Results we already knew about for cabozantinib in mCRPC

Back in September 2014, Exelixis had announced (and we had reported) the failure of the COMET-1 trial to show a meaningful survival benefit for treatment with cabozantinib in men with metastatic, castration-resistant prostate cancer (mCRPC).

The final results of the COMET-1 trial have just been reported by Smith et al. in the Journal of Clinical Oncology, and newer readers could easily have been led to think that this was a “new” failure of an important investigational drug in the treatment of advanced prostate cancer. That is not the case.

Cabozantinib actually failed to show clinical benefit in two randomized Phase III clinical trials in advanced forms of prostate cancer (the COMET-1 and COMET-2 trials). We knew of these failures to show meaningful clinical effect in both trials by December 2014. It can just take time for the final results of trials like this to actually get published.

Development of cabozantinib as a possible drug for the treatment of late0stage prostate cancer ceased in late 2014, but the drug has shown activity in some other forms of cancer, and is marketed as Cometriq here in the USA for the treatment of patients with metastatic medullary thyroid cancer.

2 Responses

  1. Wondering how many failing drugs would actually succeed if targeted to patients with the right genes. I suspect that research leaders are thinking about that, but their attention may be glued to more pressing concerns.

  2. Dear Jim:

    I suspect that almost every drug now at any stage of development for the treatment of advanced forms of prostate cancer is being tested to see if it can be targeted to certain genetic subtypes of prostate cancer. However, the genetic subtype of a cancer is only one of the factors that can be considered as a predisposing factor as to whether a particular drug may work in that cancer (and how effectively and safely). Please do not make the mistake of thinking that the genetic category of a particular cancer is the only factor that will affect whether a particular cancer works well. That is not the case at all.

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