Cabozantinib: A Miracle Cancer Drug without Survival Benefit

The FDA recently approved cabozantinib for use in medullary carcinoma.  What’s noteworthy about this drug is that it will likely be very expensive and that it does not, repeat does not improve the patients survival. 

Read the following for an extremely biased assessment of the drug’s efficacy: (likely from the drug companies PR info)

Below are some data showing Cometriq’s superiority over placebo:

  • Those on Cometriq survived 11.2 months (average) with no tumor growth
  • Patients in the placebo group survived 4 months (average) with no tumor growth
  • 27% of those in the placebo group experienced tumor reductions which lasted an average of almost 15 months
  • None of the participants in the placebo group experienced tumor reduction

What’s obscured in the above is that this drug results in 0 months increased longevity, that is, it had no effect on the longevity of the patients.

The ORR (overall remission rate:  Medicynical clarification) was significantly higher in the cabozantinib arm (27% versus 0%; p<0.0001) and all were partial responses.  The median response duration was 14.7 months (95% CI: 11.1, 19.3). No statistically significant difference in overall survival was observed between the treatment arms at the planned interim analysis and in an updated survival analysis requested by FDA.

Medicynical Note:  This is a new one for me.  Other new miracle agents often have limited efficacy with say two months median survival improvement.  But this is the first such drug being actively promoted, that I can recall, that has no survival benefit. 

Maybe this is yet another reason we spend more on health care than any other country in the world….by a wide margin. 

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