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Comment & Response
March 3, 2022

Cabozantinib for Treatment of Brain Metastases in Patients With Renal Cell Carcinoma

Author Affiliations
  • 1Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
JAMA Oncol. 2022;8(5):783-784. doi:10.1001/jamaoncol.2022.0049

To the Editor Improving outcomes in patients with renal cell carcinoma (RCC) with brain metastases remains a major challenge.1 Systemic treatment should be considered a crucial component of care, considering that most of these patients will harbor distant metastases outside the central nervous system, and brain metastases at diagnosis confer a dismal prognosis.2 In JAMA Oncology, Hirsch and colleagues3 reported the results of a cohort study of cabozantinib for patients with RCC with progressing brain metastases without concomitant brain-directed local therapy (cohort A) or with stable or progressing brain metastases concomitantly treated by brain-directed local therapy (cohort B). Many objective partial responses in the brain were noted, and median overall survival was 15 months and 16 months in cohorts A and B, respectively. Although this was a relatively small cohort study, these data are relevant to clinical practice, and the trial by Hirsch et al3 represents an interesting piece of work in this setting.

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