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<TEI>
<teiHeader>
<fileDesc>
<titleStmt>
<title xml:lang="en">Cabozantinib versus everolimus in advanced renal cell carcinoma</title>
<author>
<name sortKey="Choueiri, Toni K" sort="Choueiri, Toni K" uniqKey="Choueiri T" first="Toni K." last="Choueiri">Toni K. Choueiri</name>
</author>
<author>
<name sortKey="Escudier, Bernard" sort="Escudier, Bernard" uniqKey="Escudier B" first="Bernard" last="Escudier">Bernard Escudier</name>
</author>
<author>
<name sortKey="Powles, Thomas" sort="Powles, Thomas" uniqKey="Powles T" first="Thomas" last="Powles">Thomas Powles</name>
</author>
<author>
<name sortKey="Mainwaring, Paul" sort="Mainwaring, Paul" uniqKey="Mainwaring P" first="Paul" last="Mainwaring">Paul Mainwaring</name>
</author>
<author>
<name sortKey="Rini, Brian I" sort="Rini, Brian I" uniqKey="Rini B" first="Brian I." last="Rini">Brian I. Rini</name>
</author>
<author>
<name sortKey="Donskov, Frede" sort="Donskov, Frede" uniqKey="Donskov F" first="Frede" last="Donskov">Frede Donskov</name>
</author>
<author>
<name sortKey="Hammers, Hans" sort="Hammers, Hans" uniqKey="Hammers H" first="Hans" last="Hammers">Hans Hammers</name>
</author>
<author>
<name sortKey="Hutson, Thomas E" sort="Hutson, Thomas E" uniqKey="Hutson T" first="Thomas E." last="Hutson">Thomas E. Hutson</name>
</author>
<author>
<name sortKey="Lee, Jae Lyun" sort="Lee, Jae Lyun" uniqKey="Lee J" first="Jae-Lyun" last="Lee">Jae-Lyun Lee</name>
</author>
<author>
<name sortKey="Peltola, Katriina" sort="Peltola, Katriina" uniqKey="Peltola K" first="Katriina" last="Peltola">Katriina Peltola</name>
</author>
<author>
<name sortKey="Roth, Bruce J" sort="Roth, Bruce J" uniqKey="Roth B" first="Bruce J." last="Roth">Bruce J. Roth</name>
</author>
<author>
<name sortKey="Bjarnason, Georg A" sort="Bjarnason, Georg A" uniqKey="Bjarnason G" first="Georg A." last="Bjarnason">Georg A. Bjarnason</name>
</author>
<author>
<name sortKey="Geczi, Lajos" sort="Geczi, Lajos" uniqKey="Geczi L" first="Lajos" last="Géczi">Lajos Géczi</name>
</author>
<author>
<name sortKey="Keam, Bhumsuk" sort="Keam, Bhumsuk" uniqKey="Keam B" first="Bhumsuk" last="Keam">Bhumsuk Keam</name>
</author>
<author>
<name sortKey="Moroto, Pablo" sort="Moroto, Pablo" uniqKey="Moroto P" first="Pablo" last="Moroto">Pablo Moroto</name>
</author>
<author>
<name sortKey="Heng, Daniel Y C" sort="Heng, Daniel Y C" uniqKey="Heng D" first="Daniel Y. C." last="Heng">Daniel Y. C. Heng</name>
</author>
<author>
<name sortKey="Schmidinger, Manuela" sort="Schmidinger, Manuela" uniqKey="Schmidinger M" first="Manuela" last="Schmidinger">Manuela Schmidinger</name>
</author>
<author>
<name sortKey="Kantoff, Philip W" sort="Kantoff, Philip W" uniqKey="Kantoff P" first="Philip W." last="Kantoff">Philip W. Kantoff</name>
</author>
<author>
<name sortKey="Borgman, Anne" sort="Borgman, Anne" uniqKey="Borgman A" first="Anne" last="Borgman">Anne Borgman</name>
</author>
<author>
<name sortKey="Hessel, Colin" sort="Hessel, Colin" uniqKey="Hessel C" first="Colin" last="Hessel">Colin Hessel</name>
</author>
<author>
<name sortKey="Scheffold, Christian" sort="Scheffold, Christian" uniqKey="Scheffold C" first="Christian" last="Scheffold">Christian Scheffold</name>
</author>
<author>
<name sortKey="Schwab, Gisela M" sort="Schwab, Gisela M" uniqKey="Schwab G" first="Gisela M." last="Schwab">Gisela M. Schwab</name>
</author>
<author>
<name sortKey="Tannir, Nizar M" sort="Tannir, Nizar M" uniqKey="Tannir N" first="Nizar M." last="Tannir">Nizar M. Tannir</name>
</author>
<author>
<name sortKey="Motzer, Robert J" sort="Motzer, Robert J" uniqKey="Motzer R" first="Robert J." last="Motzer">Robert J. Motzer</name>
</author>
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<idno type="wicri:source">PMC</idno>
<idno type="pmid">26406150</idno>
<idno type="pmc">5024539</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5024539</idno>
<idno type="RBID">PMC:5024539</idno>
<idno type="doi">10.1056/NEJMoa1510016</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">001C82</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C82</idno>
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<title xml:lang="en" level="a" type="main">Cabozantinib versus everolimus in advanced renal cell carcinoma</title>
<author>
<name sortKey="Choueiri, Toni K" sort="Choueiri, Toni K" uniqKey="Choueiri T" first="Toni K." last="Choueiri">Toni K. Choueiri</name>
</author>
<author>
<name sortKey="Escudier, Bernard" sort="Escudier, Bernard" uniqKey="Escudier B" first="Bernard" last="Escudier">Bernard Escudier</name>
</author>
<author>
