CheckMate-9ER Trial Results

After more than five years of follow-up, the findings demonstrated that efficacy benefits with Cabometyx  in combination with Opdivo were sustained long term. These results, including subgroup analyses, will be presented at 8:10 a.m. PT on February 15 during Oral Abstract Session C: Renal Cell Cancer and Testicular Cancer at the American Society of Clinical Oncology 2025 Genitourinary Cancers Symposium (ASCO GU).

“In this evolving treatment landscape for renal cell carcinoma, patients are looking for options that have shown improved survival time in the long-term,” said Robert J. Motzer, M.D., Kidney Cancer Section Head, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center. “These final five-year results from CheckMate -9ER demonstrated the durable clinical benefits of cabozantinib in combination with nivolumab—including for those with organ metastases or intermediate- or poor-risk disease classifications—and continue to support this combination regimen as a valuable first-line option for this patient population.”

At a median follow-up of 67.6 months, Cabometyx  in combination with Opdivo improved progression-free survival (PFS; hazard ratio [HR]: 0.58; 95% confidence interval [CI]: 0.49-0.70) and overall survival (OS; HR: 0.79; 95% CI: 0.65-0.96) compared with sunitinib in the intent-to-treat population. A subgroup analysis by International Metastatic RCC Database Consortium (IMDC) risk showed PFS and objective response rates (ORR) favored Cabometyx in combination with Opdivo versus sunitinib regardless of IMDC risk group. 

The combination therapy showing a nearly doubled median PFS and a substantial improvement in OS compared to sunitinib alone; this was considered a major clinical benefit for first-line treatment of advanced RCC. 

Results; Median PFS ,mo: Cabometyx + Opdivo (the combination) 16.4 Sunitinib 8.3 (PFS HR 95% Cl) 0.58 ( 0.49-0.70). Median OS The combination,mo  46.5 Sunitinib 35.5. (OS HR 95%Cl) 0.79 (0,65-0,96).ORR The combination  55.7 sunitinib  27.4. DOR mo The combination 22-0 Sunitinib 15.2. CI: confidence interval; DOR: duration of response; HR: hazard ratio; IMDC: International Metastatic RCC Database Consortium; ITT: intent-to-treat; ORR: objective response rate; OS: overall survival; PFS: progression-free survival.

“With now more than five years of follow-up, these results continue to support CABOMETYX in combination with Opdivo as a treatment regimen that can have enduring survival benefits for patients with previously untreated advanced kidney cancer,” said Amy Peterson, M.D., Executive Vice President, Product Development & Medical Affairs, and Chief Medical Officer, Exelixis. “The efficacy was sustained across multiple subgroups, further underscoring the potential of this regimen to benefit a broad population with variable disease burden. We are proud to have established such a compelling standard of care for this community and remain committed to developing much-needed treatment options for all patients living with advanced cancers.”

Safety and tolerability with long-term follow-up were manageable and consistent with previous analyses. No new safety signals were reported. Grade 3/4 adverse events (AEs) occurred in 68% of patients treated with Cabometyx in combination with Opdivo versus 55% of patients treated with sunitinib, with the most frequent being diarrhea (7% versus 5%, respectively), palmar-plantar erythrodysesthesia (8% versus 8%), hypertension (13% versus 13%), fatigue (3% versus 5%), thrombocytopenia (<1% versus 5%) and alanine aminotransferase increased (6% versus 1%). One treatment-related death per investigator occurred with Cabometyx combination with Opdivo versus three with sunitinib. Treatment-related AEs leading to discontinuation occurred in 28% of patients treated with Cabometyx in combination with Opdivo versus 11% of patients treated with sunitinib.