Jorge A. Garcia, MD, Department of Hematology and Oncology, discusses the results of the randomized phase III METEOR trial, which compared the efficacy of cabozantinib (Cabometyx) versus everolimus (Afinitor) in patients with advanced renal cell carcinoma (RCC).

In the study, which led to the April 2016 FDA approval of cabozantinib for RCC, more than 600 patients were randomized to receive oral cabozantinb at 60 mg or everolimus at 10 mg daily. The primary endpoint was progression-free survival (PFS) with a secondary endpoint of overall survival (OS), Garcia explains.

Results showed that there was a significant PFS improvement in the patients who received cabozantinib versus everolimus, at 7.4 months and 3.9 months, respectively. The median OS was 21.4 months with cabozantinib and 16.5 months with everolimus. The objective response rate per independent review was 17% in the cabozantinib arm versus 3% in the everolimus arm. Subset analyses show that treatment with cabozantinib improves both PFS and OS, Garcia explains.

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Jorge A. Garcia, MD, Department of Hematology and Oncology, discusses the results of the phase III METEOR trial, which compared the efficacy of cabozantinib (Cabometyx) versus everolimus (Afinitor) in patients with advanced renal cell carcinoma.

Dr. Jorge Garcia on METEOR Trial for RCC

Jorge A. Garcia, MD, Department of Hematology and Oncology, Cleveland Clinic, discusses some of the challenges with immunotherapy in prostate cancer.

The only immunotherapy agent approved to treat prostate cancer is sipuleucel-T. Moreover, Garcia explains practitioners caution use of sipuleucel-T because it is unclear if it is an active agent, and there are challenges with identifying patients who may benefit from it.

Other challenges with sipuleucel-T include lack of the following: PSA response, response evaluation criteria in solid tumors (RECIST), bone scan improvement, and symptom improvement. However, Garcia says patients are likely to have a better outcome with sipulencel-T than without it.

The next step in overcoming some of these challenges, Garcia predicts, is using sipuleucel-T in combination with oral therapies, such as enzalutamide or abiraterone acetate with prednisone. This could help mitigate side effects without decreasing the efficacy of sipuleucel-T.

Data suggest patients who may benefit from sipuleucel-T are those with low-volume or indolent disease; however, this subset may change if sipuleucel-T is used in combination with other agents. 

Jorge A. Garcia, MD

Articles

Dr. Jorge Garcia on METEOR Trial for RCC

Dr. Garcia on Challenges With Immunotherapy in Prostate Cancer