Identification of genomic drivers for the therapeutic response of Cabozantinib in patients with metastatic renal cell carcinoma

© 2024. The Author(s)..

PURPOSE: Cabozantinib (CAB) as monotherapy or in combination with immune checkpoint inhibitors is used for systemic treatment of metastatic renal cell carcinoma (mRCC). However, little is known about predictors of treatment response to CAB. For this reason, known genomic drivers were examined to identify potential predictors of treatment response with CAB.

METHODS: Twenty mRCC patients receiving monotherapy (≥ first-line) with CAB were prospectively included. DNA was extracted from archived primary tumors or metastatic tissue. Targeted DNA sequencing was performed using a gene panel including 328 genes (QIAseq Targeted DNA V3 Panel, Qiagen). The variant evaluation was performed using Varsome. The endpoints were treatment-failure-free-survival (TFFS) to CAB.

RESULTS: 26% of patients received systemic RCC treatment as the primary option. Six patients were treated with CAB in first-line (1L) and 12 patients in ≥ 2L. The median follow-up after initiation of systemic treatment was 26.7 months (mo). The PBRM1 (7 alleles), SETD2 (7 alleles), VHL (11 alleles), and CHEK2 (14 alleles) genes were most frequently altered. The median time to TFFS was 10.5 mo (95% confidence interval (CI) 6.2-14.7 mo). There was a longer treatment response to CAB in patients with alterations of the SETD2 gene (SETD2 alteration median TFFS not reached vs. no SETD2 alterations 8.4 mo (95% CI 5.2-11.6 mo); p = 0.024).

CONCLUSION: Pathogenic variant genes may indicate treatment response to systemic therapy in mRCC. Patients with alterations of the SETD2 gene show longer responses to CAB treatment.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:42

Enthalten in:

World journal of urology - 42(2024), 1 vom: 22. Feb., Seite 94

Sprache:

Englisch

Beteiligte Personen:

Borkowetz, Angelika [VerfasserIn]
Sommer, Ulrich [VerfasserIn]
Baretton, Gustavo [VerfasserIn]
Gruellich, Carsten [VerfasserIn]
Bürk, Björn Thorben [VerfasserIn]
Erb, Holger H H [VerfasserIn]
Thomas, Christian [VerfasserIn]
MORECAB Consortium [VerfasserIn]

Links:

Volltext

Themen:

1C39JW444G
9007-49-2
Anilides
Cabozantinib
DNA
Genomic alterations
Journal Article
Metastatic renal cell carcinoma
Pyridines

Anmerkungen:

Date Completed 23.02.2024

Date Revised 25.02.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1007/s00345-024-04783-y

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368761312