Practical management of adverse events associated with cabozantinib treatment in patients with renal-cell carcinoma.

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Gerendash BS, Creel PA

Practical management of adverse events associated with cabozantinib treatment in patients with renal-cell carcinoma.

Onco Targets Ther. 2017 Oct 19;10:5053-5064. doi: 10.2147/OTT.S145295. eCollection 2017.

PubMed ID

29089775 [ View in PubMed

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Abstract

Cabozantinib is an oral tyrosine-kinase inhibitor whose targets include VEGFR, MET, and AXL. Cabozantinib is approved for the treatment of patients with advanced clear-cell renal-cell carcinoma (RCC) who have received prior antiangiogenic therapy. In the pivotal Phase III trial of second-line RCC, cabozantinib was associated with a significant improvement in overall survival, progression-free survival, and antitumor response compared with everolimus. Adverse events (AEs) were common for patients receiving cabozantinib, but were effectively managed with supportive care and dose modifications, as discontinuations of cabozantinib due to an AE were infrequent. This article reviews the management of the more common AEs associated with cabozantinib based on findings from the pivotal study, clinical practice guidelines, and the authors' real-world clinical experience, with support from published literature. We focus on hypertension, palmar-plantar erythrodysesthesia, diarrhea, nausea, vomiting, decreased appetite, fatigue, and stomatitis. Effective management of these AEs involves a multimodal strategy that includes patient education, prophylactic and supportive care, and dose modifications. Effective AE management can allow patients to maintain antitumor activity with cabozantinib while mitigating the impact on quality of life.

DrugBank Data that Cites this Article

Drug Enzymes

Drug	Enzyme	Kind	Organism	Pharmacological Action	Actions
Cabozantinib	Cytochrome P450 3A4	Protein	Humans	No	Substrate	Details

Drug Interactions

• Approved
• Vet approved
• Nutraceutical
• Illicit
• Withdrawn
• Investigational
• Experimental
• All Drugs

Drugs	Interaction
Integrate drug-drug interactions in your software
Cabozantinib Amiodarone	The metabolism of Cabozantinib can be decreased when combined with Amiodarone.
Cabozantinib Delavirdine	The metabolism of Cabozantinib can be decreased when combined with Delavirdine.
Cabozantinib Methimazole	The metabolism of Cabozantinib can be decreased when combined with Methimazole.
Cabozantinib Midostaurin	The metabolism of Cabozantinib can be decreased when combined with Midostaurin.
Cabozantinib Ritonavir	The metabolism of Cabozantinib can be decreased when combined with Ritonavir.