Patients with an advanced form of kidney cancer had similar quality of life outcomes taking a drug called cabozantinib as those who received the standard treatment, everolimus, according to a new Northwestern Medicine study. The findings were published in the Journal of Clinical Oncology.
Cabozantinib was approved by the FDA in 2016 for previously treated patients with advanced renal cell carcinoma, the most common kidney cancer in adults. The drug had been shown to improve key clinical outcomes in patients—including the response rate and progression-free survival—compared to everolimus. But it was not known what impact the drug had on patients' quality of life.
"It is very common these days to see a new and exciting cancer therapy come along. Often, those new therapies increase the proportion of people whose measurable tumors shrink or delay the average time it takes for the cancer to progress, but they do not necessarily lengthen life itself," said lead author David Cella, Ph.D., the Ralph Seal Paffenbarger Professor and chair of Medical Social Sciences. "In these cases, it becomes critically important to know if those clinical benefits are associated with better quality of life, or worse quality of life, compared to standard available therapy."
In the current study, the investigators assessed quality of life outcomes—such as treatment side effects, disease-related symptoms and overall well-being—in patients with advanced renal cell carcinoma undergoing treatment with either cabozantinib or everolimus.
In the trial, 658 patients with advanced renal cell carcinoma, who had all experienced disease progression despite previous treatment, were randomized to receive one of the two therapies.
Participants then completed a series of questionnaires at baseline and throughout the study about various measures of their quality of life.
The findings demonstrated that although side effects of the two treatments differed, there was no overall difference in quality of life between the two groups.
Still, even though patients who received cabozantinib did not necessarily live any better than those treated with everolimus, cabozantinib did extend overall time to deterioration—indicating that patients lived longer with a stable quality of life prior to seeing their cancer progress, when compared to everolimus.
"In this regard, the quality of life data support the superiority of cabozantinib over everolimus among people whose kidney cancer has progressed rapidly on prior therapy," Cella said.
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David Cella et al. Quality of Life Outcomes for Cabozantinib Versus Everolimus in Patients With Metastatic Renal Cell Carcinoma: METEOR Phase III Randomized Trial, Journal of Clinical Oncology (2018). DOI: 10.1200/JCO.2017.75.2170