From the Research
The response rate to cabozantinib as first-line therapy for metastatic renal cell carcinoma (mRCC) is approximately 35%.
Key Points
- Cabozantinib (brand name Cabometyx) is typically administered at a dose of 60 mg orally once daily for mRCC patients.
- The drug works as a tyrosine kinase inhibitor that targets multiple pathways involved in tumor growth, angiogenesis, and metastasis, including VEGFR, MET, and AXL.
- In clinical trials, cabozantinib has demonstrated efficacy in both treatment-naïve and previously treated mRCC patients.
- The BONSAI trial specifically evaluated cabozantinib as first-line therapy in patients with metastatic collecting duct renal cell carcinoma, showing an objective response rate of 35% 1.
- Common side effects include diarrhea, fatigue, hypertension, palmar-plantar erythrodysesthesia, and decreased appetite, which may require dose modifications.
- Regular monitoring of blood pressure, liver function, electrolytes, and proteinuria is recommended during treatment.
- Cabozantinib is generally continued until disease progression or unacceptable toxicity occurs.
Treatment Considerations
- The choice of cabozantinib as first-line therapy should be based on individual patient factors, including tumor histology, performance status, and comorbidities.
- Patients with metastatic collecting duct renal cell carcinoma may benefit from cabozantinib as first-line therapy, given the limited treatment options available for this rare tumor type.
- Further studies are needed to fully elucidate the efficacy and safety of cabozantinib in different patient populations and to explore potential biomarkers for response to therapy.