What is Cabozantinib: Uses, Dosage, Side Effects and More

Cabozantinib is a targeted cancer medication that helps slow the growth of certain types of cancer cells. It belongs to a class of drugs called tyrosine kinase inhibitors, which work by blocking specific proteins that cancer cells need to grow and spread throughout your body.

This medication represents an important treatment option for people facing advanced kidney cancer, liver cancer, and thyroid cancer. Your doctor may recommend cabozantinib when other treatments haven't been effective or when your cancer has specific characteristics that make this drug a good choice for your situation.

What is Cabozantinib Used For?

Cabozantinib treats three main types of advanced cancer. Your oncologist will determine if this medication is right for your specific situation based on your cancer type, stage, and how you've responded to other treatments.

The most common use is for advanced kidney cancer, also called renal cell carcinoma. This medication can help slow tumor growth when the cancer has spread to other parts of your body or when surgery isn't possible.

Doctors also prescribe cabozantinib for hepatocellular carcinoma, which is the most common type of liver cancer. It's typically used when the cancer is advanced and other treatments like surgery or liver transplant aren't options.

Additionally, this medication treats differentiated thyroid cancer that has spread and doesn't respond to radioactive iodine treatment. Your doctor will usually try other thyroid cancer treatments first before considering cabozantinib.

How Does Cabozantinib Work?

Cabozantinib is considered a strong, targeted cancer medication that blocks multiple pathways cancer cells use to survive and grow. Unlike chemotherapy that affects all rapidly dividing cells, this drug specifically targets proteins that cancer cells depend on.

The medication works by blocking tyrosine kinases, which are enzymes that send growth signals to cancer cells. When these signals are blocked, cancer cells can't multiply as quickly and may even die.

This drug also targets the blood vessels that feed tumors, cutting off their oxygen and nutrient supply. By blocking these pathways, cabozantinib can help shrink tumors or slow their growth, giving you more time and potentially better quality of life.

The effects aren't immediate since this medication works gradually over weeks to months. Your doctor will monitor your response through regular scans and blood tests to see how well the treatment is working.

How Should I Take Cabozantinib?

Take cabozantinib exactly as your doctor prescribes, usually once daily at the same time each day. The medication comes in capsules that you should swallow whole with a full glass of water.

You must take this medication on an empty stomach, which means at least one hour before eating or two hours after eating. Food can affect how much of the drug your body absorbs, potentially making it less effective.

If you have trouble swallowing the capsules, don't open or crush them. Instead, talk to your doctor about alternative ways to take the medication. The capsules contain a specific formulation that needs to remain intact.

Your doctor will likely start you on a standard dose but may adjust it based on how you respond and what side effects you experience. Don't change your dose or stop taking the medication without talking to your healthcare team first.

How Long Should I Take Cabozantinib For?

You'll typically take cabozantinib for as long as it's helping control your cancer and you're tolerating the side effects reasonably well. This often means taking it for months or even years, as it's designed to be a long-term treatment.

Your doctor will regularly assess whether the medication is still working through scans, blood tests, and monitoring your symptoms. If your cancer starts growing again or if side effects become too difficult to manage, your doctor may discuss changing your treatment plan.

Some people take cabozantinib for many months with good results, while others may need to stop sooner due to side effects or if the cancer doesn't respond. Your treatment timeline is unique to your situation and will be closely monitored by your healthcare team.

Never stop taking cabozantinib suddenly without your doctor's guidance, even if you're feeling better. Stopping the medication could allow your cancer to grow more quickly.

What Are the Side Effects of Cabozantinib?

Like all cancer medications, cabozantinib can cause side effects, though not everyone experiences them the same way. Your doctor will help you manage these effects so you can continue treatment safely.

Here are the most common side effects you might experience:

• Fatigue and weakness that may affect your daily activities
• Diarrhea, which can sometimes be severe
• Nausea and decreased appetite
• Hand-foot syndrome, causing pain, swelling, and skin changes on palms and soles
• High blood pressure that needs monitoring
• Weight loss
• Hair color changes or hair thinning
• Mouth sores or taste changes

Your healthcare team will monitor you closely for these effects and can provide medications or strategies to help manage them. Many side effects improve as your body adjusts to the treatment.

More serious but less common side effects need immediate medical attention. These include severe bleeding, blood clots, heart problems, or signs of liver damage like yellowing skin or severe abdominal pain.

Some rare but serious complications can occur, including severe high blood pressure, blood clots in the lungs or legs, and problems with wound healing. Your doctor will watch for these carefully and may need to adjust your treatment if they occur.

Who Should Not Take Cabozantinib?

Cabozantinib isn't safe for everyone, and your doctor will carefully review your medical history before prescribing it. Certain health conditions or medications can make this drug unsuitable or dangerous for you.

You shouldn't take cabozantinib if you're pregnant or planning to become pregnant, as it can harm a developing baby. Women of childbearing age need to use effective birth control during treatment and for several months after stopping the medication.

People with severe liver problems may not be able to take this medication safely, as the liver processes the drug. Your doctor will check your liver function before starting treatment and monitor it regularly.

If you have recent surgery or wounds that haven't healed properly, your doctor may delay starting cabozantinib. The medication can interfere with wound healing and increase bleeding risk.

Other conditions that may make cabozantinib unsuitable include severe heart problems, uncontrolled high blood pressure, or recent blood clots. Your doctor will weigh these risks against the potential benefits of treatment.

Cabozantinib Brand Names

Cabozantinib is available under two main brand names, each with different formulations for specific uses. Your doctor will prescribe the version that's most appropriate for your type of cancer.

Cabometyx is the brand name for cabozantinib tablets used to treat kidney cancer and liver cancer. This is the most commonly prescribed form of the medication.

Cometriq is the brand name for cabozantinib capsules specifically approved for certain types of thyroid cancer. The dosing and formulation differ slightly from Cabometyx.

Both versions contain the same active ingredient but are formulated differently, so you shouldn't switch between them without your doctor's guidance. The pharmacy will dispense whichever version your doctor specifically prescribes.

Cabozantinib Alternatives

Several other targeted therapy medications can treat similar cancers when cabozantinib isn't suitable or stops working effectively. Your oncologist will consider these alternatives based on your specific cancer type and situation.

For kidney cancer, alternatives include sunitinib, pazopanib, axitinib, and nivolumab. Each works differently and may be better suited to different stages of disease or individual patient factors.

Liver cancer alternatives include sorafenib, lenvatinib, and regorafenib. Your doctor may try these medications before or after cabozantinib depending on your cancer's characteristics.

For thyroid cancer, alternatives include sorafenib, lenvatinib, and vandetanib. The choice depends on your thyroid cancer type and how it has responded to previous treatments.

Your doctor will consider factors like your overall health, previous treatments, and specific cancer characteristics when choosing the best alternative for your situation.

Is Cabozantinib Better Than Sunitinib?

Both cabozantinib and sunitinib are effective medications for treating advanced kidney cancer, but they work in slightly different ways. Your doctor will choose the one that's most likely to help your specific situation.

Clinical studies suggest that cabozantinib may help people live longer than sunitinib when used as a second-line treatment after other therapies. However, this doesn't mean it's automatically better for everyone.

The side effect profiles differ between these medications. Cabozantinib more commonly causes hand-foot syndrome and diarrhea, while sunitinib may cause more fatigue and blood count changes.

Your doctor will consider your overall health, previous treatments, and ability to tolerate certain side effects when choosing between these options. What works best varies from person to person.