Trial Outcomes & Findings for Neoadjuvant Cabozantinib in Treating Patients With Locally Advanced Kidney Cancer (NCT NCT04022343)

NCT ID: NCT04022343

Last Updated: 2026-01-05

Results Overview

Objective response rate will be evaluated using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) criteria. All tumor measurements must be recorded in centimeters. For target lesions, a complete response (CR) is defined as the disappearance of all target lesions. A partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter.

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

PHASE2

Target enrollment

22 participants

Primary outcome timeframe

At 12 weeks after cabozantinib dose

Results posted on

2026-01-05

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment (Cabozantinib)
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Overall Study
STARTED
22
Overall Study
COMPLETED
17
Overall Study
NOT COMPLETED
5

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Neoadjuvant Cabozantinib in Treating Patients With Locally Advanced Kidney Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment (Cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Age, Categorical
<=18 years
0 Participants
n=9667 Participants
Age, Categorical
Between 18 and 65 years
13 Participants
n=9667 Participants
Age, Categorical
>=65 years
4 Participants
n=9667 Participants
Age, Continuous
57 years
n=9667 Participants
Sex: Female, Male
Female
3 Participants
n=9667 Participants
Sex: Female, Male
Male
14 Participants
n=9667 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=9667 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
17 Participants
n=9667 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=9667 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=9667 Participants
Race (NIH/OMB)
Asian
0 Participants
n=9667 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants
n=9667 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=9667 Participants
Race (NIH/OMB)
White
14 Participants
n=9667 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=9667 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=9667 Participants
Region of Enrollment
United States
17 participants
n=9667 Participants

PRIMARY outcome

Timeframe: At 12 weeks after cabozantinib dose

Objective response rate will be evaluated using Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) criteria. All tumor measurements must be recorded in centimeters. For target lesions, a complete response (CR) is defined as the disappearance of all target lesions. A partial response (PR) is defined as at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Objective Response Rate (ORR)
Partial Response
6 Participants
Objective Response Rate (ORR)
Stable Disease
11 Participants

SECONDARY outcome

Timeframe: From time of surgery to first tumor recurrence or death, assessed up to 3 years

Disease-free survival will be defined as the interval between time of surgery and the first tumor recurrence or death. Patients will be censored at time of last follow-up. Disease-free survival will be estimated with the Kaplan-Meier method.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Disease-free Survival (DFS)
12 month survival rate
82.4 percentage of participants
Interval 54.7 to 93.9
Disease-free Survival (DFS)
24 month survival rate
76.5 percentage of participants
Interval 48.8 to 90.4

SECONDARY outcome

Timeframe: From time of surgery to death from any cause, assessed up to 3 years

For overall survival, death from any cause will be defined as the event. Patients will be censored at time of last follow-up. Overall survival will be estimated with the Kaplan-Meier method.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Overall Survival (OS)
12 month survival rate
94.1 percentage of participants
Interval 65.0 to 99.1
Overall Survival (OS)
24 month survival rate
88.2 percentage of participants
Interval 60.6 to 96.9

SECONDARY outcome

Timeframe: Baseline and weeks 6 and 12 after treatment initiation

Quality of life will be studied using the Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) questionnaire. The questionnaire consists of 19 statements that patients answer on a 0-4 scale ("Not at all" to "Very much"). Per the instrument's official scoring guidelines, items are then reverse scored as needed and summed to create a final score ranging from 0-76, where 76 indicates the best quality of life and 0 indicates the worst.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Baseline
60 score on a scale
Interval 54.6 to 65.4
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Week 6
48.6 score on a scale
Interval 43.2 to 54.1
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Week 12
48.5 score on a scale
Interval 43.4 to 53.6

SECONDARY outcome

Timeframe: Baseline and weeks 6 and 12 after treatment initiation

Quality of life will be studied using the Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) questionnaire. The questionnaire consists of 19 statements such as "I have a lack of energy" and "I have pain" which are answered on a scale of 0-4, with 0 being "Not at all" and 4 being "Very much." The scale is 0-76 (0 = worst QoL, 76 = best QoL).

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Baseline
64 score on a scale
Interval 55.0 to 67.0
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Week 6
51 score on a scale
Interval 38.0 to 55.0
Quality of Life Assessment: Functional Assessment of Cancer Therapy-Kidney Specific Index-19 (FKSI-19) Questionnaire
Week 12
48 score on a scale
Interval 43.0 to 57.0

SECONDARY outcome

Timeframe: Baseline and weeks 6 and 12 after treatment initiation

Frailty assessment will be studied using the Fried Frailty score. Domains to be assessed include shrinking, weakness, exhaustion, low activity, and slow walking speed. Scored on a total scale of 0-25 (from 5 variables, each 0-5). 0 = not frail, 25 = most frail.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=17 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Frailty Assessment
Baseline
1.18 score on a scale
Standard Deviation 1.33
Frailty Assessment
Week 6
1.82 score on a scale
Standard Deviation 1.47
Frailty Assessment
Week 12
2.06 score on a scale
Standard Deviation 1.39

SECONDARY outcome

Timeframe: Baseline and week 12 after treatment initiation

Sarcopenia assessment will be done by using baseline and week 12 scans via SliceOmatic version 5.0 by TomoVision program. Cross-sectional skeletal muscle area (SMA) at the L3 vertebra will be segmented to calculate the Skeletal Muscle Index (SMI = SMA cm² / height m²). Sarcopenia is defined as an SMI at or below the 25th percentile of age- and sex-specific reference values from the Fintelmann et al. (2024) Framingham Heart Study cohort.

