Targeted drug shows activity against brain metastases in kidney cancer
BOSTON - A targeted drug has shown promising activity against brain metastases resulting from kidney cancer, achieving a 50 percent response rate, and supporting further studies of the drug in this patient group whose poor prognosis has created a significant unmet need.
The drug, cabozantinib, is a tyrosine kinase inhibitor that attacks several targets in cancer cells. It has been approved to treat advanced renal cell (kidney) cancer, but it has undergone very little testing in patients with brain metastases. Historically these patients are typically excluded from clinical trials out of concern for poor life expectancy and intervention tolerability. The new report in JAMA Oncology suggests that cabozantinib can potentially pass through the blood-brain barrier to reach the metastases, some of which shrank significantly, said senior author Toni Choueiri, MD, director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute.
The drug was tolerated in two cohorts of patients, amounting to 88 individuals with brain metastases from kidney cancer. Some patients also received local treatment with surgery or radiation, while others did not. Patients in one cohort survived for a median of 15 months, and 16 months in the other cohort.
Choueiri said that kidney cancer spreads to the brain in 2-10% of patients, causing significant morbidity and mortality, and the metastases are usually treated with surgery and/or radiation. Until now, systemic treatment with targeted drugs like sunitinib has proven relatively ineffective, and immunotherapy drugs have not shown much benefit either. "A lot of drugs that work well outside the brain don't work well for brain metastases," Choueiri noted.
https://jamanetwork.com/journals/jamaoncology/article-abstract/2784989?resultClick=1
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