Results from #CONTACT03
Results from #CONTACT03 are out both @ASCO #ASCO23 and @TheLancet. The 1st phase 3 trial to assess the efficacy of rechallenge with anti-PDL1 in ANY cancer type. According to real world treatment patterns, IO (PD1/L1 inhibitors) rechallenge is common in pts w/ mRCC and other cancer types.
Toni Choueiri, MD
Senior Executive & Chief GU Cancers @DanaFarber; Prof Medicine @HarvardMed; 2021 Giants of Cancer Award ⚽ lover; 🚲@PanMass, seen on @msnbc @cnn @TODAYshow
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1/ Results from #CONTACT03 are out both @ASCO #ASCO23 and @TheLancet . The 1⃣st phase 3 trial to assess the efficacy of rechallenge with anti-PDL1 in ANY cancer type.
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
Kudos to @montypal, SC members, @roche, our patients, = for this phenomenal job. https://t.co/p7hYD4snXA pic.twitter.com/CXk1vqfB26 -
2/ According to real world treatment patterns, IO (PD1/L1 inhibitors) rechallenge is common in pts w/ mRCC and other cancer types.
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
But is this practice well-founded? -
3/ #CONTACT03 is a multicenter (135 sites from 15 countries), randomized, open-label, phase 3 trial
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
Inclusion criteria:
- Metastatic #RCC
- KPS >= 70
- Prior progression on anti-PD(L)1 (1L, 2L or adj) -
4/ Pts were randomized 1:1 to receive cabozantinib 60mg PO QD + atezolizumab 1200mg IV Q3W or cabozantinib alone
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
1ary endpoints: PFS (BICR), OS
2ary endpoints: PFS (investigator), ORR, DOR pic.twitter.com/aOc9nPWjhw -
5/ 522 pts were enrolled in the ITT: 263 atezo+cabo vs 259 cabo only
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
Median follow up was: 15.2 months (IQR 10.7-19.3)
Baseline characteristics can be found in the table below: pic.twitter.com/d0F5kaS8hP -
6/ PFS was not significantly different between the 2 grps: median 10·6 months for atezo+cabo vs 10·8 months for cabo
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
HR 1·03 (95% CI 0·83–1·28); p=0·78
No benefit seen in any subgroup! pic.twitter.com/2ndZ5eqbI5 -
7/ Similarly, there was no difference in OS between the 2 grps with 79% alive at 1y w/ atezo+cabo vs 76% w/ cabo alone
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
HR 0·94 (95% CI 0·70–1·27); p=0·69 pic.twitter.com/8uKdai7fXu -
8/ Similar ORR (50% vs 53%) and DOR (12.7 vs 14.8 months) were observed w/ atezo+cabo and cabo alone resp. pic.twitter.com/6JlmXYu08s
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023 -
9/ However, serious adverse events occurred in 48% of pts treated w/ atezo+cabo vs 33% w/ cabo alone
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
The following table displays the toxicity profile for each treatment arm: pic.twitter.com/T6OjZBjfaX -
10/ In conclusion, this the 1st ph3 clinical trial to show NO benefit of adding anti-PDL1 to targeted therapy beyond progression on PD1/L1 blockade, in patients with mRCC
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
Ongoing ph3 trials are testing the efficacy of IO rechallenge in other cancers including #HCC and #NSCLC -
11/ What about rechallenge with a PD1 inhibitor?
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023
Luckily, we have another trial to guide us ➡️ TiNivo-2
Check the design below: pic.twitter.com/xPZylbMnxL -
12/ Finally, huge thanks to all the investigators who made this trial possible, and to our patients and their families, to whom we dedicate all our efforts.
— Toni Choueiri, MD (@DrChoueiri) June 5, 2023