Dr. Pal on the Background of the COSMIC-021 Trial in ​Urothelial Cancer

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 background of the COSMIC-021 trial in urothelial cancer.

COSMIC-021 is an exciting multicenter, phase 1b study that was designed to enroll patients with genitourinary cancers, says Pal. Investigators began with 3 cohorts of patients ​with bladder cancer, kidney cancer, and prostate cancer. ​However, the ​trial was expanded ​to over 20 cohorts ​of patients.

Patients enrolled in the trial received a combination of cabozantinib (Cabometyx) and atezolizumab (Tecentriq).

In cohort ​2, investigators looked at a total of 30 patients ​with urothelial carcinoma who had received prior platinum-based chemotherapy, says Pal. Moreover, investigators found that 43%* of patients received greater than or equal to 2 ​or more prior lines of ​anti-cancer therapy. The fact that these patients were heavily pretreated should be taken into consideration when comparing the results from cohort 2 of the trial with other data sets regarding combinations of immunotherapy and targeted therapy, concludes Pal.