Thomas A. Abrams, MD, senior physician, Dana-Farber Cancer Institute, assistant professor of medicine, Harvard Medical School, discusses the next steps for exploration of cabozantinib (Cabometyx) plus atezolizumab (Tecentriq) in the treatment of microsatellite stable (MSS) and mismatch repair proficient (MMRp) colorectal cancer (CRC).

The phase 1/2 COSMIC-021 (NCT03170960) trial examined the safety and efficacy of cabozantinib plus atezolizumab across multiple solid tumor types, including CRC.

While there are no immediate ramifications of the study, it does set the stage for the investigation of patients with 

 wild-type CRC who have already progressed on at least 1 line of therapy, Abrams says. A potential phase 2 trial could examine outcomes generated by the cabozantinib plus atezolizumab combination in this specific patient population, Abrams explains.

If this combination continues to elicit high levels of efficacy, designing a phase 3 study would be the next logical step, Abrams continues. However, conducting a phase 3 trial remains a long-term goal, Abrams concludes.

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Thomas A. Abrams, MD, discusses the next steps for exploration of cabozantinib plus atezolizumab in the treatment of microsatellite stable and mismatch repair proficient colorectal cancer.


Dr. Abrams on Next Steps for Cabozantinib/Atezolizumab Combo in MSS/MMRp CRC

Thomas A. Abrams, MD, senior physician, Dana-Farber Cancer Institute, assistant professor of medicine, Harvard Medical School, discusses the rationale for the ongoing phase 1/2 COSMIC-021 trial (NCT03170960) in microsatellite stable (MSS) and mismatch repair proficient colorectal cancer (CRC).

The development of combination regimens of checkpoint inhibitors and other agents for patients with MSS CRC has been an ongoing area of research, Abrams says. Although some data have emerged, the field of CRC is behind in terms of determining the full clinical utility of these agents.

Notably, preclinical data suggest that the TKI cabozantinib (Cabometyx) has the potential to induce responses with immunotherapy in patients with MSS CRC, Abrams explains.

As such, the COSMIC-021 trial is evaluating the combination of cabozantinib and atezolizumab (Tecentriq) in patients with advanced solid tumors. During the 2022 Gastrointestinal Cancers Symposium, the results of the CRC cohort evaluating this doublet will be presented, Abrams concludes.

Thomas A. Abrams, MD, discusses the rationale for the ongoing phase 1/2 COSMIC-021 trial in microsatellite stable and mismatch repair proficient colorectal cancer. 



Thomas A. Abrams, MD, Harvard Medical School

Articles

Dr. Abrams on Next Steps for Cabozantinib/Atezolizumab Combo in MSS/MMRp CRC

Dr. Abrams on the Rationale for the COSMIC-021 Trial in MSS/pMMR CRC