Dr. Hahn on the Investigation of Lenvatinib/Everolimus Vs Cabozantinib in mRCC

Andrew W. Hahn, MD, assistant professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the investigation of lenvatinib (Lenvima) plus everolimus (Afintor) vs cabozantinib (Cabometyx) in metastatic renal cell carcinoma (RCC) following progression on an immune checkpoint inhibitor.

The phase 2 LenCabo trial (NCT05012371) is evaluating lenvatinib plus everolimus vs cabozantinib monotherapy in patients with metastatic RCC who have progressed on a PD-1/PD-L1 immune checkpoint inhibitor and have received 1 to 2 lines of prior therapy.

In clinical practice, many patients receive cabozantinib as second-line therapy, and lenvatinib plus everolimus is typically administered as a third-line therapy, since lenvatinib has shown activity in patients who progress on cabozantinib, Hahn explains. Although cabozantinib and lenvatinib are both multitargeted TKIs, they have distinct mechanisms of action, Hahn adds.

The phase 2 study was initiated to compare lenvatinib plus everolimus vs cabozantinib monotherapy in a head-to-head trial that's designed to reflect contemporary practice, Hahn continues. Although the prevailing assumption is that the efficacy, toxicity, and impact on quality of life are similar between the 2 regimens, direct comparison in a prospective trial could shed additional light differences between them, Hahn concludes.