Cabozantinib is a type of oral tyrosine kinase inhibitor (TKI) used to treat a number of cancers, such as medullary thyroid cancer (MTC), hepatocellular carcinoma (HCC), and renal cell carcinoma (RCC). One of the dose alternatives that patients are administered as part of their treatment plan is Cabozantinib 20 mg, which comes in various strengths. The composition, mode of action, indications, usage, possible adverse effects, and safety measures of Cabozantinib 20 mg are all covered in detail in this publication.

Composition and Formulation

Cabozantinib 20 mg is offered as either film-coated tablets or capsules, based on the brand or formulation. By blocking many receptor tyrosine kinases implicated in tumor growth and angiogenesis, the active ingredient, cabozantinib (S)-malate, produces its anti-cancer actions. In order to guarantee stability and bioavailability, the tablets also include inert excipients such lactose monohydrate, magnesium stearate, hypromellose, croscarmellose sodium, and microcrystalline cellulose.

Mechanism of Action

Cabozantinib works as a multi-kinase inhibitor, focusing on particular pathways that encourage the growth and metastasis of tumors. The medicine mainly blocks receptors that are essential for angiogenesis, tumor invasion, and treatment resistance, including MET (hepatocyte growth factor receptor), VEGFR (vascular endothelial growth factor receptor), and AXL. Through blocking these pathways, Cabozantinib improves the immune response against cancer cells, inhibits the creation of new blood vessels required for tumor growth, and decreases the proliferation of tumor cells.

Indications and Uses

Cabozantinib 20 mg is indicated for the treatment of:

For patients with metastatic kidney cancer, advanced renal cell carcinoma (RCC) is a first- or second-line treatment option.

Hepatocellular Carcinoma (HCC): Suitable for patients who have received sorafenib treatment in the past.

For patients with progressing, metastatic, or incurable forms of the disease, Medullary Thyroid Cancer (MTC) is used.

Additional Investigative Uses: Clinical studies are assessing its potential for treating solid cancers, including prostate cancer.

Dosage and Administration

The type of cancer being treated, patient tolerance, and doctor recommendations all influence the recommended dosage of cabotinib. Although the entire dose often falls between 40 and 60 mg per day, the 20 mg strength is utilized when side effects or certain therapy modifications need a dose reduction. To optimize absorption, take the tablet whole with water, on an empty stomach, and at least one hour before or two hours after a meal.

Potential Side Effects

Cabozantinib 20 mg, like other TKIs, can cause side effects, some of which may require dose modification or discontinuation. Common side effects include:

• Fatigue
• Diarrhea
• Nausea and vomiting
• Hypertension (high blood pressure)
• Loss of appetite
• Hand-foot syndrome (palmar-plantar erythrodysesthesia)
• Weight loss
• Elevated liver enzymes

Gastrointestinal perforation, significant bleeding, problems with wound healing, and QT interval prolongation are examples of serious side effects. Any troubling symptoms should be reported right away to the patient’s healthcare physician.

Precautions and Contraindications

Pregnancy and Breastfeeding: Cabozantinib should not be used during pregnancy or nursing due to the possibility of fetal damage.

Drug Interactions: Drug levels may be impacted by concurrent use of potent CYP3A4 inducers or inhibitors.

Renal and Hepatic Impairment: Patients who have liver or kidney problems may need to change their dosage.

Surgical Considerations: Because of the possibility of wound healing difficulties, treatment should be stopped at least three weeks before to major surgery.

Conclusion

Cabozantinib 20 mg is a successful targeted treatment for a number of cancer forms, namely MTC, RCC, and HCC. It functions by blocking important pathways that contribute to the development and spread of tumors. Even though the medication has many therapeutic advantages, patients should be mindful of any adverse effects and take the appropriate safety measures to maximize treatment results. Before beginning or altering cabozantinib treatment, always get medical advice.

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1. When should cabozantinib be stopped?
It may be necessary to cease taking cabotizantinib at least three weeks before the planned operation and for two weeks following the procedure, or until the wound has healed. When taking cabozantinib, your blood pressure may rise. Take regular readings of your blood pressure and report any significant rises to your care team.

2. What is the rate of action of cabozantinib?
Dr. Durán and his team found that the median time to objective response for cabozantinib was 1.91 months (range: 1.6-11.0 months) and for everolimus, it was 2.14 months (range: 1.9-9.2 months). This matched to the time to the first post-baseline scan.

3. Does cabozantinib work?
Cabozantinib proved successful in unselected, significantly pretreated mRCC patients in the largest real-world investigation to date. A starting dose of 60 mg per day was linked to better results.

4. What is the duration required for Cabometyx to begin functioning?

After your initial dosage, Cabometyx begins to operate. You probably won’t feel the effects of the medicine on your body because of the way it functions. However, throughout therapy, your doctor will keep an eye on you to see if the medication is helping to address your illness.

5. What time of day is ideal for taking cabozantinib?
Both tablets (Cabometyx) and capsules (Cometriq) are available for oral administration of cabotezantinib. On an empty stomach, it is typically taken once daily, at least an hour before and two hours after meals. Take cabozantinib daily at approximately the same time.

6. What side effects might cabozantinib cause?
Weight loss, nausea, stomatitis, hand-foot syndrome, diarrhea, exhaustion, and high blood pressure are the most common adverse effects (AEs). The safety profile of cabozantinib in patients with RCC is compiled in this article, along with recommendations for handling these adverse events.