Cabometyx superior to Stivarga as second-line liver cancer treatment
September 24, 2019
Treatment with Cabometyx as second-line therapy for patients with advanced hepatocellular carcinoma who previously received Nexavar demonstrated superior progression-free and overall survival compared with Stivarga, according to a study presented at the International Liver Cancer Association 2019 meeting and a press release.
“Hepatocellular carcinoma is a devastating disease with only a few treatment options demonstrating survival benefits and many investigational drugs have failed to meet overall survival endpoints in clinical trials,” Katie Kelley, MD, study investigator from the University of California, San Francisco, said in the release. “[This] analysis brings further insight into the comparative effectiveness of the key second-line treatments for advanced hepatocellular carcinoma, particularly in relation to important endpoints like progression-free survival. These results may support clinicians in making informed treatment decisions in order to deliver optimal care for their patients.”
Kelly presented results from a matching-adjusted indirect comparison (MAIC) of Cabometyx (cabozantinib, Ipsen) vs. Stivarga (regorafenib, Bayer) for the second-line treatment after Nexavar (sorafenib, Bayer). Investigators used data from the phase 3 CELESTIAL and RESOURCE trials for the comparison.
In the CELESTIAL trial, cabozantinib improved median progression-free survival (5.2 vs. 1.9 months; 95% CI, 4-5.5) and median overall survival (10.2 vs. 8 months; 95% CI, 9.1-12) compared with placebo.
The comparison study matched patients by baseline characteristics including age, race, geographical region, Eastern Cooperative Oncology Group performance status, Child-Pugh class, duration of prior sorafenib treatment, extrahepatic disease, macrovascular invasion, etiology of HCC, and alpha-fetoprotein tumor marker levels. Results showed that cabozantinib improved progression-free survival (5.6 vs. 3.2 months; 95% CI, 4.9-7.26) and numerically improved median overall survival (11.4 vs. 10.8 months) compared with regorafenib.
“At Ipsen, our mission is to prolong and improve patients’ lives and health outcomes, and we acknowledge the importance of providing health care professionals with the best available evidence to achieve these goals for patients,” Yan Moore, MD, senior vice president and head of oncology therapeutic area at Ipsen, said in the release. “While alternative methodological approaches such as MAIC are not substitutes to evidence-based prospective clinical trials, it is important to recognize the need for further insights into the comparative effectiveness of current treatment approaches.” – by Talitha Bennett
在CELESTIAL试验中，与安慰剂相比，卡波替尼改善了无进展生存期的中位值（5.2 vs. 1.9个月； 95％CI，4-5.5）和中位总体生存期（10.2 vs. 8个月； 95％CI，9.1-12）。
对比研究通过基线特征匹配患者，包括年龄，种族地区，东部合作肿瘤小组的表现状态，Child-Pugh等级，索拉非尼先前治疗的持续时间，肝外疾病，大血管浸润，HCC病因和甲胎蛋白肿瘤标记物水平。结果显示，与雷戈非尼相比，卡巴替尼改善了无进展生存期（5.6 vs. 3.2个月； 95％CI，4.9-7.26），并在数值上改善了中位总体生存期（11.4 vs. 10.8个月）。
