Effect of cabozantinib on bone metastasis

Cabozantinib (Cabozantinib) is a tyrosine kinase inhibitor, including MET, vascular endothelial growth factor receptor, and AXL. In the phase III METEOR trial, patients with advanced renal cell carcinoma (RCC) increased progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) after receiving vascular endothelial growth factor receptor-targeted therapy. Because bone metastases are associated with increased incidence in patients with renal cell carcinoma, bone-related outcomes were analyzed in METEOR.

For patients with bone metastases at baseline (cabotinib [n=77]; everolimus [n=65]), median PFS was 7.4 months with cabozantinib and 2.7 months with everolimus (hazard ratio, 0.33 [95% CI, 0.21-0.51]). Cabozantinib also had longer median OS (20.1 months vs. 12.1 months; hazard ratio, 0.54 [95% CI, 0.34-0.84]) and higher ORR per IRC (17% vs. 0%). The incidence of skeletal-related events was 23% in the cabozantinib group and 29% in the everolimus group, and the bone scan response rates were 20% and 10%, respectively. Cabozantinib also improved PFS, OS, and ORR in patients without bone metastases. Bone biomarker changes were greater in the cabozantinib group than in the everolimus group. The overall safety profile of cabozantinib and everolimus in patients with bone metastases was consistent with that observed in patients without bone metastases.

So based on this result. In patients with advanced renal cell carcinoma and bone metastases, cabozantinib treatment is associated with improved PFS, OS, and ORR compared with everolimus treatment and is a good treatment option for these patients. These significant improvements with cabozantinib were also observed in patients with bone and visceral metastases and in patients without bone metastases.