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Cabozantinib

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-CABOZANTINIB
TypeDrug
Aliases
CabometyxCometriqКабозантиніб
Statusreviewed 2026-04-27 | pending_clinical_signoff
DiseasesDIS-HCC DIS-MTC DIS-RCC
SourcesSRC-NCCN-HCC-2025 SRC-NCCN-KIDNEY-2025 SRC-NCCN-THYROID-2025

Drug Facts

ClassMulti-kinase inhibitor (MET, VEGFR1-3, RET, AXL, KIT, FLT3, ROS1)
MechanismOral multi-targeted TKI inhibiting MET, VEGFR1-3, RET, AXL, KIT, FLT3, and ROS1. Approved for medullary thyroid carcinoma (EXAM trial — capsule formulation Cometriq 140 mg), renal cell carcinoma (METEOR / CABOSUN — tablet formulation Cabometyx 60 mg), HCC (CELESTIAL 2L), and DTC (COSMIC-311). Activity in MTC independent of RET mutation status — option for RET-WT MTC where selective RET inhibitors are not appropriate.
Typical dosingMedullary thyroid carcinoma (Cometriq capsules): 140 mg PO once daily on empty stomach (≥1 h before / ≥2 h after food). RCC / HCC / DTC (Cabometyx tablets): 60 mg PO once daily on empty stomach. Capsule and tablet formulations are NOT bioequivalent.
Ukraine registeredFalse
NSZU reimbursedFalse
Ukraine last verified2026-04-27

Warnings

Notes

EXAM (Schoffski 2012, MTC): cabozantinib 140 mg vs placebo improved PFS 11.2 vs 4.0 mo; OS benefit in M918T-mutant subgroup. ZETA (vandetanib) is the alternative MTC multikinase TKI; both predate RET-selective era. Modern preferred sequence in advanced RET-mutant MTC: selpercatinib > pralsetinib > cabozantinib / vandetanib (toxicity pushes selectives first). For RET-WT MTC (RAS-mutant or unknown), cabozantinib retains primary role. Capsule (Cometriq) and tablet (Cabometyx) are NOT interchangeable — different bioavailability per FDA prescribing information.

Used By

Regimens