<name sortKey="Powles, Thomas" sort="Powles, Thomas" uniqKey="Powles T" first="Thomas" last="Powles">Thomas Powles</name>
</author>
<author>
<name sortKey="Mainwaring, Paul" sort="Mainwaring, Paul" uniqKey="Mainwaring P" first="Paul" last="Mainwaring">Paul Mainwaring</name>
</author>
<author>
<name sortKey="Rini, Brian I" sort="Rini, Brian I" uniqKey="Rini B" first="Brian I." last="Rini">Brian I. Rini</name>
</author>
<author>
<name sortKey="Donskov, Frede" sort="Donskov, Frede" uniqKey="Donskov F" first="Frede" last="Donskov">Frede Donskov</name>
</author>
<author>
<name sortKey="Hammers, Hans" sort="Hammers, Hans" uniqKey="Hammers H" first="Hans" last="Hammers">Hans Hammers</name>
</author>
<author>
<name sortKey="Hutson, Thomas E" sort="Hutson, Thomas E" uniqKey="Hutson T" first="Thomas E." last="Hutson">Thomas E. Hutson</name>
</author>
<author>
<name sortKey="Lee, Jae Lyun" sort="Lee, Jae Lyun" uniqKey="Lee J" first="Jae-Lyun" last="Lee">Jae-Lyun Lee</name>
</author>
<author>
<name sortKey="Peltola, Katriina" sort="Peltola, Katriina" uniqKey="Peltola K" first="Katriina" last="Peltola">Katriina Peltola</name>
</author>
<author>
<name sortKey="Roth, Bruce J" sort="Roth, Bruce J" uniqKey="Roth B" first="Bruce J." last="Roth">Bruce J. Roth</name>
</author>
<author>
<name sortKey="Bjarnason, Georg A" sort="Bjarnason, Georg A" uniqKey="Bjarnason G" first="Georg A." last="Bjarnason">Georg A. Bjarnason</name>
</author>
<author>
<name sortKey="Geczi, Lajos" sort="Geczi, Lajos" uniqKey="Geczi L" first="Lajos" last="Géczi">Lajos Géczi</name>
</author>
<author>
<name sortKey="Keam, Bhumsuk" sort="Keam, Bhumsuk" uniqKey="Keam B" first="Bhumsuk" last="Keam">Bhumsuk Keam</name>
</author>
<author>
<name sortKey="Moroto, Pablo" sort="Moroto, Pablo" uniqKey="Moroto P" first="Pablo" last="Moroto">Pablo Moroto</name>
</author>
<author>
<name sortKey="Heng, Daniel Y C" sort="Heng, Daniel Y C" uniqKey="Heng D" first="Daniel Y. C." last="Heng">Daniel Y. C. Heng</name>
</author>
<author>
<name sortKey="Schmidinger, Manuela" sort="Schmidinger, Manuela" uniqKey="Schmidinger M" first="Manuela" last="Schmidinger">Manuela Schmidinger</name>
</author>
<author>
<name sortKey="Kantoff, Philip W" sort="Kantoff, Philip W" uniqKey="Kantoff P" first="Philip W." last="Kantoff">Philip W. Kantoff</name>
</author>
<author>
<name sortKey="Borgman, Anne" sort="Borgman, Anne" uniqKey="Borgman A" first="Anne" last="Borgman">Anne Borgman</name>
</author>
<author>
<name sortKey="Hessel, Colin" sort="Hessel, Colin" uniqKey="Hessel C" first="Colin" last="Hessel">Colin Hessel</name>
</author>
<author>
<name sortKey="Scheffold, Christian" sort="Scheffold, Christian" uniqKey="Scheffold C" first="Christian" last="Scheffold">Christian Scheffold</name>
</author>
<author>
<name sortKey="Schwab, Gisela M" sort="Schwab, Gisela M" uniqKey="Schwab G" first="Gisela M." last="Schwab">Gisela M. Schwab</name>
</author>
<author>
<name sortKey="Tannir, Nizar M" sort="Tannir, Nizar M" uniqKey="Tannir N" first="Nizar M." last="Tannir">Nizar M. Tannir</name>
</author>
<author>
<name sortKey="Motzer, Robert J" sort="Motzer, Robert J" uniqKey="Motzer R" first="Robert J." last="Motzer">Robert J. Motzer</name>
</author>
</analytic>
<series>
<title level="j">The New England journal of medicine</title>
<idno type="ISSN">0028-4793</idno>
<idno type="eISSN">1533-4406</idno>
<imprint>
<date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc>
<textClass></textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<sec id="S1">
<title>Background</title>
<p id="P1">Cabozantinib is an oral small molecule tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor (VEGFR) as well as MET and AXL; each has been implicated in metastatic renal cell carcinoma (RCC) pathobiology or development of resistance to antiangiogenic drugs. This randomized open-label phase 3 trial evaluated the efficacy of cabozantinib compared to everolimus in RCC patients who progressed after VEGFR-targeted therapy.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">The trial randomized 658 patients to receive cabozantinib at a dose of 60 mg daily, or everolimus at a dose of 10 mg daily. The primary endpoint was progression-free survival. Secondary efficacy endpoints were overall survival and objective response rate.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">Median progression-free survival was 7.4 months with cabozantinib and 3.8 months with everolimus. The risk of progression or death was 42% lower with cabozantinib compared to everolimus (hazard ratio, 0.58; 95% confidence interval [CI] 0.45 to 0.75; P < 0.001). Objective response rates were 21% with cabozantinib and 5% with everolimus (P < 0.001). A planned interim analysis showed that overall survival was improved with cabozantinib (hazard ratio, 0.67; 95% CI, 0.51 to 0.89; P = 0.005) but did not cross the significance boundary. Adverse events (grade 3 or 4, regardless of causality) were reported in 74% of cabozantinib patients and 65% of everolimus patients. Discontinuation of study treatment for adverse events occurred in 9.1% of cabozantinib patients and 10% of everolimus patients.</p>
