Uses

Indicated for: (1) advanced renal cell carcinoma (RCC), including as first-line therapy in combination with nivolumab; (2) hepatocellular carcinoma (HCC) previously treated with sorafenib; (3) locally advanced or metastatic differentiated thyroid cancer (DTC) progressing after prior VEGFR-targeted therapy in patients radioactive iodine-refractory or ineligible (adults and pediatric patients ≥12 years).

Do not use if

No absolute contraindications listed in the FDA label. However, cabozantinib should not be administered to patients with a recent history of severe hemorrhage.

Side effects

Common adverse effects include diarrhea, fatigue, decreased appetite, nausea, palmar-plantar erythrodysesthesia, hypertension, and weight loss. Serious risks include hemorrhage, gastrointestinal perforations and fistulas, thromboembolic events, hypertensive crisis, cardiac failure, hepatotoxicity, and wound healing complications.

Warnings

Do not administer if there is a recent history of clinically significant hemorrhage. Monitor for gastrointestinal perforations, fistulas, thromboembolic events, hypertension, hepatotoxicity, osteonecrosis of the jaw, and wound healing complications. Advise patients of reproductive potential to use effective contraception during and after treatment.

How it works

Cabozantinib is a small-molecule tyrosine kinase inhibitor that targets multiple receptors including MET, VEGFR-1/2/3, AXL, RET, ROS1, TYRO3, MER, KIT, TRKB, FLT-3, and TIE-2. Inhibition of these pathways interferes with tumor growth, angiogenesis, and metastasis.

Storage

Store at controlled room temperature. Keep in original container. See manufacturer labeling for specific storage conditions for each tablet strength.