Cabozantinib after prior checkpoint inhibitor therapy in patients with solid tumors: a systematic literature review
A partir d'une revue systématique de la littérature publiée jusqu'en mars 2021 (21 études), cette étude évalue l'efficacité et la toxicité du cabozantinib après un traitement par inhibiteurs de point de contrôle immunitaire, chez des patients atteints d'une tumeur solide
Introduction : We conducted a systematic literature review to identify evidence for cabozantinib activity in patients with solid tumors after prior checkpoint inhibitor (CPI) therapy. Methods : The review was conducted according to PRISMA guidelines and registered with PROSPERO(CRD42021259873). MEDLINE®, Embase, and the Cochrane Library were searched on 19 May2021 to identify publications reporting the efficacy/effectiveness and safety/tolerabilityof cabozantinib in patients with solid tumors who had received prior CPI-based therapy.Publications were screened by one reviewer with uncertainties resolved by a secondand/or the full author group. Risk of bias was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) for clinical trialsand the Newcastle–Ottawa Scale (NOS) for observational studies. Results : Of 669 publications screened, 21 were eligible: 18 reported data on renal cell carcinoma,and one each for hepatocellular carcinoma, metastatic urothelial carcinoma, and non-smallcell lung cancer. Of six trial publications, three reported moderate-quality evidenceand three low-quality evidence. Of 15 observational studies, NOS scores ranged from3 to 6, suggesting a high potential for uncertainty. The studies consistently reportedclinical activity for cabozantinib after CPI therapy, across treatment lines and tumortypes, with no new safety signals. The findings were limited by the quality and quantityof available data. Conclusion : Cabozantinib appears to have anti-tumor activity after prior CPI therapy in patients with solid tumors. Our results are driven largely by studies in reneal cell carcinaoma.Evidence from ongoing phase 3 trials is required to establish further the role ofcabozantinib after CPI therapy.