</sec>
<sec id="S4">
<title>Conclusions</title>
<p id="P4">Cabozantinib improved progression-free survival compared to everolimus in RCC patients who progressed after VEGFR-targeted therapy.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article">
<pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-journal-id">0255562</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5985</journal-id>
<journal-id journal-id-type="nlm-ta">N Engl J Med</journal-id>
<journal-id journal-id-type="iso-abbrev">N. Engl. J. Med.</journal-id>
<journal-title-group>
<journal-title>The New England journal of medicine</journal-title>
</journal-title-group>
<issn pub-type="ppub">0028-4793</issn>
<issn pub-type="epub">1533-4406</issn>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26406150</article-id>
<article-id pub-id-type="pmc">5024539</article-id>
<article-id pub-id-type="doi">10.1056/NEJMoa1510016</article-id>
<article-id pub-id-type="manuscript">NIHMS768250</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Cabozantinib versus everolimus in advanced renal cell carcinoma</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Choueiri</surname>
<given-names>Toni K.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A1">Dana Farber Cancer Institute, Boston, MA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Escudier</surname>
<given-names>Bernard</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A2">Institut Gustave Roussy, Villejuif, France</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Powles</surname>
<given-names>Thomas</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A3">Barts Cancer Institute, London, UK</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mainwaring</surname>
<given-names>Paul</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A4">ICON Cancer Care, South Brisbane, Australia</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Rini</surname>
<given-names>Brian I.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A5">Cleveland Clinic, Cleveland, OH</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Donskov</surname>
<given-names>Frede</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A6">Aarhus University Hospital, Aarhus, Denmark</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hammers</surname>
<given-names>Hans</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A7">Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hutson</surname>
<given-names>Thomas E.</given-names>
</name>
<degrees>D.O.</degrees>
<aff id="A8">Baylor Sammons Cancer Center–Texas Oncology, Dallas, TX</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lee</surname>
<given-names>Jae-Lyun</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A9">University of Ulsan College of Medicine, Seoul, Korea</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Peltola</surname>
<given-names>Katriina</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A10">Helsinki University Central Hospital Cancer Center, Helsinki, Finland</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Roth</surname>
<given-names>Bruce J.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A11">Washington University, St. Louis, MO</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Bjarnason</surname>
<given-names>Georg A.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A12">Sunnybrook Odette Cancer Centre, Toronto, Canada</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Géczi</surname>
<given-names>Lajos</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A13">National Institute of Oncology, Budapest, Hungary</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Keam</surname>
<given-names>Bhumsuk</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A14">Seoul National University Hospital, Seoul, Korea</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Moroto</surname>
<given-names>Pablo</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A15">Hospital de la Santa Creu i Sant Pau, Barcelona, Spain</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Heng</surname>
<given-names>Daniel Y. C.</given-names>
</name>
<degrees>M.D., M.P.H</degrees>