Outcome measures

Outcome measures
Measure
Treatment (cabozantinib)
n=16 Participants
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Sarcopenia Assessment
Participants with Sarcopenia (baseline)
9 Participants
Sarcopenia Assessment
Participants with Sarcopenia (week12)
9 Participants

Adverse Events

Treatment (Cabozantinib)

Serious events: 4 serious events
Other events: 17 other events
Deaths: 3 deaths

Serious adverse events

Serious adverse events
Measure
Treatment (Cabozantinib)
n=17 participants at risk
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Vascular disorders
Vascular disorders - Other, specify
5.9%
1/17 • 3 years
Vascular disorders
Thromboembolic event
5.9%
1/17 • 3 years
Hepatobiliary disorders
Cholecystitis
5.9%
1/17 • 3 years
General disorders
Death
17.6%
3/17 • 3 years

Other adverse events

Other adverse events
Measure
Treatment (Cabozantinib)
n=17 participants at risk
Patients receive cabozantinib orally once daily for 12 weeks in the absence of disease progression or unacceptable toxicity. The assigned starting dose for cabozantinib is 60 mg/day. Two dose reduction levels of cabozantinib are permitted Cabozantinib: Given PO
Respiratory, thoracic and mediastinal disorders
Respiratory, thoracic and mediastinal disorders - Other, specify
5.9%
1/17 • 3 years
Metabolism and nutrition disorders
Hyperglycemia
5.9%
1/17 • 3 years
Hepatobiliary disorders
Hepatobiliary disorders - Other, specify
5.9%
1/17 • 3 years
Blood and lymphatic system disorders
Blood and lymphatic system disorders - Other, specify
5.9%
1/17 • 3 years
Investigations
GGT increased
5.9%
1/17 • 3 years
Renal and urinary disorders
Urinary frequency
5.9%
1/17 • 3 years
Psychiatric disorders
Insomnia
11.8%
2/17 • 3 years
Metabolism and nutrition disorders
Hyperkalemia
5.9%
1/17 • 3 years
Investigations
Hemoglobin increased
5.9%
1/17 • 3 years
Blood and lymphatic system disorders
Anemia
5.9%
1/17 • 3 years
Gastrointestinal disorders
Bloating
5.9%
1/17 • 3 years
Nervous system disorders
Dysgeusia
17.6%
3/17 • 3 years
Gastrointestinal disorders
Hemorrhoids
5.9%
1/17 • 3 years
Gastrointestinal disorders
Dry mouth
5.9%
1/17 • 3 years
Hepatobiliary disorders
Cholecystitis
5.9%
1/17 • 3 years
Hepatobiliary disorders
Gallbladder perforation
5.9%
1/17 • 3 years
Psychiatric disorders
Depression
5.9%
1/17 • 3 years
Respiratory, thoracic and mediastinal disorders
Voice alteration
11.8%
2/17 • 3 years
Gastrointestinal disorders
Abdominal pain
11.8%
2/17 • 3 years
Vascular disorders
Hypotension
5.9%
1/17 • 3 years
Investigations
Electrocardiogram QT corrected interval prolonged
5.9%
1/17 • 3 years
Nervous system disorders
Paresthesia
17.6%
3/17 • 3 years
Skin and subcutaneous tissue disorders
Skin hypopigmentation
5.9%
1/17 • 3 years
Cardiac disorders
Cardiac disorders - Other, specify
11.8%
2/17 • 3 years
General disorders
Edema limbs
5.9%
1/17 • 3 years
Gastrointestinal disorders
Oral pain
5.9%
1/17 • 3 years
Investigations
Investigations - Other, specify
5.9%
1/17 • 3 years
Musculoskeletal and connective tissue disorders
Pain in extremity
23.5%
4/17 • 3 years
Metabolism and nutrition disorders
Hypophosphatemia
17.6%
3/17 • 3 years
Nervous system disorders
Peripheral sensory neuropathy
5.9%
1/17 • 3 years
Vascular disorders
Thromboembolic event
17.6%
3/17 • 3 years
Gastrointestinal disorders
Oral dysesthesia
11.8%
2/17 • 3 years
Investigations
Weight loss
11.8%
2/17 • 3 years
Metabolism and nutrition disorders
Hyperphosphatemia
5.9%
1/17 • 3 years
Infections and infestations
Papulopustular rash
11.8%
2/17 • 3 years
Nervous system disorders
Dizziness
11.8%
2/17 • 3 years
Respiratory, thoracic and mediastinal disorders
Dyspnea
5.9%
1/17 • 3 years
Vascular disorders
Hot flashes
5.9%
1/17 • 3 years
Investigations
Creatinine increased
11.8%
2/17 • 3 years
Musculoskeletal and connective tissue disorders
Back pain
5.9%
1/17 • 3 years
Psychiatric disorders
Anxiety
17.6%
3/17 • 3 years
Gastrointestinal disorders
Nausea
52.9%
9/17 • 3 years
General disorders
Fever
5.9%
1/17 • 3 years
Metabolism and nutrition disorders
Hypomagnesemia
23.5%
4/17 • 3 years
Gastrointestinal disorders
Fecal incontinence
5.9%
1/17 • 3 years
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other, specify
23.5%
4/17 • 3 years
General disorders
Gait disturbance
5.9%
1/17 • 3 years
Gastrointestinal disorders
Gastroesophageal reflux disease
17.6%
3/17 • 3 years
Nervous system disorders
Headache
23.5%
4/17 • 3 years
Gastrointestinal disorders
Diarrhea
58.8%
10/17 • 3 years
Skin and subcutaneous tissue disorders
Palmar-plantar erythrodysesthesia syndrome
41.2%
7/17 • 3 years
Psychiatric disorders
Suicidal ideation
5.9%
1/17 • 3 years

Additional Information

Mehmet Asim Bilen, MD

Emory University

Phone: 404-778-1900

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place