Joel W. Neal, MD, PhD Discusses the Data on Cabozantinib and Atezolizumab Use in Advanced NSCLC


In terms of tumor control, treatment with cabozantinib and atezolizumab led to an overall response rate of 19% among patients with advanced non–small cell lung cancer, according to Joel W. Neal, MD, PhD.

Joel W. Neal, MD, PhD, a medical oncologist and associate professor of medicine at Stanford Cancer Institute, sat down with CancerNetwork® during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting to discuss key data from the phase 1b COSMIC-021 study (NCT03170960), assessing cabozantiniband atezolizumab (Tecentriq) in patients with advanced non-squamous non-small cell lung cancer (NSCLC). In addition to noting the encouraging clinical activity of the combination in this patient population, Neal highlighted that patients with an unknown PD-L1 status experienced a slightly higher response rate following treatment.


One interesting thing we looked at was the response rate [for] the combination of cabozantinib and atezolizumab; 19% of those 81 patients had tumors that responded. [Moreover], 76% of tumors actually had some degree of tumor shrinkage. We saw this as a very encouraging sign of clinical activity from the combination regimen.

Even though we didn't have PD-L1 status on all the tumors that were collected, of the PD-L1–negative tumors, there were lower response rates in the 10% range vs PD-L1–positive tumors. And most interesting to me, the PD-L1 unknown [tumors], the ones that hadn't been tested or [for which] we don't have central tissue to retest, actually had a slightly higher response rate and seemed to have better outcomes. There was some effect by PD-L1. It was interesting because I would have thought that the first-line use of immunotherapy would have minimized any effect from the PD-L1 being high or low.


Neal JW, Santoro A, Viteri A, et al. Cabozantinib (C) plus atezolizumab (A) or C alone in patients (pts) with advanced non–small cell lung cancer (aNSCLC) previously treated with an immune checkpoint inhibitor (ICI): results from Cohorts 7 and 20 of the COSMIC-021 study. J Clin Oncol 2022;40 (suppl 16):abstr9005. doi:10.1200/JCO.2022.40.16_suppl.9005

Related Videos
Robust genetic testing guidelines in the prostate cancer space must be supported by strong clinical research before they can be properly implemented, says William J. Catalona, MD.
Treatment with tisotumab vedotin may be a standard of care in second- or third-line recurrent or metastatic cervical cancer, says Brian Slomovitz, MD, MS, FACOG.
The difference in adverse effect profiles between sorafenib and nirogacestat may make one treatment more appealing than the other for certain patients with desmoid tumors, says Brian Van Tine, MD, PhD.
Experts on NSCLC
Experts on NSCLC
The Epione robot eliminates the need for multiple check scans during surgery by allowing physicians to target a tumor with a single button press, according to Govindarajan Narayanan, MD.
The Epione robot may help less experienced surgeons carry out complex cases with a high level of accuracy, says Govindarajan Narayanan, MD.
Domenica Lorusso, MD, PhD, says that paying attention to the quality of chemoradiotherapy is imperative to feeling confident about the potential addition of pembrolizumab for locally advanced cervical cancer.
Cell therapy and vaccine approaches are among the several potential options for targeting KRAS in patients with KRAS G12C–mutated non–small cell lung cancer, says Sandip P. Patel, MD.
Related Content