Cabozantinib shows clinical benefit in refractory GCT with over 40% disease control

ASCO GU 2026

26 - 28 Feb 2026

Published: 17 Mar 2026

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Dr Jennifer King - Indiana University School of Medicine, Indianapolis, USA

Dr Jennifer King speaks to ecancer about a phase II trial of cabozantinib in relapsed refractory germ-cell tumours (GCT).

This trial evaluated cabozantinib, a multi-targeted tyrosine kinase inhibitor, in patients with relapsed or refractory germ cell tumours (GCT) who had progressed after multiple prior treatments.

Among 44 evaluable patients, the clinical benefit rate was 43.2 percent, driven primarily by durable stable disease, although no complete responses were observed.

Nearly half of patients showed measurable tumour shrinkage, and most experienced reductions in tumour markers.

Treatment was generally well tolerated, with mostly low-grade side effects and limited severe toxicity.

Dr King concludes by saying that these results suggest cabozantinib provides a meaningful non-chemotherapy option with disease control and a manageable safety profile in heavily pretreated GCT.

We investigated the use of cabozantinib in patients with relapsed/refractory germ cell tumour.

Can you describe the study design and the patient population enrolled?

This was a phase II single arm study. It used a Simon two-stage design and it enrolled patients with relapsed/refractory disease. So these patients had been through frontline cisplatin chemotherapy and at least one salvage regimen.

What signals of clinical activity were observed with cabozantinib in this heavily pretreated population?

Our primary outcome was clinical benefit rate which was defined as the proportion of CR, PR and stable disease for at least three months. We demonstrated a clinical benefit rate of 43.2% in this highly heavily pretreated patient population.

How might these findings influence future treatment strategies for refractory GCT?

This is a tough patient population to show clinical benefit in, especially in this heavily pretreated patient population. So I do think that this shows it provides an opportunity for patients to be on a drug that can give them stability of disease but also have fewer side effects than some of the other typical chemotherapy regimens that we have in germ cell tumour. Then the next step would be trying to try this earlier in germ cell tumour.

Is there anything else you would like to add?

Based off of this, these initial results, we do have an ongoing trial of zanzalintinib with oral etoposide. There is a safety lead-in in patients with relapsed/refractory disease but then once that shows safety it will move to the post high-dose chemotherapy maintenance phase. So trying to move this treatment paradigm earlier for germ cell tumour.