Comparative efficacy and safety of cabozantinib for malignant tumors: a systematic review and meta-analysis

ABSTRACT

Objectives

To provide a more comprehensive understanding of the efficacy and safety profile of cabozantinib versus placebo in malignant tumors, we conducted a systematic review and meta-analysis. This involved analyzing a collection of published randomized controlled trials to assess the outcomes.

Methods

We used RevMan5.3 software to evaluate the outcomes of the collected studies. The primary outcome we focused on was progression-free survival (PFS), and the secondary outcomes included overall survival (OS) and disease control rate (DCR).

Results

Our findings revealed that compared to placebo, cabozantinib significantly extended the PFS of patients [hazard ratios (HR) 0.37, 95% confidence intervals (CI): 0.32, 0.43, p < 0.00001]. Additionally, cabozantinib improved the OS of patients [HR 0.78, 95%CI: 0.68, 0.91, p = 0.002]. While it is important to note that cabozantinib was associated with a higher likelihood of causing digestive, cutaneous, and cardiovascular related adverse events [relative risk (RR) 4.40, 95% CI: 3.10, 6.25, p < 0.00001].

Conclusion

Based on our analysis, cabozantinib significantly prolonged the PFS and OS of patients with malignant tumors (p < 0.01). We recommend the use of cabozantinib in treating advanced malignant tumors. However, it is important to continuously monitor and manage the drug-related adverse events.

Registration

PROSPERO (No. CRD42023449261).

KEYWORDS:

• Cabozantinib
• malignant tumors
• efficacy
• safety
• meta-analysis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed they are a consultant for Exelixis and Ipsen. Another reviewer on this manuscript has disclosed they have received honorarium for consulting or advisory role at Amgen, Astellas, AstraZeneca, Bayer, BMS, Eisai, Ipsen, Janssen, Merck, MSD, Novartis, Pfizer, Roche. And has received research grants from Ipsen, Janssen, Gilead, MSD. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Author contributions

J Su. C Ni, J Zhang designed and wrote the manuscript, and Y Wu were responsible for conducting the literature search and data collection. The figures, tables, and data analysis for this study were performed by J Su and Z Cai. J Lu and S Lin played a crucial role in revising and improving the manuscript. Manuscript drafting and finalization and funds support were done by J Wang. All authors read and approved the final manuscript.

Availability of data and materials

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737140.2024.2337266.

Additional information

Funding

This paper was funded by the Construction Fund of Medical Key Disciplines of Hangzhou. Oncology Therapeutics (Joint Unit), platform code [OO20200385], Expense reimbursement [2020SJZDXK04] and by the Zhejiang Lin Shengyou famous Traditional Chinese Medicine expert inheritance studio project [GZS202002].