RTP On Demand — Head & Neck/Thyroid | Research To PracticeEXAM Phase III study of cabozantinib in progressive medullary thyroid cancer
1:58 minutes.
TRANSCRIPTION:
DR COHEN: The data there were primarily focused on the updated overall survival in the medullary thyroid cancer trial with cabozantinib. And what we began to see in overall survival is that the curves are beginning to separate but not separating enough to reach statistical significance. And that likely is related to patients getting subsequent therapy. But in a subset analysis looking at mutations, it’s becoming abundantly clear that patients with the most common mutation in RET, the M918T mutation, which, incidentally, is also associated with a worse prognosis for medullary thyroid cancer patients, appeared to be the ones who have a dramatic benefit and perhaps the most benefit from cabozantinib, most benefit with respect to progression-free survival, but also, in that group of patients, a statistically significant difference in overall survival. Now, I’m not suggesting that we need to necessarily test patients or do a mutational profiling and decide if they should get cabozantinib or not, because irrespective of mutation status, patients appear to benefit with respect to progression-free survival. But I would say that, if we are aware of a patient with the M918T mutation, those are patients who I would definitely treat with a TKI, probably lean toward treating with cabozantinib, because of the dramatic difference that we see in overall survival in that group of patients. So it may influence my management a little bit. But I have to say that it was really, really striking how those patients appeared to benefit from the drug. |