Is There a Role for Cabozantinib in the First-Line Setting in Advanced RCC in Certain Populations?

Tian Zhang, MD: Dr Bilen, how comfortable are we using cabozantinib as a first-line treatment option, given the recent availability of adjuvant therapies in addition to cabozantinib in combination in the frontline setting?

Mehmet A. Bilen, MD: In general, cabozantinib has a broad data set, like in RCC [renal cell carcinoma]. First, was the METEOR trial in the salvage setting. Then, CABOSUN in the front-line setting. Most recently, CheckMate 9ER showed the efficacy of cabozantinib with immune checkpoint inhibitors. Thus, we know this agent is working in different lines. In addition, there are a number of real-world data also showing the effectiveness of cabozantinib plus VEGF plus I/O [immuno-oncology]. Because of this, cabozantinib is 1 agent we use after adjuvant immunotherapy.

Dr [David] Braun mentioned earlier that the type of failure from adjuvant immunotherapy is very important. If this is a failure that happened during, if this is a rapid failure, and if we see problem sites of metastases like the bone and liver, then this is 1 drug I use as a single agent or with immune checkpoint inhibitors.

This transcript has been edited for clarity.