Cabozantinib (Cometriq)

General information

Class/mechanism: Tyrosine kinase inhibitor; inhibits RET, MET/c-Met, VEGFR-1, VEGFR-2, VEGFR-3, KIT, TRKB, FLT-3, AXL, and TIE-2.
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Hepatocellular carcinoma
• Non-small cell lung cancer
• Prostate cancer
• Renal cell carcinoma
  • Papillary renal cell carcinoma
• Medullary thyroid cancer

Patient drug information

• Cabozantinib (Cometriq) package insert pages 20-24 (the numbering for the PDF is off, so in some PDF viewers, the patient information is on pages 27-31)
• Cabozantinib (Cabometyx) package insert
• Cabozantinib (Cometriq) patient drug information (Chemocare)
• Cabozantinib (Cometriq) patient drug information (UpToDate)

History of changes in FDA indication

Hepatocellular carcinoma

• 1/14/2019: Approved for patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. (new disease entity)

Medullary thyroid cancer

• 11/29/2012: Initial approval (as Cometriq) for treatment of progressive metastatic medullary thyroid cancer (MTC).

Renal cell carcinoma

• 4/25/2016: Approved (as Cabometyx) for the treatment of advanced renal cell carcinoma in patients who have received prior anti-angiogenic therapy. (new disease entity)
• 12/19/2017: Granted FDA regular approval for treatment of patients with advanced renal cell carcinoma (RCC). (converted to regular approval; no longer requires prior treatment)

Also known as

Note: Cometriq is the brand name for cabozantinib's medullary thyroid cancer indication. Cabometyx is the brand name for cabozantinib's renal cell carcinoma indication.

• Code names: XL184, XL-184
• Brand names: Cabometyx, Caboxen, Cabozanib, Cabozanix, Cometriq, Lucicaboz