Cabozantinib instructions, indications, usage and dosage, side effects

Cabozantinib, sold under the brand names Cometriq and Cabometyx, is an anticancer drug used to treat medullary thyroid cancer, renal cell carcinoma, and hepatocellular carcinoma. It is a small molecule inhibitor of the tyrosine kinases c-Met and VEGFR2, and also inhibits AXL and RET. The capsule form Cometriq and the tablet form Cabometyx brands have different formulations and are not interchangeable.

Indications: Cabozantinib tablets (Cabometyx) is particularly suitable for the following situations:

Treatment of patients with advanced renal cell carcinoma who have received prior anti-angiogenic therapy.

Patients with hepatocellular carcinoma (HCC) previously treated with sorafenib.

With Opdivo (nivolumab) in combination with for the first-line treatment of advanced renal cell carcinoma.

Indicated Patients 12 years of age and older with locally advanced or metastatic differentiated thyroid cancer (DTC) who have progressed on prior vascular endothelial growth factor receptor (VEGFR)-targeted therapy and are refractory to or ineligible for radioactive iodine

Cabozantinib capsules (Cometriq) are specifically approved for the treatment of progressive, metastatic medullary thyroid cancer.

Dosage: Cabozantinib is available in two oral forms: tablets (Cabometyx) and capsules (Cometriq).

Cabometyx is available as an oral tablet.

Patients with advanced renal cell carcinoma who are experienced with cabozantinib tablets and patients with hepatocellular carcinoma who have been previously treated with sorafenib: The recommended dose of cabozantinib as a single agent is 60 mg once daily without food until the patient no longer experiences clinical benefit or experiences unacceptable toxicity.

Cabozantinib tablets in combination with Opdivo (nivolumab) for the first-line treatment of advanced renal cell carcinoma : The recommended dose is cabozantinib 40 mg PO once daily in combination with 240 mg nivolumab every 2 weeks or 480 mg nivolumab every 4 weeks until disease progression or unacceptable toxicity, for up to 2 years.

Cabozantinib Tablets Age of treatment >Patients 12 years of age with locally advanced or metastatic DTC who have progressed after prior VEGFR-targeted therapy and are radioiodine refractory or ineligible:

The recommended dose of cabozantinib as a single agent is 60 mg once daily in adults and pediatric patients 12 years and older with BSA greater than or equal to 1.2 m2 until disease progression or unacceptable toxicity when administered as recommended.

For pediatric patients 12 years of age and older with a BSA less than 1.2 m2, the recommended dose of cabozantinib as a single agent is 40 mg once daily until disease progression or unacceptable toxicity when administered as recommended.

Cometriq is available as an oral capsule. The recommended daily dose of cabozantinib capsules is 140 mg (one 80 mg capsule and three 20 mg capsules).

SIDE EFFECTS: Get emergency medical help if you have signs of an allergic reaction: hives; trouble breathing; swelling of the face, lips, tongue, or throat.

Cabozantinib may cause a perforation (hole or tear) or fistula (abnormal passage) in the stomach or intestines. Call your doctor if you have severe stomach pain or if you feel like you are choking or gagging when you eat or drink.

Cabozantinib may cause serious side effects. Contact your doctor right away if you have: severe headache, blurred vision, severe shaking in your neck or ears; severe and persistent vomiting, diarrhea, or constipation; swelling of your hands, arms, legs, or feet; easy bruising or bleeding (nosebleeds, gum bleeding, heavy menstrual bleedingor any bleeding that doesn't stop); bloody or tarry stools, cough Bloody mucus or vomit that looks like coffee grounds; jaundice (yellowing of the skin or eyes); pain, blisters, bleeding, or severe rash on the palms or soles of the feet; confusion, thinking problems, weakness, vision changes, seizures; dizziness, like you might pass out; pain or numbness in the jaw, red and swollen gums, loose teeth, or slow healing after dental work; low Blood calcium - muscle spasms or contractions, numbness or tingling (around mouth, fingers and toes); low white blood cell count - fever, mouth sores, skin ulcers, sore throat, cough, difficulty breathing; Adrenal gland problems - nausea, vomiting, extreme Tiredness, dizziness, weakness, fainting; or signs of stroke or blood clots - sudden numbness or weakness on one side of your body, vision or balance problems, trouble speaking or understanding what others are saying to you, chest pain, trouble breathing, swelling or pain in your arms or legs.

Common side effects of cabozantinib may include: tiredness, moodiness, dry skin, thinning hair, decreased sweating, weight gain, facial puffiness, increased sensitivity to cold temperatures; stomach pain, nausea, vomiting, loss of appetite, diarrhea, constipation; pain, redness, swelling, or ulcers in the mouth or throat; difficulty speaking, change in taste; cold symptoms such as stuffy nose, sneezing, sore throat, cough; rash; muscle, bone, and joint pain; abnormal liver function tests or other blood tests; weight loss; or lightening of hair color. This is not a complete list of side effects, and other side effects may occur.

Precautions: Cabozantinib may cause a perforation (hole or tear) or fistula (abnormal passage) in the stomach or intestines. Cabozantinib also increases the risk of serious bleeding. Contact your doctor if you have: severe stomach pain, choking or gagging when eating or drinking, unusual bleeding, bloody or tarry stools, heavy menstrual bleeding, or coughing up blood.

Cabozantinib has not been tested in pregnant women; it can cause harm to rodent fetuses. Pregnant women should not take this drug, and women should not become pregnant while taking this drug. It is unknown whether cabozantinib is excreted in breast milk.

Storage: Store at room temperature, away from moisture and heat.