Dr. Pal on Cohort Findings of COSMIC-021 Trial in mCRPC

Sumanta K. Pal, MD, associate clinical professor, Department of Medical Oncology and Therapeutics Research, co-director, Kidney Cancer Program, medical oncologist, City of Hope, discusses the phase Ib results of cohort 6 from the COSMIC-021 trial (NCT03170960), which is enrolling patients with metastatic castration-resistant prostate cancer (mCRPC).

The COSMIC-021 trial is evaluating the combination of cabozantinib (Cabometyx) and atezolizumab (Tecentriq), which initially launched in a smaller number of malignancies, including prostate cancer, renal cell carcinoma, and bladder cancer, Pal explains. Now, the study has expanded to include additional malignancies, such as lung cancer, hepatocellular carcinoma, and triple-negative breast cancer, among others.

In 2019, results from the renal cell carcinoma cohort were presented, which demonstrated encouraging response rates with the combination. At the 2020 Genitourinary Cancers Symposium, data with the combination showcased its efficacy in patients with mCRPC, including those with high-risk clinical features. Cabozantinib plus atezolizumab elicited an overall response rate (ORR) of 32%, including 2 complete responses and 12 partial responses, in the overall cohort of patients with mCRPC. In those with visceral metastases and/or extra-pelvic lymph node metastases, the ORR was 33%.

These data are serving as the foundation for a phase III trial that is expected to launch soon, Pal concludes.

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