Multinational phase 3 trial of cabozantinib plus atezolizumab for metastatic castration-resistant prostate cancer

Patients with metastatic castration-resistant prostate cancer (mCRPC) with extrapelvic soft-tissue metastases that has progressed on an androgen receptor pathway inhibitor (ARPI) have poor prognosis and few treatment options. The multinational phase 3 CONTACT-02 trial randomized such patients to cabozantinib plus atezolizumab (n=289) or switch of the ARPI (abiraterone or enzalutamide; n=286). The median PFS was 6.3 months with cabozantinib-atezolizumab versus 4.2 months with ARPI switch (HR 0.65; p=0.0007). The median OS was similar in both groups (14.8 versus 15.0 months). Adverse events leading to discontinuation occurred in 17% versus 15%. The authors conclude that cabozantinib plus atezolizumab could be a useful treatment option for patients with mCRPC and soft-tissue metastases after progression on an ARPI.