Cabometyx is usually administered orally once daily in tablet form. It can be taken with or without food, but the same time of day is recommended for every dose to facilitate adherence to the treatment schedule.

Cabometyx for RCC, HCC, and MTC is typically administered at a standard dose of 60 mg once a day, but dosage adjustments may be based on the patient’s response to treatment and any side effects.

Adjustments in cases of adverse effects: this can be through reducing doses to 40 mg or as low as 20 mg per day according to patient tolerance to side effects of the medication.

Patients should take their doctor’s advice seriously. If a dose is missed, the patient should omit the missed dose and continue with the regular schedule. Patients should never take two doses at once to make up for a missed dose.

Cabometyx functions by inhibiting multiple receptor tyrosine kinases implicated in tumor growth and survival. Specifically, it inhibits:

VEGFR (vascular endothelial growth factor receptor): Inhibiting VEGFR disrupts the process of angiogenesis, which tumors use to form new blood vessels and feed themselves.

c-MET receptor: This receptor is responsible for the dissemination and survival of cancer cells. The inhibition of c-MET prevents tumor cell proliferation, invasion, and metastasis by Cabometyx.

AXL receptor: AXL is another tyrosine kinase that is involved in cancer progression. Cabometyx works by blocking the resistance mechanisms through which the cancer cells evade the treatments.

Cabometyx restricts the tumor’s supply of blood, halts the spread of cancerous cells, and disrupts growth and survival of the tumour.

While Cabometyx is relatively well-tolerated, it has the side effect potential. Common and some serious include:

Tiredness or weakness : Most patients experience this during their treatment.

Diarrhea: Gastrointestinal complaints of diarrhea occur frequently among the users of Cabometyx and should be controlled by anti-diarrhea medication.

Loss of appetite : Loss of appetite can contribute to weight loss in affected patients.

Nausea and vomiting: Gastrointestinal distress is very common, especially in the initial phase of treatment.

Hand-foot syndrome: This is characterized by redness, swelling, and pain on the palms of the hands and soles of the feet, which can occur with Cabometyx.

Elevated liver enzymes: Blood tests may indicate elevated liver enzymes, which is a sign of liver toxicity.

Hypertension: Cabometyx may cause hypertension in some cases, which should be managed and monitored.

Hypertension: The patient’s blood pressure should be monitored regularly. If the blood pressure is high, then antihypertensive drugs may be prescribed.

Gastrointestinal perforation: The patient should be educated about the signs of gastrointestinal perforation which include severe abdominal pain, fever, and vomiting and must seek medical attention immediately.

Liver function: Liver enzyme levels should be monitored at regular intervals throughout the treatment course to note any signs of liver toxicity. Dose adjustments or discontinuation may be warranted if liver problems occur.

Bleeding risks: Due to the increased risk of bleeding, patients should be monitored for signs of bleeding, especially those with a history of bleeding disorders or taking anticoagulants.

CYP3A4 Inhibitors: Strong CYP3A4 inhibitors, such as ketoconazole, can increase cabozantinib levels, potentially leading to enhanced toxicity. Dose adjustments may be needed when co-administered.

CYP3A4 Inducers: Medications like rifampin that induce CYP3A4 may decrease cabozantinib efficacy by reducing its plasma concentration, requiring close monitoring.

Anticoagulants: Cabometyx may increase the risk of bleeding when combined with anticoagulants like warfarin or direct-acting agents, necessitating careful monitoring of coagulation parameters.

P-glycoprotein Inhibitors: Co-administration with P-glycoprotein inhibitors, such as verapamil, can increase cabozantinib absorption, possibly enhancing side effects.

Renal Cell Carcinoma (RCC): The usual recommended dose is 60 mg once a day.

Hepatocellular Carcinoma (HCC): The recommended dose is also typically 60 mg once a day.

Medullary Thyroid Cancer (MTC): 60 mg once a day is the recommended starting dose.

Dosage adjustments may be made based on the patient’s tolerance and the severity of side effects.

Cabometyx is a prescription medication and should be administered only by an oncologist or a healthcare professional that is experienced in the management of cancers such as RCC, HCC, and MTC. 

