Oral
cabozantinib tablets (Cabometyx®) are an important option for the treatment of advanced
renal cell carcinoma (RCC).
Cabozantinib is an anti-angiogenic agent and potently inhibits multiple
tyrosine kinases, including those implicated in the development of RCC. The previously approved indication of
cabozantinib tablets (i.e. treatment of advanced RCC following prior
VEGF-targeted
therapy) has been extended to include the first-line treatment of advanced RCC in treatment-naïve adults with intermediate or poor risk (EU) and all patients with advanced RCC (USA). These label extensions are based on the results of a randomized, open-label phase 2 trial, in which adults with metastatic RCC of poor or intermediate risk received targeted first-line treatment with
cabozantinib or standard-of-care
sunitinib. Relative to
sunitinib,
cabozantinib significantly prolonged median progression-free survival (primary endpoint; investigator and independent assessments), and increased the objective response rate (investigator assessment). The tolerability profile of
cabozantinib is comparable to those of other
tyrosine kinase inhibitors, with adverse events being manageable with medical intervention, dosage reductions, treatment interruption and/or permanent discontinuation.