Cabozantinib (Cabozantinib) instruction manual Chinese version

1. Indications (Indications):

Cabotinib is an oral multi-target tyrosine kinase inhibitor mainly used to treat the following diseases:

1.Renal Cell Carcinoma (Renal Cell Carcinoma, RCC): used for the treatment of advanced or metastatic renal cell carcinoma.

2.Thyroid Cancer (Thyroid Cancer): used for the treatment of locally advanced or metastatic thyroid cancer that is ineffective in radioactive iodine therapy.

3.Hepatocellular Carcinoma (Hepatocellular Carcinoma, HCC): used for hepatocellular carcinoma that relapses or progresses after previous treatment with sorafenib (Sorafenib).

2. Mechanism of Action and Pharmacology (Mechanism of Action and Pharmacology):

Cabozantinib is a multi-target tyrosine kinase inhibitor that exerts anti-tumor effects by simultaneously inhibiting the activity of multiple receptor kinases and interfering with tumor growth, angiogenesis and metastasis.

1.The main mechanisms of action include: Inhibiting the proliferation of tumor cells: Cabozantinib can inhibit a variety of receptor kinases, including vascular endothelial growth factor receptor (VEGFR), hepatocyte growth factor receptor ( MET), platelet-derived growth factor receptor (PDGFR), etc., thus blocking signal transduction and inhibiting the proliferation and growth of tumor cells.

2.Inhibit tumor angiogenesis: Cabozantinib inhibits the activity of VEGFR, reduces the signaling pathway of tumor angiogenesis factors (VEGF), blocks the tumor's dependence on blood supply, thereby reducing the nutrient supply of the tumor and inhibiting tumor growth.

3.Inhibiting tumor metastasis: Cabozantinib also inhibits the migration and invasion of tumor cells, thereby reducing the ability of tumors to metastasize.

3. Dosage and Administration (Dosage and Administration):

The dosage and usage of cabozantinib should be determined according to the doctor's prescription and the patient's specific conditions. In general, it is recommended to follow the following guidance:

Renal cell carcinoma (RCC): The recommended dose is 60mg (mg) taken orally once daily, continuously.

Thyroid Cancer: The recommended dose is 140mg (mg) once daily, continuously.

Hepatocellular carcinoma (HCC): The recommended dose is 60mg (mg) taken orally once daily, continuously.

During medication, patients should receive regular monitoring and follow-up from doctors to ensure the efficacy and safety of the medication.

4. Side effects (Adverse Reactions):

Cabozantinib may cause a range of side effects, some of which may be serious. Common side effects include:

1.Hypertension: It may lead to the onset of hypertension. Patients need to monitor blood pressure regularly and adjust treatment under the guidance of a doctor.

2.Diarrhea and nausea: common digestive system side effects, but generally mild, patients can adjust their diet and fluid intake according to the situation.

3.Fatigue and reduced energy: Some patients may feel tired or have reduced energy and need to take appropriate rest.

4.Hand-foot syndrome: manifests as an eczematous rash on the palms and soles of the feet, which may be accompanied by pain and peeling.

5.Proteinuria: It may lead to proteinuria, and kidney function needs to be checked regularly.

For patients who experience side effects, they should inform their doctor in time and adjust the medication plan according to the situation.

5. Warnings and Precautions (Warnings and Precautions):

Patients taking cabozantinib should pay attention to the following:

1.Liver function monitoring: Liver function should be monitored regularly to avoid liver toxicity.

2.Bleeding risk: Because cabozantinib may cause coagulation abnormalities, patients need to avoid using anticoagulants or antiplatelet drugs during treatment.

3.Cardiovascular complications: Cabozantinib may cause cardiovascular complications, such as tachycardia, arrhythmia, heart failure, etc. Patients taking cabozantinib should undergo a cardiac evaluation before initiating treatment and have cardiac function monitored periodically during treatment.

4.Fracture risk: Some patients may have an increased risk of fracture while taking cabozantinib. Your doctor may recommend a bone density test to avoid other bone-related complications.

5.Thyroid function monitoring: For patients using cabozantinib to treat thyroid cancer, thyroid function needs to be monitored regularly to ensure the effectiveness and safety of the treatment.

6.Contraindicated during pregnancy: Cabozantinib may cause harm to the fetus, so its use during pregnancy is strictly prohibited. Female patients should take effective contraceptive measures to avoid pregnancy during medication.

7.Excretion in breast milk: Cabozantinib may be excreted in breast milk, so breastfeeding should be avoided during treatment.

6. Contraindications (Contraindications):

Cabozantinib should not be used in patients with the following conditions:

1.Patients with known hypersensitivity to cabozantinib or other ingredients.

2.Patients with severe unstable hypertension that cannot be controlled through treatment.

3.Patients with severe heart disease, such as heart failure, are not suitable for this drug.

7. Drug Interactions (Drug Interactions):

Cabozantinib may interact with other drugs, affecting their efficacy or increasing the risk of side effects. Before using cabozantinib, patients should inform their doctor of any other medications they are currently taking, including prescription drugs, over-the-counter drugs, supplements, and herbal preparations.

Some drugs that may cause drug interactions include but are not limited to:

1.Anticoagulant drugs: such as warfarin, may increase the risk of bleeding.

2.Anti-epileptic drugs: such as carbamazepine, may reduce the plasma concentration of cabozantinib.

3.Enzyme inducers and enzyme inhibitors: may affect the metabolism of cabozantinib, thus changing the efficacy of the drug.

8. Medication for special populations (Special Populations):

1.Children and Adolescents: The safety and effectiveness of cabozantinib in children and adolescents have not been established and use in this age group is not recommended.

2.Elderly patients: Elderly patients may be more susceptible to side effects when using cabozantinib and therefore require closer monitoring and medication adjustment.

9. Listing and price situation:

Cabozantinib is not currently on the market in China and is therefore not included in medical insurance because it requires approval from the National Medical Products Administration. Therefore, patients cannot purchase it domestically and need to purchase it through overseas channels. There are original and generic cabozantinib drugs abroad. The original drugs are mainly Japanese original drugs, Turkish original drugs and European original drugs. The price is relatively high, ranging from 35,000 to 46,000 yuan. Foreign generic drugs are mainly Lao generic drugs and Bangladeshi generic drugs, with prices ranging from 1,300 to 2,700 yuan. The price is much cheaper than original drugs and is more suitable for the needs of patients in ordinary families. The ingredients of original drugs and generic drugs are basically the same.

The above are the general instructions and precautions for cabozantinib. Each patient's condition and constitution are different. Therefore, when using this drug, you should follow the doctor's prescription and recommendations, and receive regular monitoring and follow-up from the doctor to ensure the safety and effectiveness of the treatment. At the same time, if any new discomfort or side effects occur during medication, please report it to your doctor in time.