Using a combination of Cabozantinib plus Nivolumab and Ipilimumab to treat Renal-Cell Carcinoma
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by An Duc Thien Le |
Posted on June 12th, 2023
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The immune checkpoint inhibitors, cabozantinib and nivolumab, are the first-line therapies for renal cell carcinoma; however, the effectiveness rate of these treatments can be suboptimal. Tyrosine kinase is a major signal transducer for various pathways that can benefit the tumor such as growth, angiogenesis, immunomodulation, and metastasis. Thus, it is an essential target for antitumor therapy. Cabozantinib is a tyrosine kinase inhibitor, and a study was conducted to assess its efficacy and safety when used with the immune checkpoint inhibitor to treat renal cell carcinoma.
The phase 3 clinical trial included 855 participants who were diagnosed with metastatic renal-cell carcinoma, which was confirmed with histology. These participants have an average age of approximately 60 years old and had experienced intermediate or poor prognosis, which was assessed using the Renal-Cell Carcinoma Database Consortium (IMDC) categories. These patients were randomly assigned to 2 treatment groups. Both groups were given nivolumab (3 mg per kilogram of body weight) and ipilimumab (1 mg per kilogram) intravenously every 3 weeks for four cycles. One group was given placebo, and the other was given one pill containing 40 mg of cabozantinib daily. After 1 year of follow-up, the researchers concluded that the addition of cabozantinib to the immune checkpoint inhibitors, cabozantinib and nivolumab, prevent progression in 27% more of the participants. In addition, the treatment group has much longer progression-free survival than the placebo. However, those participants who received cabozantinib plus cabozantinib and nivolumab experienced significantly more adverse events. To be specific, more of those in the experimental group experienced an elevated level of alanine aminotransferase and aspartate aminotransferase
The phase 3 clinical trial included 855 participants who were diagnosed with metastatic renal-cell carcinoma, which was confirmed with histology. These participants have an average age of approximately 60 years old and had experienced intermediate or poor prognosis, which was assessed using the Renal-Cell Carcinoma Database Consortium (IMDC) categories. These patients were randomly assigned to 2 treatment groups. Both groups were given nivolumab (3 mg per kilogram of body weight) and ipilimumab (1 mg per kilogram) intravenously every 3 weeks for four cycles. One group was given placebo, and the other was given one pill containing 40 mg of cabozantinib daily. After 1 year of follow-up, the researchers concluded that the addition of cabozantinib to the immune checkpoint inhibitors, cabozantinib and nivolumab, prevent progression in 27% more of the participants. In addition, the treatment group has much longer progression-free survival than the placebo. However, those participants who received cabozantinib plus cabozantinib and nivolumab experienced significantly more adverse events. To be specific, more of those in the experimental group experienced an elevated level of alanine aminotransferase and aspartate aminotransferase