{"product_id":"generic-cabozantinib-cabodx-20","title":"CABODX 20 (Cabozantinib)","description":"\u003cp\u003eCabozantinib is an anti-cancer medication used to treat medullary thyroid cancer, renal cell carcinoma, and hepatocellular carcinoma. It is a small molecule inhibitor of the tyrosine kinases c-Met and VEGFR2, and also inhibits AXL and RET.\u003c\/p\u003e\u003ch3\u003eMedullary Thyroid Cancer\u003c\/h3\u003e\u003cp\u003eCapsule only\u003c\/p\u003e\u003cp\u003eIndicated for treatment of progressive, metastatic medullary thyroid cancer (MTC)\u003c\/p\u003e\u003cp\u003e140 mg PO qDay\u003c\/p\u003e\u003cp\u003eContinue until disease progression or unacceptable toxicity occurs\u003c\/p\u003e\u003ch3\u003eRenal Cell Carcinoma\u003c\/h3\u003e\u003cp\u003eTablet only\u003c\/p\u003e\u003ch4\u003eCombination with nivolumab\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eIndicated in combination with nivolumab for first-line treatment of advanced renal cell carcinoma (RCC)\u003c\/li\u003e\n\u003cli\u003eCabozantinib 40 mg PO qDay PLUS nivolumab 240 mg IV q2Weeks or 480 mg IV q4Weeks\u003c\/li\u003e\n\u003cli\u003eContinue until disease progression or unacceptable toxicity\u003c\/li\u003e\n\u003cli\u003eNivolumab only: Continue for up to 2 years\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eSingle agent\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eIndicated for advanced RC\u003c\/li\u003e\n\u003cli\u003e60 mg PO qDay\u003c\/li\u003e\n\u003cli\u003eContinue until disease progression or unacceptable toxicity occurs\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch3\u003eHepatocellular Carcinoma\u003c\/h3\u003e\u003cp\u003eTablet only\u003c\/p\u003e\u003cp\u003eIndicated for patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib\u003c\/p\u003e\u003cp\u003e60 mg PO qDay\u003c\/p\u003e\u003cp\u003eContinue until disease progression or unacceptable toxicity occurs\u003c\/p\u003e\u003ch3\u003eDifferentiated Thyroid Cancer\u003c\/h3\u003e\u003cp\u003eIndicated for locally advanced or metastatic differentiated thyroid cancer (DTC) in adults who have progressed following prior VEGFR-targeted therapy and who are radioactive iodine-refractory or ineligible\u003c\/p\u003e\u003cp\u003eBSA \u0026gt;1.2 m\u003csup\u003e2\u003c\/sup\u003e: 60 mg PO qDay\u003c\/p\u003e\u003cp\u003eContinue until disease progression or unacceptable toxicity\u003c\/p\u003e\u003ch3\u003eDosage Modifications\u003c\/h3\u003e\u003ch4\u003eDosage reductions (Cabometyx)\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003e\n\u003ch5\u003eMonotherapy with BSA \u0026gt;1.2 m2\u003c\/h5\u003e\n\u003cul\u003e\n\u003cli\u003eFirst dose reduction: 40 mg PO qDay\u003c\/li\u003e\n\u003cli\u003eSecond dose reduction: 20 mg PO qDay\u003c\/li\u003e\n\u003cli\u003ePreviously receiving 20 mg qDay: Resume at same dose\u003c\/li\u003e\n\u003cli\u003eUnable to tolerate 20 mg qDay: Discontinue treatment\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003ch5\u003eIn combination with nivolumab\u003c\/h5\u003e\n\u003cul\u003e\n\u003cli\u003eFirst dose reduction: 20 mg PO qDay\u003c\/li\u003e\n\u003cli\u003eSecond dose reduction: 20 mg PO every other day\u003c\/li\u003e\n\u003cli\u003ePreviously receiving 20 mg every other day: Resume at same dose\u003c\/li\u003e\n\u003cli\u003eUnable to tolerate 20 mg every other day: Discontinue treatment\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eWithhold dose until Grade ≤1 or until complete resolution\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eResume at reduced dose\u003c\/li\u003e\n\u003cli\u003eGrade ≥2 diarrhea\u003c\/li\u003e\n\u003cli\u003eGrade 3 or intolerable grade 2 palmar-plantar erythrodysesthesia\u003c\/li\u003e\n\u003cli\u003eGrade 2 or 3 proteinuria\u003c\/li\u003e\n\u003cli\u003eAny grade osteonecrosis of jaw (ONJ)\u003c\/li\u003e\n\u003cli\u003eGrade ≥3 or intolerable grade 2 other adverse reactions\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eWithhold dose until Grade ≤1\u003c\/h4\u003e\u003cul\u003e\u003cli\u003e\n\u003ch5\u003eTablet\u003c\/h5\u003e\n\u003cul\u003e\n\u003cli\u003eConsider corticosteroid therapy if withheld or discontinued when administered in combination