Comparative efficacy and safety of cabozantinib for malignant tumors: a systematic review and meta-analysis

Expert Rev Anticancer Ther. 2024 May;24(5):293-302. doi: 10.1080/14737140.2024.2337266. Epub 2024 Apr 1.

Abstract

Objectives: To provide a more comprehensive understanding of the efficacy and safety profile of cabozantinib versus placebo in malignant tumors, we conducted a systematic review and meta-analysis. This involved analyzing a collection of published randomized controlled trials to assess the outcomes.

Methods: We used RevMan5.3 software to evaluate the outcomes of the collected studies. The primary outcome we focused on was progression-free survival (PFS), and the secondary outcomes included overall survival (OS) and disease control rate (DCR).

Results: Our findings revealed that compared to placebo, cabozantinib significantly extended the PFS of patients [hazard ratios (HR) 0.37, 95% confidence intervals (CI): 0.32, 0.43, p < 0.00001]. Additionally, cabozantinib improved the OS of patients [HR 0.78, 95%CI: 0.68, 0.91, p = 0.002]. While it is important to note that cabozantinib was associated with a higher likelihood of causing digestive, cutaneous, and cardiovascular related adverse events [relative risk (RR) 4.40, 95% CI: 3.10, 6.25, p < 0.00001].

Conclusion: Based on our analysis, cabozantinib significantly prolonged the PFS and OS of patients with malignant tumors (p < 0.01). We recommend the use of cabozantinib in treating advanced malignant tumors. However, it is important to continuously monitor and manage the drug-related adverse events.

Registration: PROSPERO (No. CRD42023449261).

Keywords: Cabozantinib; efficacy; malignant tumors; meta-analysis; safety.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anilides* / administration & dosage
  • Anilides* / adverse effects
  • Anilides* / pharmacology
  • Antineoplastic Agents* / administration & dosage
  • Antineoplastic Agents* / adverse effects
  • Antineoplastic Agents* / pharmacology
  • Disease-Free Survival
  • Humans
  • Neoplasms* / drug therapy
  • Neoplasms* / pathology
  • Progression-Free Survival*
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / pharmacology
  • Pyridines* / administration & dosage
  • Pyridines* / adverse effects
  • Pyridines* / pharmacology
  • Randomized Controlled Trials as Topic*
  • Survival Rate

Substances

  • cabozantinib
  • Pyridines
  • Anilides
  • Antineoplastic Agents
  • Protein Kinase Inhibitors