Vol 13, No 4 (2017)
Guidelines / Expert consensus
Published online: 2017-09-13
Cabozantinib for the treatment of renal cell carcinoma patients
DOI: 10.5603/OCP.2017.0019
Oncol Clin Pract 2017;13(4):147-155.
Abstract
Anti-angiogenesis is a key target of the first-line systemic therapy in renal cell carcinoma. Resistance to this therapy
ultimately occurs in almost every patient who requires subsequent treatment to manage disease progression.
Cabozantinib is a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor and additionally
blocking MET and AXL kinases, which are associated with tumour growth, proliferation, invasion, and resistance.
Cabozantinib has been shown to improve overall survival, progression-free survival, and objective response rate in
comparison to everolimus in patients with advanced renal cell carcinoma in the phase 3 METEOR study. It resulted
in the approval for use in the treatment of advanced renal cell carcinoma following prior vascular endothelial growth
factor (VEGF)-targeted therapy and contributed to a change of treatment guidelines, placing cabozantinib among
second-line therapy options. Herein we discuss the biological and clinical rationale behind cabozantinib use in
renal cell carcinoma therapy and its position in the rapidly developing renal cell carcinoma treatment landscape.
We outline current research and future directions for renal cell carcinoma therapy.
Keywords: anti-angiogenesiscabozantinibpractice guidelinesrenal cell carcinomatumour resistance
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