Renal cell carcinoma (RCC), commonly known as kidney cancer, originates in the lining of the kidney tubules. This type of cancer can be challenging to treat, particularly when it has spread to other parts of the body. Cabozantinib is a medication used as a targeted therapy for advanced forms of renal cell carcinoma. It represents an important advancement in managing this disease.
How Cabozantinib Targets Cancer
Cabozantinib functions as a multi-targeted tyrosine kinase inhibitor (TKI), which means it interferes with several specific pathways that promote cancer growth. It primarily targets receptor tyrosine kinases such as MET, VEGFR2, and AXL. These receptors play roles in tumor angiogenesis (new blood vessel formation) and the growth and spread of cancer cells.
By blocking the activity of these key targets, cabozantinib aims to slow tumor growth, inhibit the development of new blood vessels that feed the tumor, and reduce the cancer’s ability to spread. This multi-pronged approach distinguishes it from some other therapies that may focus on a single pathway.
Who Receives Cabozantinib Treatment
Cabozantinib is prescribed for patients with advanced renal cell carcinoma. It is approved for those with advanced clear cell RCC who have previously received anti-angiogenic therapy. The FDA initially approved cabozantinib for this group in April 2016.
The medication’s use has expanded to include treatment-naive patients with advanced renal cell carcinoma, following its approval for this indication in December 2017. Cabozantinib is also being investigated and has shown promise in treating non-clear cell RCC, such as papillary renal cell carcinoma. In clinical trials, cabozantinib has demonstrated effectiveness in prolonging progression-free survival in patients with metastatic papillary RCC.
Managing Treatment Side Effects
Patients on cabozantinib may experience various side effects. Fatigue is a common side effect, and managing it often involves balancing activity with rest periods. Diarrhea is also frequently reported, and can be managed with anti-diarrheal medications and dietary adjustments, such as avoiding foods that might exacerbate symptoms.
Hand-foot syndrome, characterized by redness, swelling, and pain on the palms and soles, can occur. This condition may be alleviated by using moisturizing creams, avoiding prolonged pressure on hands and feet, and sometimes with dose adjustments of the medication. High blood pressure is another notable side effect, requiring regular monitoring and potentially medication to keep it within a healthy range.
Changes in appetite and weight loss can also be experienced, necessitating nutritional support and dietary counseling. Other possible side effects include nausea, vomiting, and changes in liver function. Patients should promptly communicate any side effects to their healthcare team, as dose modifications or supportive care can often help manage these issues and maintain treatment adherence.
Understanding Treatment Outcomes
Cabozantinib has demonstrated a positive impact on treatment outcomes for patients with advanced renal cell carcinoma. Clinical trials have shown that it can improve progression-free survival, meaning patients live longer without their disease worsening.
The medication has also shown an improvement in overall survival in specific settings. For instance, in a randomized Phase III trial, cabozantinib significantly improved overall survival compared to another standard treatment, with a median overall survival of 21.4 months versus 16.5 months. These outcomes indicate that cabozantinib offers a benefit in controlling the disease and extending life for eligible patients.