-world setting.


[1] Choueiri TK et al. Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial. Lancet Oncol. 2016 Jul;17(7):917-927.
[2] Choueiri TK et al. Cabozantinib Versus Sunitinib As Initial Targeted Therapy for Patients With Metastatic Renal Cell Carcinoma of Poor or Intermediate Risk: The Alliance A031203 CABOSUN Trial. J Clin Oncol. 2017 Feb 20;35(6):591-597.

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