Belzutifan: enhancing the blockade of angiogenesis in renal cell carcinoma
Mené sur 52 patients atteints d'un carcinome rénal à cellules claires de stade avancé (âge médian : 63 ans ; durée médiane de suivi : 24,6 mois), cet essai de phase II évalue l'efficacité, du point de vue du taux de réponse objective, et la toxicité d'un traitement combinant belzutifan (un inhibiteur de HIF-2alpha) et cabozantinib après l'échec d'une immunothérapie par anti-PD-1/PD-L1
In The Lancet Oncology, Toni K Choueiri and colleagues 1 report the findings from cohort 2 of a phase 2 trial of belzutifan plus cabozantinib in patients with renal cell carcinoma who had previously received an with one previous immune checkpoint inhibitor (28 [54%] of 52 patients enrolled) or immunotherapy and an anti-VEGF or anti-VEGFR tyrosine-kinase inhibitor (24 [46%]). The results were promising, with a confirmed objective response rate of 30·8% (95% CI 18·7–45·1). 1 The additional effect of belzutifan is highlighted by the indirect comparison with the phase 3 METEOR trial, 2 in which cabozatinib had an objective response rate of 17% (95% CI 13–22) in patients pretreated with tyrosine-kinase inhibitors. Moreover, in Choueiri and colleagues' study, the short median time to response (3·2 months [IQR 1·9–7·3]) and number of patients with a change from baseline in the diameter of target lesions (45 [87%]) are two endpoints that support the pivotal role of enhancing the blockade of angiogenesis to achieve satisfactory disease control.
The Lancet Oncology , commentaire, 2022