Cabozantinib in 2^nd line of therapy after first-line sunitinib failure: a 4-year durable response in a patient with multifocal visceral renal cell carcinoma metastases (clinical observation)

Renal cell carcinoma (RCC) remains one of the leading oncological pathologies. A feature of the epidemiology of RCC is its predominant prevalence both in the morbidity structure of the elderly (60 years and older) (3.7 %) and in the young age group of 30–59 years (4.5 %).

In the present rare clinical observation of a patient with a late recurrence of RCC 10 years after nephrectomy, salvage surgical treatment (metastasectomy), rapid progression on first-line sunitinib targeted therapy and subsequent long-term durable tumor response to targeted therapy with multikinase inhibitor cabozantinib.

In this observation of a patient with multifocal visceral metastases in the 2^nd line, stabilization of disease was achieved during 4 years cabozantinib monotherapy, treatment continues to the present. Despite the extremely long continuous intake of cabozantinib at full dose and patient’s morbidity, no dose reduction or temporary breaks in therapy were required. Patient tolerates treatment satisfactorily with controlled adverse events – II grade drug-induced steatohepatitis with moderate cytolysis syndrome, I grade toxic dermatitis, I grade nause. Patient’s quality of life is preserved.