Cabozantinib Cabanib-20 (XL184) Drug International Pharma

Product Name: Cabozantinib

English Name: Cabozantinib

Specification: 20 mg × 90 capsules/box

Manufacturer: Drug International Pharma

Cabozantinib is a multi-targeted, broad-spectrum anticancer drug capable of inhibiting at least nine distinct targets, including MET, VEGFR1/2/3, ROS1, RET, AXL, NTRK, and KIT.

Currently, Cabozantinib has demonstrated significant therapeutic efficacy across a wide range of solid tumors, including kidney cancer, thyroid cancer, liver cancer, soft tissue sarcoma, non-small cell lung cancer, prostate cancer, breast cancer, ovarian cancer, and colorectal cancer. It is particularly effective in controlling bone metastases. Due to its broad efficacy against multiple cancer types, Cabozantinib is often referred to as the "universal remedy" among targeted therapies, possessing broad-spectrum anticancer capabilities.

Treatment of Renal Cell Carcinoma: The response rate of Cabozantinib is several times higher than that of Sutent (46% vs. 18%), and it significantly extends overall survival (30.3 months vs. 21.8 months). The side effect profiles of both drugs are quite similar, with adverse event rates of 67% and 68%, respectively. The primary side effects include diarrhea, fatigue, hypertension, and hand-foot syndrome. Currently, Cabozantinib has become a preferred first-line treatment option for advanced kidney cancer.

Treatment of Hepatocellular Carcinoma: In patients with advanced liver cancer treated with Cabozantinib, overall survival was significantly prolonged, and the risk of death was reduced by 37%. The objective response rate was approximately 5%. Currently, alongside drugs such as Regorafenib and PD-1 antibodies, Cabozantinib has established itself as one of the key therapeutic agents for advanced liver cancer.

Treatment of Lung Cancer: Among patients with non-small cell lung cancer, approximately 2% harbor RET gene rearrangements. These patients are eligible for treatment with Cabozantinib. In 2016, the prestigious medical journal *The Lancet Oncology* published clinical trial data regarding the use of Cabozantinib in lung cancer patients with RET rearrangements: among 26 patients, the response rate was 28%, and the disease control rate approached 100%. Furthermore, in EGFR wild-type lung cancer patients who failed first-line treatment, the combination of cabozantinib and erlotinib significantly prolonged overall survival compared to cabozantinib or erlotinib alone. The overall survival was 13.3 months in the combination therapy group, 9.2 months in the cabozantinib alone group, and 5.1 months in the erlotinib alone group.

For thyroid cancer: In patients with RET-mutant thyroid cancer, cabozantinib significantly prolonged overall survival, from 18.9 months to 44.3 months, more than doubling it. In the general population, overall survival also increased from 21.1 months to 26.6 months.

Cabozantinib has many molecular targets, some of which are involved in bone metastasis formation, demonstrating a strong ability to control bone metastasis in solid tumors. It has been widely used to treat bone metastases in renal cell carcinoma and prostate cancer.

Cabozantinib can enhance the efficacy of immunotherapy such as PD-1 antibodies by eliminating malignant myeloid-derived immunosuppressive cells (MDSCs) around the tumor. Therefore, many studies have selected cabozantinib as the "golden partner" with PD-1 antibodies for combination therapy, achieving good therapeutic effects.

Indications: Cabozantinib has a wide range of indications, mainly including:

(1) Advanced renal cell carcinoma that has previously received anti-angiogenic therapy;

(2) Medullary thyroid carcinoma that cannot be surgically removed;

(3) Liver cancer patients who have developed resistance to sorafenib;

(4) Advanced prostate cancer patients with bone metastases.

Dosage and Administration:

(1) The recommended dose is 140 mg daily (1 80 mg capsule and 3 20 mg capsules);

(2) Do not take with food;

(3) Do not eat for at least 2 hours before and at least one hour after taking the medication;

(4) For adverse reactions, consider reducing the dose or discontinuing treatment.

Adverse Reactions:

The most commonly reported adverse drug reactions (≥25%) associated with cabozantinib are diarrhea, stomatitis, palmar-plantar erythrodysesthesia syndrome (PPES), weight loss, decreased appetite, nausea, fatigue, oral pain, hair color changes, dysgeusia, hypertension, abdominal pain, and constipation.