cabozantinib

Cabozantinib is an oral, small-molecule tyrosine kinase inhibitor used in the treatment of several solid tumors. It acts as a multi-target inhibitor, blocking signaling through kinases such as MET (the hepatocyte growth factor receptor) and VEGFR2 (KDR), as well as AXL, ROS1, RET, and other kinases. Inhibition of these pathways can reduce tumor cell proliferation, angiogenesis, and metastatic potential.

Cabozantinib is approved for a range of indications in adults, including advanced renal cell carcinoma, unresectable or metastatic differentiated thyroid carcinoma, and unresectable hepatocellular carcinoma. It is taken by mouth, usually as a once-daily tablet, with a typical starting dose around 60 mg and adjustments made for toxicity, organ function, and regulatory guidance.

Common adverse effects include diarrhea, nausea, vomiting, fatigue, decreased appetite, hypertension, hand-foot syndrome, mucositis, and weight loss. Serious risks encompass hepatotoxicity, hemorrhage, thromboembolic events, wound-healing impairment, and potential fetal harm; pregnancy is contraindicated. Patients require ongoing monitoring of liver function, blood pressure, and signs of bleeding or impaired wound healing.

Drug interactions center on metabolism by CYP3A4; strong inhibitors or inducers of CYP3A4 can alter cabozantinib exposure and may necessitate dose adjustments or avoidance. Other interactions may involve agents affecting blood pressure, coagulation, or liver function. Cabozantinib has been developed by Exelixis and received approvals in the 2010s with subsequent expansion to additional cancer indications.