New anti-cancer drug: dosage of cabozantinib tablets and a brief understanding of its usage

Cabozantinib (Cabozantinib) tablets can be used to treat renal cell carcinoma (RCC), hepatocellular carcinoma (HCC), and differentiated thyroid cancer (DTC). Do not take cabozantinib with food, give cabozantinib at least 1 hour before or 2 hours after food; stop cabozantinib treatment at least 3 weeks before planned surgery (including dental surgery); do not use cabozantinib capsules instead of cabozantinib tablets.

1. Recommended dosage:

(1) Renal cell carcinoma (RCC): The recommended dose of cabozantinib as a single agent is 60 mg once daily until disease progression or unacceptable toxicity occurs, and should be administered at the recommended dose. When administered in combination with nivolumab, the recommended dose of cabozantinib is 40 mg once daily and 240 mg of nivolumab every 2 weeks or 480 mg (30-minute intravenous infusion) every 4 weeks until disease progression or unacceptable toxicity occurs, and nivolumab continued for up to 2 years.

(2) Hepatocellular carcinoma (HCC): The recommended dose of cabozantinib monotherapy is 60 mg once daily until disease progression or unacceptable toxicity.

(3) Differentiated thyroid cancer (DTC): For adult and pediatric patients 12 years and older with BSA ≥1.2m2, the recommended dose of cabozantinib as a single agent is 60 mg once daily. For pediatric patients 12 years and older with BSA <1.2 m2, the recommended dose is 40 mg once daily until disease progression or unacceptable toxicity.

2. Dosage adjustment:

Adverse reactions caused by cabozantinib treatment, adverse reactions are alleviated/ Improvement (i.e., return to baseline or remission to grade 1) may require adjustment of the drug dose under the guidance of a physician. For adult and pediatric patients 12 years and older with BSA ≥ 1.2 m2, the first dose is reduced to 40 mg once daily, and the second dose is reduced to 20 mg once daily; for patients combined with nivolumab, or pediatric patients 12 years and older with BSA < 1.2 m2, the first dose is reduced to 20 mg once daily, and the second dose is reduced to 20 mg every other day. If the lowest dose was previously received, resume the same dose. If the lowest dose is not tolerated, discontinue cabozantinib.

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.