MedPath

Spanish Real-World Evidence Cabozantinib

Completed
Conditions
Renal Cell Carcinoma
Interventions
Registration Number
NCT04510688
Lead Sponsor
Spanish Oncology Genito-Urinary Group
Brief Summary

RCC (Renal Cell Carcinoma) is the most common form of kidney cancer, accounting for 2-3% of all adult malignancies and for 90% of all kidney cancers. The incidence of RCC has steadily increased over the past two decades, showing a plateau in recent years. Many patients with RCC remain asymptomatic until late disease stages and other patients have disease at diagnosis (metastatic RCC or mRCC).

Recently, the tyrosine kinase inhibitor (TKI) cabozantinib was approved as a first-line therapy for patients with advanced clear-cell RCC (ccRCC). Cabozantinib was initially approved for patients previously treated with antiangiogenic therapy based on the phase 3 METEOR study, which demonstrated a clinical benefit compared with everolimus.

Immunotherapy has been also developed in ccRCC.

The frontline treatment paradigm for ccRCC has evolved, particularly for intermediate-/poor-risk patients, with the recent addition of cabozantinib and nivolumab/ipilimumab (immunotherapy), but overall survival data are needed to understand their benefit-to-risk profiles compared with established therapies.

In October 2016, the Spanish Agency of medicines (AEMPS) granted the temporary Authorization for special use to Cabometyx® 20/40/60 mg within a Managed Access Program (MAP) for the treatment of advanced RCC in adults following prior VEGF-targeted therapy (Vascular Endothelial Growth Factor targeted therapy). The MAP allows the possibility of using a medicinal product which is not yet commercially available or approved. By the end of the MAP period, on July 2017, 136 patients had been included by 61 centers who received at least one dose of Cabometyx® for the treatment of advanced RCC.

Since then, Cabometyx® 20/40/60 mg was made commercially available for the treatment of advanced RCC in adults following prior VEGF-targeted therapy. After the commercialization of Cabometyx® in July 2017 in Spain, the inclusion of new patients in the MAP was closed but those patients that were already included continued receiving Cabometyx® free of charge until clinical decision. In July 2018, the European Commission approved a new indication for adult patients previously untreated with intermediate or poor risk.

Based on this rationale, the aim of this study is to obtain safety and effectiveness information regarding the use of cabozantinib in a non-selected RCC population, both in patients that received this agent under the MAP or under routine clinical prescription (real-world \[RW\]).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
275
Inclusion Criteria
  1. Male or females, aged 18 years or older.
  2. Diagnosis of advanced Renal Cell Carcinoma (RCC)
  3. Alive or dead patients at study initiation who received at least one dose of cabozantinib for the treatment of RCC between October 2016 and 1 st June 2019.
  4. Alive patients who agree to participate and signed the Informed Consent Form (ICF).
Exclusion Criteria
  1. Patients who decline consent.
  2. Patients whose hospital medical records are unavailable for review.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Managed Access Program (MAP) patientsCabozantinibPatients with RCC treated with cabozantinib under a Managed Access Program (MAP) prior to Cabometyx® marketing authorization
Real World (RW) patientsCabozantinibPatients with RCC treated with cabozantinib as routine clinical prescription (Real World), with treatment started after Cabometyx® marketing authorization
Primary Outcome Measures
NameTimeMethod
Incidence of Adverse ReactionsThrough study completion, an average of 2 years

Evaluation of the safety of cabozantinib by recording the incidence of adverse reactions in both MAP and RW cohorts.

Incidence of dose reductionsThrough study completion, an average of 2 years

Evaluation of the safety of cabozantinib by recording the incidence of dose reductions in both MAP and RW cohorts.

Incidence of temporary interruptions or discontinuationsThrough study completion, an average of 2 years

Evaluation of the safety of cabozantinib by recording the Incidence of temporary interruptions or discontinuations in both MAP and RW cohorts.

Incidence of use of medications to manage adverse reactionsThrough study completion, an average of 2 years

Evaluation of the safety of cabozantinib by recording the incidence of use of medications to manage adverse reactions in both MAP and RW cohorts.

Effectiveness: Progression-Free SurvivalThrough study completion, an average of 2 years

Evaluation of the effectiveness of cabozantinib in terms of investigator-assessed PFS (Progression-Free Survival) based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (32)

Hospital Son Llatzer

🇪🇸

Palma De Mallorca, Islas Baleares, Spain

Hospital Universitario Central de Asturias

🇪🇸

Oviedo, Asturias, Spain

Hospital Universitario Juan Ramón Jiménez

🇪🇸

Huelva, Andalucía, Spain

Hospital Clínic de Barcelona

🇪🇸

Barcelona, Spain

Complejo Hospitalario Universitario Ourense

🇪🇸

Ourense, Galicia, Spain

Hospital Universitario Lucus Augusti

🇪🇸

Lugo, Spain

Hospital Arnau de Vilanova

🇪🇸

Valencia, Spain

Hospital Universitario Alvaro Cunqueiro

🇪🇸

Vigo, Spain

Fundación Instituto Valenciano de Oncología

🇪🇸

Valencia, Spain

Hospital Universitario Reina Sofía

🇪🇸

Córdoba, Andalucía, Spain

Complejo Hospitalario de Jaén

🇪🇸

Jaén, Andalucía, Spain

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Catalonia, Spain

Hospital Universitario de León

🇪🇸

León, Castilla Y León, Spain

Consorci Corporació Sanitària Parc Taulí de Sabadell

🇪🇸

Sabadell, Catalunya, Spain

Hospital Universitari Parc Taulí

🇪🇸

Sabadell, Barcelona, Spain

Hospital Universitari Sant Joan de Reus

🇪🇸

Reus, Catalunya, Spain

Hospital Clínico Universitario de Valenica

🇪🇸

Valencia, Comunitat Valenciana, Spain

Hospital Universitari i Politècnic La Fe

🇪🇸

Valencia, Comunidad Valenciana, Spain

Hospital Universitari Dr. Peset

🇪🇸

Valencia, Comunitat Valenciana, Spain

Hospital Universitario de Badajoz

🇪🇸

Badajoz, Extremadura, Spain

Centro Oncológico de Galicia

🇪🇸

A Coruña, Galicia, Spain

Complejo Hospitalario Universitario de Ferrol

🇪🇸

Ferrol, Galicia, Spain

Hospital Universitari Son Espases

🇪🇸

Palma De Mallorca, Illes Ballears, Spain

Hospital Unviersitario de Gran Canaria Doctor Negrin

🇪🇸

Las Palmas De Gran Canaria, Islas Canarias, Spain

Hospital Universitario Nuestra Señora de Candelaria

🇪🇸

Santa Cruz De Tenerife, Islas Canarias, Spain

Hospital Universitari Vall D'Hebron

🇪🇸

Barcelona, Spain

Hospital Del Mar

🇪🇸

Barcelona, Spain

Hospital Universitario de Burgos

🇪🇸

Burgos, Spain

Hospital Provincial de Castellón

🇪🇸

Castellón De La Plana, Spain

Hospital General de Ciudad Real

🇪🇸

Ciudad Real, Spain

Hospital San Pedro de Alcántara

🇪🇸

Cáceres, Spain

Hospital Virgen de La Salud

🇪🇸

Toledo, Spain

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