Cabozantinib Plus Immunotherapy Combinations in Metastatic Renal Cell and Urothelial Carcinoma

Abstract

Treatment options for metastatic renal cell carcinoma (mRCC) and metastatic urothelial carcinoma (mUC) have increased dramatically over the past decade. However, even when novel approaches have proven to be effective as monotherapy, many patients still develop progressive disease, and different strategies are needed to increase clinical response and quality of life. Strategies combining targeted therapy (TT) and immunotherapy (IO) have emerged as a way to shorten the gap between responders and nonresponders to monotherapy and have reported promising results. In this review, we discuss the current role of cabozantinib in combination with IO agents in the treatment of metastatic RCC and UC and go over future directions in the field.

Lay abstract

Treatment options for both advanced kidney and bladder cancers have increased significantly over the last decade. However, even when these new approaches have proven to be effective, many patients still experience disease progression. Therefore, different strategies are needed to increase the response to treatment and quality of life. Strategies combining therapies directed to reduce the tumor's blood supply (targeted therapies) and therapies that increase the ability of the body to recognize and attack tumor cells (immunotherapy) have emerged as a way to increase the effectiveness obtained when using these drugs on their own. In this review, we discuss the current role of cabozantinib, a targeted therapy, in combination with immune-based agents in the treatment of advanced kidney and bladder cancers and go over future directions in the field.

Keywords::

• biomarkers
• Cabozantinib
• combination therapy
• immunomodulatory
• immunotherapy
• Nivolumab
• quality of Life
• renal cell carcinoma
• targeted therapy
• urothelial carcinoma

Financial & competing interests disclosure

SK Pal reports consulting roles in Genentech, Aveo, Eisai, Roche, Pfizer, Novartis, Exelixis, Ipsen, Bristol Myers Squibb, Astellas Pharma, GlaxoSmithKline; honoraria from Novartis, Medivaton, Astellas Pharma; funding from Eisai, Pfizer, Bristol Myers Squibb, Aveo, Nektar Therapeutics, Exelixis, and QED. L Meza, J Malhotra and C Favorito have no disclosures. The authors have no other 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 apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

SK Pal reports consulting roles in Genentech, Aveo, Eisai, Roche, Pfizer, Novartis, Exelixis, Ipsen, Bristol Myers Squibb, Astellas Pharma, GlaxoSmithKline; honoraria from Novartis, Medivaton, Astellas Pharma; funding from Eisai, Pfizer, Bristol Myers Squibb, Aveo, Nektar Therapeutics, Exelixis, and QED. L Meza, J Malhotra and C Favorito have no disclosures. The authors have no other 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 apart from those disclosed.