Experimental Renal Cell Carcinoma Combination Treatment Shows Promise in Early Trial

According to a story from Targeted Oncology, an experimental combination therapy tested on patients with advanced clear cell renal cell carcinoma (ccRCC) appeared to show potential for efficacy in a phase 1b clinical trial. The two drugs that were combined were atezolizumab (marketed as Tecentriq) and cabozantinib (marketed as Cabometyx).The findings from this study were presented at the European Society of Medical Oncology (ESMO) Virtual Congress this year.

About Renal Cell Carcinoma

Renal cell carcinoma is a cancer of the kidney that generally appears in the lining of the proximal convoluted tubule, a passage in the kidney that transports primary urine. Though generally considered rare, it is the most common type of kidney cancer to affect adults. Clear cell renal cell carcinoma is a form that primarily affects older males; the name refers to the appearance of the cells, which increase in number rapidly. There are several risk factors that increase a person’s likelihood of getting renal cell carcinoma, such as smoking, obesity, and high blood pressure. Other risk factors include long term use of NSAIDs, hysterectomy, certain genetic disorders, family history, and cystic disease of the kidney. This cancer rarely produces symptoms in its early stages, but when it has reached an advanced stage, symptoms may include flank pain, a noticeable abdominal mass, bloody urine, fatigue, fever, night sweats, weight loss and appetite loss, hypertension, and elevated calcium levels. To learn more about renal cell carcinoma, click here.

Study Results

Patients in the trial were divided into either a 40mg or 60mg dose (of cabozantinib) cohort. Meanwhile, all patients were given a 1200mg dose of atezolizumab. The objective response rate was 53 percent in the 40mg cohort and 58 percent in the 60mg cohort. One patient from the 40mg cohort had a complete response; four patients from 60mg cohort did. Only two patients in each group saw progression of their disease soon after receiving treatment. Median progression free survival was 19.5 months in the 40mg cohort and 15.1 months in the 60mg cohort.

Nearly all patients who received the combination experienced adverse effects as a result. These included weight loss, proteinuria, fatigue, nausea, diarrhea, hypothyroidism, decreased appetite, stomatitis, and more. Eight patients in the 40mg cohort and seven in the 60mg cohort ultimately had to halt the treatment because of the effects.

The findings show that this therapy could be helpful to these patients. Cabozantinib is now being tested in a phase 3 trial both on its own and in combination with atezolizumab in renal cell carcinoma patients that had previously been treated with immune checkpoint inhibitors.


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