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Analysis of the Efficacy and Safety of Cabozantinib Monotherapy Versus Its Combination with Atezolizumab in Cancer Patients: A Systematic Review and Meta-Analysis

Cancer Control. 2025 Jan-Dec;32:10732748251371479. doi: 10.1177/10732748251371479. Epub 2025 Aug 28.

ABSTRACT

IntroductionCancer is a significant worldwide health problem, and targeted drugs like Cabozantinib and Atezolizumab offer new therapeutic options. These drugs enhance patient survival by specifically targeting cancer cells while minimizing damage to healthy tissues. The current research investigates the effectiveness of employing the combination of Cabozantinib and Atezolizumab vs single-agent Cabozantinib.MethodsIn this study, we searched databases including PubMed/Medline, Scopus, Embase, Cochrane, and Web of Science up to the end of January 2025. The results were categorized into two groups: the intervention group (Cabozantinib plus Atezolizumab) and the control group (Cabozantinib monotherapy) in cancer patients. We evaluated variables such as efficacy outcomes, including Objective Response Rate (ORR) and Disease Control Rate (DCR), as well as adverse events (safety). Data analysis was performed using random-effects models, and Relative Risk (RR) was reported as the effect size.ResultsThree clinical trials were included in this study. Regarding efficacy outcomes, there was no statistically significant difference in ORR between the intervention group and the control group (RR = 1.11, 95% CI: 0.76-1.61). Similarly, DCR did not differ significantly between groups (RR = 0.98, 95% CI: 0.94-1.03). In terms of safety, the combination therapy was associated with a statistically significant reduction in four treatment-related adverse events: diarrhea (RR = 0.91, 95% CI: 0.83-0.99), nausea (RR = 0.79, 95% CI: 0.65-0.95), vomiting (RR = 0.70, 95% CI: 0.52-0.96), and hypokalemia (RR = 0.28, 95% CI: 0.19-0.40).ConclusionThe findings suggest that the combination of Cabozantinib and Atezolizumab does not offer significant improvement in treatment efficacy compared to Cabozantinib alone. However, the combination may be associated with a lower incidence of certain chemotherapy-related adverse events. These exploratory findings may inform future research on treatment strategies for patients who experience intolerance to Cabozantinib monotherapy.

PMID:40874322 | DOI:10.1177/10732748251371479

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