Patients will require frequent follow-up visits for potential side effects, which can include high blood pressure, potential liver function abnormalities, and bleeding risks. Regular laboratory testing, including liver and kidney function tests, is included in the monitoring schedule of patients on treatment.

1. What is Cabometyx?

   • Cabometyx (cabozantinib) is a prescription medication used to treat certain types of cancer, including advanced renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC).

2. How does Cabometyx work?

   • Cabometyx is a tyrosine kinase inhibitor that works by blocking specific proteins involved in cancer cell growth and blood vessel formation, ultimately slowing the progression of cancer.

3. What types of cancer is Cabometyx used to treat?

   • It is primarily approved for advanced renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC) in patients who have previously been treated with other therapies.

4. What are the common side effects of Cabometyx?

   • Common side effects include fatigue, decreased appetite, nausea, diarrhea, and hypertension. Patients may also experience more serious side effects, including liver problems.

5. How is Cabometyx administered?

   • Cabometyx is taken orally in tablet form, usually once daily, with or without food. It’s important to follow the prescribed dosage by a healthcare provider.

6. Can Cabometyx be taken with other medications?

   • Patients should inform their healthcare providers about all medications they are taking to avoid potential drug interactions. Some medications may affect how Cabometyx works or increase side effects.

7. What should I do if I miss a dose of Cabometyx?

   • If you miss a dose, take it as soon as you remember on the same day. However, if it’s almost time for the next dose, skip the missed dose and return to your regular schedule. Do not double the dose.

8. Are there any contraindications for taking Cabometyx?

   • Yes, Cabometyx should not be used in patients with a known hypersensitivity to cabozantinib or any of its components. Pregnant or breastfeeding individuals should also avoid this medication due to potential risks.

9. How should Cabometyx be stored?

   • Store Cabometyx at room temperature, away from moisture and heat, and keep it out of reach of children.

10. What precautions should I take while on Cabometyx?

    • Patients should have regular liver function tests, monitor for signs of high blood pressure or bleeding, and report any unusual symptoms to their healthcare provider.

11. What is the recommended dosage for Cabometyx?

    • The usual starting dose for Cabometyx in treating RCC is 60 mg once daily. This may vary based on individual factors, so it’s essential to follow your doctor’s recommendations.

12. Can Cabometyx cause liver damage?

    • Yes, Cabometyx can cause serious liver issues. Patients should undergo regular liver function tests and contact their doctor if they experience symptoms like jaundice, dark urine, or abdominal pain.

13. Is Cabometyx suitable for elderly patients?

    • Elderly patients can take Cabometyx, but they may be more susceptible to side effects. Dosage adjustments may be necessary based on their overall health.

14. How long do patients typically stay on Cabometyx?

    • The duration of treatment with Cabometyx varies among individuals, depending on response to therapy and tolerance of side effects. Regular evaluations help determine the continuation of treatment.

15. Can Cabometyx be used in combination with immunotherapy?

    • Some studies suggest that combining Cabometyx with certain immunotherapies may enhance treatment efficacy. Always consult your oncologist for personalized treatment plans.

16. What are the signs of a serious allergic reaction to Cabometyx?

    • Signs of a serious allergic reaction may include rash, itching, swelling, severe dizziness, and trouble breathing. Seek immediate medical attention if these occur.

17. How can I manage side effects while taking Cabometyx?

    • It’s important to communicate any side effects with your doctor. They may recommend dietary changes, hydration, or medications to help manage symptoms.

18. What clinical trials are currently ongoing for Cabometyx?

    • Several clinical trials are investigating Cabometyx for different cancers and combinations with other therapies. Patients can consult clinical trial databases or their healthcare provider for more information.

19. Can I drink alcohol while taking Cabometyx?

    • It is advisable to limit or avoid alcohol while on Cabometyx, as alcohol can exacerbate liver side effects and overall health.

20. Where can I find more information about Cabometyx?

    • For more information, patients can visit the official website or talk to their healthcare provider or pharmacist, who can provide resources and support tailored to individual needs.