What is the difference between cabozantinib and axitinib?

Cabozantinib and axitinib, as two multi-target tyrosine kinase inhibitors, have shown certain efficacy in tumor treatment, but they have significant differences in many aspects.

Cabozantinib was initially approved for the treatment of unresectable malignant locally advanced or metastatic medullary thyroid cancer and has subsequently been used to treat other types of tumors, such as advanced renal cancer, liver cancer, and non-small cell lung cancer. It has shown some efficacy in these tumors, especially in cases with specific genetic mutations.

Axitinib is mainly used to treat adult patients with advanced renal cell carcinoma (RCC) who have failed previous treatment with a tyrosine kinase inhibitor or cytokine. It is one of the important therapeutic drugs for advanced kidney cancer.

Both are multi-target tyrosine kinase inhibitors, but the specific targets they inhibit are different. Cabozantinib can inhibit multiple targets related to tumor growth, angiogenesis and metastasis, including MET, VEGFR, and RET. Axitinib mainly inhibits VEGFR, PDGFRβ and c-Kit signaling pathways.

The usual recommended dose of cabozantinib is 140mg/day, once a day, and should not be taken with food to ensure optimal absorption of the drug. Dose adjustments may be based on patient tolerance and adverse reaction profile.

The recommended starting oral dose of axitinib is 5 mg twice daily, and the dose can be gradually increased based on patient safety and tolerability to a maximum of 10 mg twice daily. Axitinib can be taken with or without food.

Adverse reactions may occur during use of both, but the specific type and severity may differ. Common adverse reactions of cabozantinib include diarrhea, stomatitis, palmar-foot syndrome, hypertension, etc. Axitinib may cause adverse reactions such as hypertension, neutropenia, and fatigue. In addition, the patient's liver and kidney function and other related indicators need to be closely monitored during use.