Journal
JOURNAL OF CLINICAL ONCOLOGY
Volume 36, Issue 8, Pages 757-+Publisher
AMER SOC CLINICAL ONCOLOGY
DOI: 10.1200/JCO.2017.75.2170
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Funding
- Exelixis (South San Francisco, CA)
- Memorial Sloan Kettering Cancer Center Support Grant/Core Grant [P30 CA008748]
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PurposeIn the phase III METEOR trial (ClinicalTrials.gov identifier: NCT01865747), 658 previously treated patients with advanced renal cell carcinoma were randomly assigned 1:1 to receive cabozantinib or everolimus. The cabozantinib arm had improved progression-free survival, overall survival, and objective response rate compared with everolimus. Changes in quality of life (QoL), an exploratory end point, are reported here.Patients and MethodsPatients completed the 19-item Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19) and the five-level EuroQol (EQ-5D-5L) questionnaires at baseline and throughout the study. The nine-item FKSI-Disease-Related Symptoms (FKSI-DRS), a subset of FKSI-19, was also investigated. Data were summarized descriptively and by repeated-measures analysis (for which a clinically relevant difference was an effect size 0.3). Time to deterioration (TTD) was defined as the earlier of date of death, radiographic progressive disease, or 4-point decrease from baseline in FKSI-DRS.ResultsThe QoL questionnaire completion rates remained 75% through week 48 in each arm. There was no difference over time for FKSI-19 Total, FKSI-DRS, or EQ-5D data between the cabozantinib and everolimus arms. Among the individual FKSI-19 items, cabozantinib was associated with worse diarrhea and nausea; everolimus was associated with worse shortness of breath. These differences are consistent with the adverse event profile of each drug. Cabozantinib improved TTD overall, with a marked improvement in patients with bone metastases at baseline.ConclusionIn patients with advanced renal cell carcinoma, relative to everolimus, cabozantinib generally maintained QoL to a similar extent. Compared with everolimus, cabozantinib extended TTD overall and markedly improved TTD in patients with bone metastases. (C) 2018 by American Society of Clinical Oncology
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