Cabozantinib latest Chinese instruction manual

Indications:

1.Metastatic medullary thyroid cancer: Cabozantinib is a drug used to treat metastatic medullary thyroid cancer, especially for those cases that are progressive.

2. Other cancer types: In addition to medullary thyroid cancer, cabozantinib has also shown therapeutic effects in a variety of other cancer types, including but not limited to prostate cancer, non-small cell lung cancer, liver cancer, etc. In clinical trials of these cancers, cabozantinib has shown some anti-tumor activity.

3.Special indications: Cabozantinib is also considered an effective treatment for certain cancer conditions, such as prostate cancer with bone metastases, advanced hepatocellular carcinoma that has progressed after other standard treatments, and advanced renal cell carcinoma that has been treated with anti-angiogenic therapy.

Mechanism of action:

Caboozantinib is a multi-target tyrosine kinase inhibitor. In vitro biochemical and cytological analyzes show that cabozantinib can inhibit the activity of multiple tyrosine kinases, including RET, MET, VEGFR-1, -2 and -3, KIT, TRKB, FLT-3, AXL and TIE-2 etc. These kinase receptors play important roles in normal cellular functions and pathological processes, such as tumor initiation, metastasis, tumor angiogenesis, and maintenance of the tumor microenvironment. By inhibiting the activity of the above-mentioned tyrosine kinases, cabozantinib can interfere with the signal transduction pathways of tumor cells, thereby inhibiting the growth, proliferation and metastasis of tumor cells. This inhibitory effect has been verified in a variety of tumor models, including medullary thyroid cancer, prostate cancer, non-small cell lung cancer, and liver cancer.

Medication method:

1.For patients with medullary thyroid cancer, take 140 mg once daily.

2.For patients with renal cell carcinoma and hepatocellular carcinoma, take 60 mg once a day.

3.Differentiated thyroid cancer: For patients aged ≥12 years old and BSA ≥1.2 m pediatric patients, 60mg once daily; aged ≥12 years old andBSA<1.2m pediatric patients, once daily, 40mg each time. For adult patients, 60 mg once daily.

Side effects:

1.Gastrointestinal side effects: Diarrhea, nausea, vomiting, loss of appetite, etc. are common gastrointestinal side effects. Diarrhea, in particular, has a relatively high incidence and may require symptomatic treatment as well as appropriate fluid replacement and electrolyte balance adjustments.

2.Skin and mucous membrane reactions: including stomatitis, hand-foot syndrome (palm and plantar redness, swelling and pain syndrome), hair color changes, etc. These reactions may affect the patient's quality of daily life.

3.Cardiovascular system reaction: Hypertension is one of the common side effects of cabozantinib, which requires regular monitoring of blood pressure and timely adjustment of the treatment plan. In addition, cardiotoxic reactions may occur, manifesting as chest tightness, palpitations and other symptoms.

4.Other systemic reactions: such as fatigue, weight loss, dysgeusia, constipation, etc. are also possible problems during cabozantinib treatment.

5.Laboratory test abnormalities: Some patients may experience laboratory test abnormalities such as elevated liver function indicators (such as AST, ALT), lymphopenia, etc. during treatment.

Warnings and precautions:

Patients taking cabozantinib who require surgery, including dental surgery, should stop treatment at least28 days before surgery and resume treatment after surgery based on wound healing.

Drug interactions:

1. Interactions with strong CYP3A4 inhibitors: Administration of strong CYP3A4 inhibitors (such as ritonavir, clarithromycin, etc.) will significantly increase the plasma concentration of cabozantinib, which may lead to increased toxicity. Therefore, special caution is required when using these drugs concurrently.

2. Interaction with gastric pH regulators: When gastric pH regulators such as proton pump inhibitors are combined with cabozantinib, the clinical impact is not obvious, and there is no indication that dose adjustment is required.

Medication for special populations:

Pregnant and lactating women should use this medication with caution.