How effective is cabozantinib in treating prostate cancer?

Cabozantinib (Cabozantinib) is a small molecule that inhibits multiple receptor tyrosine kinases, including MET, VEGFR2 and RET, which play key roles in angiogenesis and tumor cell proliferation, invasion and metastasis. Cabozantinib blocked the progression of osteolytic and osteoblastic lesions in a xenograft model of castration-resistant prostate cancer (CRPC). The labeling for cabozantinib does not indicate that the drug can be used to treat prostate cancer.

A phase 2 randomized discontinuation trial in a large expansion cohort showed that cabozantinib had significant disease-stabilizing activity in 75% of 171 enrolled patients. Among people with bone metastases, 68% showed improvement on bone scans, including 12% who had all uptake fully resolved. A confirmatory phase 2 trial in men with mCRPC after docetaxel showed a similar bone scan response rate (63%), with an additional 19% of patients having stable disease. Although patients with advanced prostate cancer appear to derive some clinical benefit from cabozantinib, bone scan changes may not reflect any antitumor effect.

The original drug Cabozantinib is not marketed in the country and therefore cannot be included in medical insurance. The original cabozantinib drug marketed overseas includes Japanese, Turkish and European versions. The price of tablets may be more than 30,000 yuan, and the price of capsule preparations may be more than 40,000 yuan (prices may fluctuate due to exchange rates). There are also generic drugs produced in other countries overseas, and their pharmaceutical ingredients are basically the same as those of the original drugs. For example, the price of pharmaceuticals produced by Bangladeshi pharmaceutical factories may be more than 2,000 yuan (the price may fluctuate due to the exchange rate), which is relatively cheap.