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Cabozantinib in Japanese patients with advanced hepatocellular carcinoma: Final results of a multicenter phase II study
Authors:Naoya Kato  Masatoshi Kudo  Kaoru Tsuchiya  Atsushi Hagihara  Kazushi Numata  Hiroshi Aikata  Yoshitaka Inaba  Shunsuke Kondo  Kenta Motomura  Naohiro Okano  Masafumi Ikeda  Manabu Morimoto  Shingo Kuroda  Akiko Kimura
Affiliation:1. Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan;2. Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan;3. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan;4. Department of Hepatology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan;5. Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan;6. Department of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima, Japan;7. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Japan;8. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan;9. Department of Hepatology, Iizuka Hospital, Iizuka, Japan;10. Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan;11. Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan;12. Department of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Kanagawa, Japan;13. Statistical and Quantitative Sciences, Data Science Institute, Takeda Pharmaceutical Company Limited, Osaka, Japan;14. Oncology Cell Therapy and Therapeutic Area Unit, Takeda Pharmaceutical Company Limited, Osaka, Japan
Abstract:

Aim

Cabozantinib showed a favorable benefit–risk profile in Japanese patients with advanced hepatocellular carcinoma (HCC) in an open-label, phase II study (NCT03586973). This analysis presents cumulative data to final database lock.

Methods

Patients with previously treated, advanced HCC received cabozantinib 60 mg/day. Progression-free survival (PFS) and tumor response rates in prior-sorafenib and sorafenib-naïve cohorts were assessed by independent radiology committee (IRC) and an investigator. Liver function was evaluated by albumin–bilirubin (ALBI) score.

Results

Median cabozantinib exposure was 5.6 months. In the prior-sorafenib cohort (n = 20), median PFS was 7.4 months per IRC assessment and 5.6 months per investigator assessment. In the sorafenib-naïve cohort (n = 14), median PFS was 3.6 and 4.4 months per IRC and investigator assessment, respectively. Six-month PFS rate per IRC and investigator assessment in the prior-sorafenib cohort was 59.8% and 49.5%, respectively, and in the sorafenib-naïve cohort was 16.7% and 35.7%, respectively. Disease control rate by both IRC and investigator assessment was 85.0% in the prior-sorafenib cohort and 64.3% in the sorafenib-naïve cohort. Median overall survival (Kaplan–Meier estimate) was 19.3 and 9.9 months in the prior-sorafenib and sorafenib-naïve cohort, respectively. Mean ALBI score remained relatively constant in patients able to continue treatment. The most frequent adverse events were palmar–plantar erythrodysesthesia syndrome, diarrhea, hypertension, and decreased appetite. No new safety concerns were identified.

Conclusions

Cabozantinib showed efficacy and a manageable safety profile in Japanese patients with advanced HCC.
Keywords:cabozantinib  carcinoma  hepatocellular  Japan  lenvatinib  protein kinase inhibitor  sorafenib
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