Introduction
Caboz Capsule 20 mg is a multi-target tyrosine kinase inhibitor used in the treatment of several advanced cancers, including medullary thyroid cancer, advanced renal cell carcinoma, and hepatocellular carcinoma. It works by inhibiting multiple receptor tyrosine kinases involved in tumor growth, angiogenesis, and metastasis.
Uses
Caboz Capsule 20 mg is a tyrosine kinase inhibitor used to treat advanced renal cell carcinoma, hepatocellular carcinoma, and medullary thyroid cancer.
Caboz Capsule 20 mg is indicated for the treatment of progressive, metastatic medullary thyroid cancer. It is also indicated for the treatment of advanced renal cell carcinoma and for hepatocellular carcinoma in patients previously treated with sorafenib.
Associated Conditions
Pharmacodynamics
Caboz Capsule 20 mg suppresses metastasis, angiogenesis, and oncognesis by inhibiting receptor tyrosine kinases.
Mechanism of Action
Caboz Capsule 20 mg inhibits specific receptor tyrosine kinases such as VEGFR-1, -2 and -3, KIT, TRKB, FLT-3, AXL, RET, MET, and TIE-2.
Absorption
After oral administration, peak plasma concentration was achieved in 2-5 hours.
Volume of Distribution
The volume of distribution is 349L.
Protein Binding
Caboz Capsule 20 mg has extensive plasma protein binding (≥ 99.7%).
Route of Elimination
Caboz Capsule 20 mg is eliminated mostly by the feces (54%) and also by the urine (27%).
Half Life
Caboz Capsule 20 mg has a long half-life of 55 hours.
Clearance
At steady state, the clearance is 4.4 L/hr.
Toxicity
Caboz Capsule 20 mg carries a warning of serious gastrointestinal fistulas and perforations, and potentially fatal hemoptysis and gastrointestinal hemorrhage.
Food Interactions
- Avoid grapefruit products. Grapefruit inhibits CYP3A4 metabolism, which may increase levels of cabozantinib.
- Avoid St. John's Wort. This herb induces CYP3A4 metabolism, which may reduce serum levels of cabozantinib.
- Take on an empty stomach. Separate the administration of cabozantinib from food by at least 1 hour before or 2 hours after eating.
- Take with a full glass of water.
Dosage
Recommended Dosage for Hepatocellular Carcinoma: The recommended dosage of Caboz Capsule 20 mg is 60 mg once daily without food until disease progression or unacceptable toxicity. Or, as directed by the registered physicians.
- Stop treatment with Caboz Capsule 20 mg at least 28 days prior to scheduled surgery, including dental surgery.
- Do not substitute Caboz Capsule 20 mg tablets with Caboz Capsule 20 mg capsules.
- Do not administer Caboz Capsule 20 mg with food. Administer at least 1 hour before or at least 2 hours after eating.
- Swallow Caboz Capsule 20 mg tablets whole. Do not crush Caboz Capsule 20 mg tablets.
- Do not take a missed dose within 12 hours of the next dose.
- Modify the dose for certain patients with hepatic impairment and for patients taking drugs known to strongly induce or inhibit CYP450.
