Cabozantinib is a molecule already used in the treatment of advanced renal cell cancer that now promises to give results in some cases of thyroid cancer as well. To test this hypothesis, two pharmaceutical companies, Ipsen and Exelixis, have decided to collaborate and advance the phase 3 study called COSMIC-311. Potential patients have differentiated thyroid carcinoma that is unresponsive to progressing RAI after up to two previous lines of therapy with vascular endothelial growth factor receptor (VEGFR) targeted drugs. RAI treatment is used when patients have a high risk of disease recurrence, incomplete tumor removal or distant metastasis. Patients with radioiodine-refractory differentiated thyroid cancer, therefore resistant to radioiodine treatment, usually have a poor prognosis with an estimated average survival of three to five years.
The results of the planned interim analysis of the COSMIC-311 study – which will be presented at the next annual meeting of the American Society of Clinical Oncology (ASCO) in early June – showed that the co-primary endpoint that confirms the significant improvement in progression-free survival. Results that confirm the decision taken in February 2021 by the US Food and Drug Administration to designate cabozantinib as an innovative therapy and potential treatment for this type of patients.
[Radioiodine-refractorydifferentiatedthyroidcarcinoma
In 2020, more than 580,000 new cases of thyroid cancer were diagnosed worldwide. Thyroid cancer is the ninth most common cancer globally and its incidence is three times higher in women than in men, accounting for one in 20 cancer diagnoses among women. Thyroid cancers include differentiated, medullary and anaplastic forms. Differentiated thyroid cancers make up about 90-95% of thyroid cancers; include papillary, follicular and Hürthle cell forms. Differentiated thyroid cancer is commonly treated with surgery, followed by radioiodine ablation of residual thyroid tissue, but approximately 5-15% of cases are resistant to RAI treatment. Patients with radioiodine-refractory differentiated thyroid cancer have a poor prognosis with an estimated average survival of three to five years.
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