with nivolumab\u003c\/li\u003e\n\u003cli\u003eALT or AST \u0026gt;3x ULN but ≤10x ULN with concurrent total bilirubin [TB] \u0026lt;2x ULN\u003c\/li\u003e\n\u003cli\u003eAfter recovery, consider rechallenge with one or both of Cabometyx and nivolumab\u003c\/li\u003e\n\u003cli\u003eIf rechallenging with nivolumab with or without Cabometyx, refer to nivolumab prescribing information\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\u003c\/ul\u003e\u003ch4\u003eWithhold dose until adequately controlled at Grade ≤2\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eResume at reduced dose\u003c\/li\u003e\n\u003cli\u003eGrade 3 hypertension and hypertensive crisis\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003ePermanently discontinue\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eGrades 3 or 4 hemorrhage\u003c\/li\u003e\n\u003cli\u003eAny grade gastrointestinal perforation\u003c\/li\u003e\n\u003cli\u003eGrade 4 fistula\u003c\/li\u003e\n\u003cli\u003eAny grade acute myocardial infarction\u003c\/li\u003e\n\u003cli\u003eGrade ≥2 cerebral infarction\u003c\/li\u003e\n\u003cli\u003eGrade 3 or 4 arterial thromboembolic events\u003c\/li\u003e\n\u003cli\u003eGrade 4 venous thromboembolic events\u003c\/li\u003e\n\u003cli\u003eGrade 4 hypertension or uncontrolled hypertensive crisis\u003c\/li\u003e\n\u003cli\u003eNephrotic syndrome\u003c\/li\u003e\n\u003cli\u003eReversible posterior leukoencephalopathy syndrome (RPLS)\u003c\/li\u003e\n\u003cli\u003eALT or AST \u0026gt;10x ULN or \u0026gt;3x ULN with concurrent TB ≥2x ULN; permanently discontinue both nivolumab and Cabometyx\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eCYP3A4 inhibitors\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eAvoid coadministration with strong CYP3A4 inhibitors\u003c\/li\u003e\n\u003cli\u003eCometriq: If strong CYP3A4 inhibitor required, decrease cabozantinib dose by 40 mg\/day (eg, from 140 mg to 100 mg qDay)\u003c\/li\u003e\n\u003cli\u003eCabometyx: If strong CYP3A4 inhibitor required, decrease cabozantinib dose by 20 mg\/day (eg, from 60 mg to 40 mg qDay)\u003c\/li\u003e\n\u003cli\u003eResume previous dose 2-3 days after strong CYP3A4 inhibitor discontinued\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eCYP3A4 inducers\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eAvoid coadministration of strong CYP3A4 inducers\u003c\/li\u003e\n\u003cli\u003eCometriq: If strong CYP3A4 inducer required, increase dose by 40 mg\/day (eg, from 140 mg to 180 mg qDay); do not exceed 180 mg\/day\u003c\/li\u003e\n\u003cli\u003eCabometyx: If strong CYP3A4 inducer required, increase dose by 20 mg\/day (eg, from 60 mg to 80 mg qDay); do not exceed 80 mg\/day\u003c\/li\u003e\n\u003cli\u003eResume previous dose 2-3 days after strong CYP3A4 inducer discontinued\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eHepatic impairment\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003e\n\u003ch5\u003eTablet\u003c\/h5\u003e\n\u003cul\u003e\n\u003cli\u003eMild-to-moderate (Child-Pugh A or B): Reduce starting dose to 80 mg\/day\u003c\/li\u003e\n\u003cli\u003eModerate (Child-Pugh C): Not recommended\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003cli\u003e\n\u003ch5\u003eTablet\u003c\/h5\u003e\n\u003cul\u003e\n\u003cli\u003eMild (Child-Pugh A): No dosage adjustment necessary\u003c\/li\u003e\n\u003cli\u003eModerate (Child-Pugh B): Reduce starting dose to 40 mg\/day\u003c\/li\u003e\n\u003cli\u003eSevere (Child-Pugh C): Avoid use\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c\/li\u003e\n\u003c\/ul\u003e\u003ch4\u003eRenal impairment\u003c\/h4\u003e\u003cul\u003e\n\u003cli\u003eMild-to-moderate (CrCl ≥30 mL\/min): No dosage adjustment necessary\u003c\/li\u003e\n\u003cli\u003eSevere (CrCl \u0026lt;30 mL\/min): No experience\u003c\/li\u003e\n\u003c\/ul\u003e","brand":"BIGBEAR Pharma, Laos PDR","offers":[{"title":"Default Title","offer_id":44797951639595,"sku":"RL1720231021","price":0.0,"currency_code":"AMD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0701\/3528\/3755\/files\/2023-10-3053.jpg?v=1787022156","url":"https:\/\/xomeds.com\/products\/generic-cabozantinib-cabodx-20","provider":"XOMEDS","version":"1.0","type":"link"}