Drug updated on 4/15/2024
| Dosage Form | Capsule (oral; 20 mg, 80 mg) |
| Drug Class | Kinase inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of patients with progressive, metastatic medullary thyroid cancer.
Summary
- Cabozantinib S-Malate (Cometriq) is indicated for the treatment of patients with progressive, metastatic medullary thyroid cancer and has also been used to treat advanced renal cell carcinoma, hepatocellular carcinoma, differentiated thyroid cancer that is radioactive iodine refractory, and Merkel cell carcinoma.
- A total of 10 studies were reviewed which provided information on the safety and efficacy of Cabozantinib in comparison to other medications such as Sorafenib and Lenvatinib.
- In terms of comparative efficacy and safety against Sorafenib or Lenvatinib in differentiated thyroid cancer (DTC), Cabozantinib could be a valuable second-line option due to limitations in effective targeted therapies for patients with certain mutations.
- When combined with other therapies, Cabozantinib showed promising results by improving progression-free survival across different solid tumors including renal cell carcinoma and non-small-cell lung cancer while maintaining a consistent toxicity profile.
- The adverse effects associated with Cometriq include hypertension, diarrhea, fatigue, along with rare cases showcasing cardiotoxicity, marking an uncommon but concerning side effect requiring monitoring of cardiovascular health during treatment. There's a high occurrence rate of grade 3 or higher adverse events, particularly when compared to Lenvatinib, suggesting a significant but manageable toxicity profile.
- While specific population considerations were not detailed exhaustively, one mention suggested broader applicability across older populations based on an 83-year-old patient responding well to Cabozantinib for MCC alongside MTC.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Cometriq (cabozantinib) Prescribing Information. | 2020 | Exelixis, Inc. Alameda, CA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Guidelines on the use of systemic therapy in patients with advanced thyroid cancer. | 2023 | Clinical Oncology |
| Essential news for clinical practice—thyroid cancer. | 2023 | Magazine of European Medical Oncology |
| Clinical utility of cabozantinib in the treatment of locally advanced or metastatic differentiated thyroid carcinoma: patient selection and reported outcomes. | 2023 | Management and Research |
| AGA clinical practice guideline on systemic therapy for hepatocellular carcinoma. | 2022 | Gastroenterology |
| ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer. | 2022 | Annals of Oncology |
| Thyroid carcinoma, version 2.2022, NCCN clinical practice guidelines in oncology. | 2022 | Journal of National Comprehensive Cancer Network |
| Current guidelines for management of medullary thyroid carcinoma. | 2021 | Endocrinology and Metabolsim |
| Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. | 2019 | Annals of Oncology |