Efficacy and Effect of Cabozantinib on Bone Metastases in Treatment-naive Castration-resistant Prostate Cancer

Cabozantinib for the treatment of solid tumors: a systematic review

Background:

Cabozantinib is approved, in various settings, for the treatment of renal cell carcinoma, medullary thyroid cancer, and hepatocellular carcinoma, and it has been investigated for the treatment of other cancers. With the available evidence and the real-world performance of cabozantinib compared with clinical trial data, we performed a systematic review of cabozantinib monotherapy as treatment for solid tumors in adults.

Methods:

This study was designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and registered with PROSPERO (CRD42020144680). We searched for clinical and observational studies of cabozantinib monotherapy for solid tumors using Embase, MEDLINE, and Cochrane databases (October 2020), and screened relevant congress abstracts. Eligible studies reported clinical or safety outcomes, or biomarker data. Small studies (n < 25) and studies of cabozantinib combination therapies were excluded. Quality was assessed using National Institute for Health and Care Excellence methodology, and study characteristics were described qualitatively.

Results:

Of 2888 citations, 114 were included (52 randomized studies, 29 observational studies, 32 nonrandomized phase I or II studies or pilot trials, and 1 analysis of data from a randomized study and a nonrandomized study). Beyond approved indications, other tumors studied were castration-resistant prostate cancer, urothelial carcinoma, Ewing sarcoma, osteosarcoma, uveal melanoma, non-small-cell lung cancer, Merkel cell carcinoma, glioblastoma, pheochromocytomas and paragangliomas, cholangiocarcinoma, gastrointestinal stromal tumor, colorectal cancer, salivary gland cancer, carcinoid and pancreatic neuroendocrine tumors, and breast, endometrial and ovarian cancers. The most common adverse events were hypertension, diarrhea, and fatigue.

Conclusion:

The identified evidence demonstrates the positive efficacy/effectiveness of cabozantinib monotherapy in various solid tumor types, with safety findings being consistent with those observed with other VEGFR-targeting tyrosine kinase inhibitors. When available, real-world findings were consistent with the data reported from clinical trials. A limitation of this review is the high proportion of abstracts; however, this allowed us to capture the most up-to-date findings.

Tumor-Specificity Growth Factor Combined with Tumor Markers in Nuclear Medicine Imaging to Identify Prostate Cancer Osteonosus

Objective

This study has explored the application value of malignant tumor SPE growth factor (TSGF) combined with tumor markers (TM) (TSGF + TM) in nuclear medicine imaging to identify prostate cancer osteonosus (PCO).

Methods

A retrospective analysis for 70 patients with prostate cancer and bone disease admitted to our hospital was performed, 30 healthy persons in the same period were selected as the control group, and the advantages and disadvantages of various examinations were analyzed. All patients were diagnosed with PET whole body bone imaging. Suspicious lesions could be examined by MRI or CT. According to the results of imaging examination, patients were divided into 40 cases of malignant prostate cancer and 30 cases of benign prostate cancer. All the patients underwent 18F-FDG-PET imaging, alpha-fetoprotein (AFP), and TSGF + TM determination. The case diagnosis results were compared and analyzed, and the sensitivity (SEN), specificity (SPE), and accuracy (ACC) of various detection methods were calculated. The SEN, SPE, and ACC of positron emission tomography (PET) were 90.9%, 57.8%, and 81.2%, respectively; those of TM were 79.2%, 94.6%, and 69.8%, respectively; and those of TSGF + TM were 95.9%, 100%, and 97.3%, respectively. The accuracy of combined diagnosis of tumors can reach 100%. The AFP and TSGF levels of serum TM were compared and analyzed, and it was found that the benign lesion group and the malignant lesion group showed significant increases compared with the control group, and the difference between the malignant lesion group and the control group was obvious (P < 0.05). SGF combined with TM could obtain a more definite diagnosis in PCO.

Conclusion

TSGF + TM combined with 18F-FDG-PET imaging showed important clinical value to diagnose the PCO. The imaging accuracy of TSGF + TM combined with 18F-FDG-PET is 97.3%, and the specificity of tumor diagnosis is 100%. Therefore, the TSGF + TM applied in medical imaging and identification of PCO was worthy of clinical promotion.