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CABOZANTINIB
Generic Name: CABOZANTINIB
ABSTRACT -
Cabozantinib (Cabometyx/Cometriq) is an oral multi-targeted tyrosine kinase inhibitor approved for progressive, metastatic medullary thyroid cancer, advanced renal cell carcinoma (RCC), and hepatocellular carcinoma (HCC) previously treated with sorafenib. It inhibits VEGFR1/2/3, MET, AXL, RET, and other kinases involved in tumour growth, angiogenesis, and metastasis.
DOSAGE -
Cabometyx (tablet): 60 mg orally once daily for RCC/HCC; Cometriq (capsule): 140 mg daily for medullary thyroid cancer. Both taken on empty stomach, 1 hour before or 2 hours after food.
SIDE EFFECTS-
- Diarrhoea
- Fatigue
- Nausea and vomiting
- Decreased appetite/weight loss
- Hand-foot skin reaction (HFSR)
ALLERGIC REACTIONS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Skin rash
- Drug hypersensitivity
- Urticaria
- Anaphylaxis (rare)
DRUG INTERACTIONS-
- Strong CYP3A4 inhibitors: reduce cabozantinib dose by 40 mg
- Strong CYP3A4 inducers: increase dose by 40 mg
- Avoid anticoagulants — haemorrhage risk
PREAUTONS–
- Monitor BP weekly for first 6 weeks then periodically
- Thyroid function monitoring in thyroid cancer patients
- Hold for elective surgery — wound healing impaired
- Discontinue if GI perforation or fistula occurs
WARNINGS –
- GI perforations and fistulae can be fatal
- Haemorrhage including fatal GI bleeds reported
- PRES/RPLS neurological toxicity — evaluate new neurological symptoms
- QT prolongation — baseline ECG recommended
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