Cabozantinib bone metastasis pain

Cabozantinib, which inhibits rearranged MET (RET) and VEGFR-2 during transfection, has been shown to block osteoblastic and osteolytic progression of xenograft tumors in bone, suggesting potential clinical activity in patients with bone metastases. Cabozantinib was approved by the U.S. Food and Drug Administration (FDA) in 2011 for the treatment of progressive metastatic medullary thyroid cancer and in 2016 for the treatment of advanced renal cell carcinoma. It has also been developed to treat other cancers that express MET, VEGFR-2, and RET, namely hepatocellular carcinoma and differentiated thyroid cancer.

Bone metastases are often difficult to manage because they may be symptomatic and skeletal-related events (SREs) may result in significant morbidity and reduced performance status. The primary purpose of a phase II study is to test cabozantinib as a possible new treatment for patients with bone metastases from solid tumor malignancies. In fact, in this group of heavily pretreated patients with various cancers, 50% of the study population were progression-free at 3.5 months, and no adverse events were observed during the study. In addition, a decrease in serum Ctx and Ntx was observed after cabozantinib administration, indicating that cabozantinib is effective in reducing bone turnover; antitumor activity was also observed with cabozantinib, as determined by frequent and significant reductions in visceral metastasis measurements.

In general, cabozantinib, as a targeted drug, shows good results in the treatment of bone metastasis pain. It was well tolerated by patients in clinical studies. Fatigue and diarrhea were the most common adverse events. However, for most patients, these adverse events can be controlled by reducing the dose to 40 mg per day.