Cabozantinib (Cabometyx) for the follow-up treatment of advanced renal cell cancer

In 2018 the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether cabozantinib (trade name: Cabometyx) offers advantages or disadvantages for adults who have had treatment before when compared with the standard treatments. The drug manufacturer submitted one relevant study to IQWiG. This study only involved patients who had already had treatment aimed at the vascular endothelial growth factor (VEGF).

The study involved 658 people. Half of the patients received cabozantinib, the other half had treatment with everolimus. The study showed the following results for them:

What are the advantages of cabozantinib?

  • Life expectancy: The study suggests that treatment with cabozantinib can prolong life more than everolimus. Half of the patients who received cabozantinib died after about 21 months. This happened after only about 17 months in the group that had treatment with everolimus.
  • Anemia and pneumonia: The study suggests that cabozantinib has an advantage for these side effects.

What are the disadvantages of cabozantinib?

  • Serious side effects: The study suggests that cabozantinib has a disadvantage here: In half the participants who had treatment with cabozantinib serious side effects already occurred after about 2 months, while it took about 4 months with everolimus. The study suggests that Cabozantinib has a disadvantage in terms of diarrhea, too: While half the participants who received cabozantinib experienced diarrhea already within about 2 months, the same was the case with everolimus only after almost 23 months.
  • High blood pressure and hand-foot syndrome: The study suggests that cabozantinib has a disadvantage in terms of these side effects, too.

No difference

There was no discernible difference between the treatments in terms of symptoms of the disease, general health, and stopping treatment.

What remains unanswered?

The manufacturer didn't provide any suitable data about health-related quality of life.