Sumanta (Monty) K. Pal, MD of the City of Hope speaks about A randomized, multi-arm comparison of targeted therapies for advanced papillary renal cell carcinoma.
PORTLAND, OR-The small molecule inhibitor cabozantinib was found to be most effective in treating patients with metastatic papillary kidney cancer in a SWOG Cancer Research Network trial that tested three targeted drugs, results that are expected to change medical practice.
These results will be discussed on Feb. 13, 2021, at 1 p.m. at ASCO’s virtual 2021 Genitourinary Cancers Symposium. ET. The et. The results will be published in The Lancet simultaneously.
For metastatic papillary kidney cancer or metastatic pRCC, a rare subtype of kidney cancer, there are currently no successful therapies. One analysis of 38 patients showed that eight months after diagnosis was the average survival rate.
Sumanta Pal, MD, City of Hope’s clinical professor of medical oncology, a comprehensive cancer center, and a researcher at SWOG, a cancer clinical trials group sponsored by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH), said that there is hope for patients with metastatic papillary kidney cancer. MET gene mutations are a characteristic of this type of cancer, and new medicines that target the MET gene are available. Pal wanted to test three of them against the latest standard medication, sunitinib, a tyrosine receptor inhibitor.
Pal studied 147 qualifying patients with papillary kidney cancer in his S1500 report, the majority of whom had not undergone any previous treatment. One of four treatment classes, those who took sunitinib and those who took one of the three MET target medicines, cabozantinib, crizotinib, and savolitinib, were randomly assigned to patients.
Pal and his team decided to see how long it would take to spread or return patients to cancer, a metric known as progression-free survival. What they found: Patients receiving sunitinib had a median progression of 5.6 months before their cancer; patients receiving savolitinib and crizotinib had an average progression of much worse. Yet cabozantinib gave patients a median of 9.2 months prior to the progression of their cancer. In addition, 23 percent of patients had a substantial decrease in their cabozantinib tumor size. In comparison, with sunitinib, only 4 percent of patients saw this type of tumor response.
Building on the S1500 momentum, SWOG will lead the next crucial papillary kidney cancer study, one focusing on the possible synergies between targeted therapies such as cabozantinib and immune therapy. Pal will lead the research at the Huntsman Cancer Institute at the University of Utah with SWOG investigator Dr. Benjamin Maughan.
SWOG 1500, also referred to as PAPMET, was funded by NCI, designed and led under the leadership of Dr. Pal by the SWOG Cancer Research Network, and performed through the National Clinical Trials Network of NCI.
Via NCI grants CA180888, CA180819, CA180820, CA180821, CA180863, and CA180868, S1500 was also sponsored by the NIH; and in part by AstraZeneca plc/AB, Exelixis, Inc. and Pfizer, Inc. For the trial under each company’s Cooperative Research and Development Agreement with the NCI, the companies given savolitinib, cabozantinib, crizotinib and sunitinib, respectively.