<aff id="A16">Tom Baker Cancer Centre, Calgary, Canada</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Schmidinger</surname>
<given-names>Manuela</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A17">Medical University of Vienna, Vienna, Austria</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kantoff</surname>
<given-names>Philip W.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A18">Dana Farber Cancer Institute, Boston, MA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Borgman</surname>
<given-names>Anne</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A19">Exelixis, Inc., South San Francisco, CA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hessel</surname>
<given-names>Colin</given-names>
</name>
<degrees>M.S.</degrees>
<aff id="A20">Exelixis, Inc., South San Francisco, CA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Scheffold</surname>
<given-names>Christian</given-names>
</name>
<degrees>M.D., Ph.D.</degrees>
<aff id="A21">Exelixis, Inc., South San Francisco, CA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Schwab</surname>
<given-names>Gisela M.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A22">Exelixis, Inc., South San Francisco, CA</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tannir</surname>
<given-names>Nizar M.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A23">University of Texas MD Anderson Cancer Center, Houston, TX</aff>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Motzer</surname>
<given-names>Robert J.</given-names>
</name>
<degrees>M.D.</degrees>
<aff id="A24">Memorial Sloan-Kettering Cancer Center, New York, NY</aff>
</contrib>
<contrib contrib-type="author">
<collab>for the METEOR Investigators</collab>
<xref rid="FN2" ref-type="author-notes">*</xref>
</contrib>
</contrib-group>
<author-notes>
<corresp id="FN1">
<bold>Corresponding author:</bold>
Toni K. Choueiri, M.D., 450 Brookline Ave. (DANA 1230), Boston, MA 02215, Phone: 617-632-5456, Fax: 617-632-2165,
<email>Toni_Choueiri@dfci.harvard.edu</email>
</corresp>
<fn id="FN2">
<label>*</label>
<p>A complete list of investigators in the METEOR trial is provided in the
<xref ref-type="supplementary-material" rid="SD1">Supplementary Appendix</xref>
.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>9</day>
<month>9</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>25</day>
<month>9</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub">
<day>5</day>
<month>11</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>15</day>
<month>9</month>
<year>2016</year>
</pub-date>
<volume>373</volume>
<issue>19</issue>
<fpage>1814</fpage>
<lpage>1823</lpage>
<pmc-comment>elocation-id from pubmed: 10.1056/NEJMoa1510016</pmc-comment>
<abstract>
<sec id="S1">
<title>Background</title>
<p id="P1">Cabozantinib is an oral small molecule tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor (VEGFR) as well as MET and AXL; each has been implicated in metastatic renal cell carcinoma (RCC) pathobiology or development of resistance to antiangiogenic drugs. This randomized open-label phase 3 trial evaluated the efficacy of cabozantinib compared to everolimus in RCC patients who progressed after VEGFR-targeted therapy.</p>
</sec>
<sec id="S2">
<title>Methods</title>
<p id="P2">The trial randomized 658 patients to receive cabozantinib at a dose of 60 mg daily, or everolimus at a dose of 10 mg daily. The primary endpoint was progression-free survival. Secondary efficacy endpoints were overall survival and objective response rate.</p>
</sec>
<sec id="S3">
<title>Results</title>
<p id="P3">Median progression-free survival was 7.4 months with cabozantinib and 3.8 months with everolimus. The risk of progression or death was 42% lower with cabozantinib compared to everolimus (hazard ratio, 0.58; 95% confidence interval [CI] 0.45 to 0.75; P < 0.001). Objective response rates were 21% with cabozantinib and 5% with everolimus (P < 0.001). A planned interim analysis showed that overall survival was improved with cabozantinib (hazard ratio, 0.67; 95% CI, 0.51 to 0.89; P = 0.005) but did not cross the significance boundary. Adverse events (grade 3 or 4, regardless of causality) were reported in 74% of cabozantinib patients and 65% of everolimus patients. Discontinuation of study treatment for adverse events occurred in 9.1% of cabozantinib patients and 10% of everolimus patients.</p>
</sec>
<sec id="S4">
<title>Conclusions</title>
<p id="P4">Cabozantinib improved progression-free survival compared to everolimus in RCC patients who progressed after VEGFR-targeted therapy.</p>
</sec>
</abstract>
</article-meta>
</front>
</pmc>
</record>

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