Pharmacological properties and clinical outcomes of the anti-cancer drug, cabozantinib (CABOMETYX<sup>®</sup>)

  • Osaka Tsuyoshi
    Department of Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited
  • Yamaguchi Naoya
    Department of Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited
  • Hara Takahito
    Strategy Planning Office, Takeda Development Center Japan, Takeda Pharmaceutical Company Limited

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Other Title
  • 抗悪性腫瘍薬カボザンチニブ(カボメティクス<sup>®</sup>錠)の薬理学的特性及び臨床成績
  • 抗悪性腫瘍薬カボザンチニブ(カボメティクス錠)の薬理学的特性及び臨床成績
  • コウアクセイ シュヨウヤク カボザンチニブ(カボメティクスジョウ)ノ ヤクリガクテキ トクセイ オヨビ リンショウ セイセキ

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Abstract

<p>Cabozantinib (CAB) is a receptor tyrosine kinase inhibitor with activity against MET, VEGFR2, and AXL, among others. This drug is considered to exert excellent antitumor effects by inhibiting these targets simultaneously. Significant improvement in the primary endpoint (overall survival or PFS) were observed in patients on CAB in comparison with controls in a phase-III study in patients with renal cell carcinoma, progressed after treatment with anti-angiogenic agents, and in another phase-III study in patients with previously treated, advanced hepatocellular carcinoma. These results led to the approval of CAB in Japan in 2020 as a therapeutic agent for unresectable or metastatic renal cell carcinoma and unresectable hepatocellular carcinoma progressed after cancer chemotherapy, under the trade name of CABOMETYX® (20 mg, and 60 mg tablets). It has been suggested that CAB may modulate the immune system in favor of antitumor immunity and combined use with PD-1 checkpoint inhibitors may exert a synergistic effect. In a phase-III study that examined the efficacy of combination therapy with CAB and nivolumab in treatment-naive patients with advanced renal cell carcinoma, progression-free survival was significantly increased in patients on combination therapy over patients on sunitinib monotherapy. Three global phase-III clinical studies of combination therapy with atezolizumab and CAB in patients with non-small cell lung cancer, castration-resistant prostate cancer, and renal cell carcinoma, are in progress to confirm the efficacy of CAB.</p>

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