Cabometyx for sarcoma – pro
Cabozantinib, an inhibitor of tyrosine kinases including MET, vascular endothelial growth factor receptors, and AXL, increased progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) in patients with advanced renal cell carcinoma (RCC) after previous vascular endothelial growth factor receptortargeted therapy in the phase III METEOR trial.Cabozantinib is currently the only drug that has improved PFS, objective RR and OS for patients with mRCC in a pivotal phase III trial after one or more prior VEGFR TKIs. Most recently, cabozantinib has been tested in the first-line setting for a subgroup of patients with mRCC, providing apparently exciting results, which in our opinion should be carefully considered before being translated into clinical practice. Cabozatiniib
There are several recent publications suggesting activity of cabozatinib in soft tissue sarcoma, but no larger prospective trials and the otinal line f therapy is not defined. The first phase II study of cabozantinib in soft-tissue sarcoma by Chen et al yielded several responses, including several subtypes such as alveolar soft-part sarcoma (ASPS) and myxoid liposarcoma. There is a trial: Cabozantinib for Adults With Advanced Soft Tissue Sarcoma, NCT01755195
Italiano A, Katz D, et al. Cabozantinib in patients with advanced osteosarcomas and Ewing sarcomas: a French Sarcoma Group (FSG)/US National Cancer Institute phase II collaborative study. Presented at: the ESMO 2018 Congress; Munich, Germany: October 19-23, 2018. Abstract LBA67.
Mukaihara K, Tanabe Y, Kubota D, et al. Cabozantinib and dastinib exert anti-tumor activity in alveolar soft part sarcoma. PLoS One. 2017;12(9):e0185321. Published 2017 Sep 25. doi:10.1371/journal.pone.0185321
B. Escudier et al, Cabozantinib, a New Standard of Care for Patients With Advanced Renal Cell Carcinoma and Bone Metastases? Subgroup Analysis of the METEOR TrialJournal of Clinical Oncology 36, no. 8 (March 2018) 765-772.