PMID- 29146618
OWN - NLM
STAT- MEDLINE
DCOM- 20190912
LR  - 20240323
IS  - 1549-490X (Electronic)
IS  - 1083-7159 (Print)
IS  - 1083-7159 (Linking)
VI  - 23
IP  - 3
DP  - 2018 Mar
TI  - Management of Adverse Events Associated with Cabozantinib Therapy in Renal Cell 
      Carcinoma.
PG  - 306-315
LID - 10.1634/theoncologist.2017-0335 [doi]
AB  - Cabozantinib was recently approved for the treatment of advanced renal cell 
      carcinoma (RCC) after treatment with vascular endothelial growth factor 
      (VEGF)-targeted therapy. Cabozantinib is a multikinase inhibitor targeting VEGF 
      receptor (VEGFR) 2, mesenchymal-epithelial transition receptor, and "anexelekto" 
      receptor tyrosine kinase. A 60-mg daily dose led to improved overall survival and 
      progression-free survival (PFS) versus everolimus in advanced RCC patients as a 
      second- or later-line treatment in the METEOR trial. Improved PFS with 
      cabozantinib versus sunitinib has also been demonstrated in the first-line 
      setting in CABOSUN. However, cabozantinib, like other VEGFR inhibitors, is 
      associated with toxicity that may affect the patient's quality of life. The most 
      frequent adverse events (AEs) are diarrhea, fatigue, hypertension, hand-foot 
      syndrome, weight loss, nausea, and stomatitis. This article summarizes the safety 
      profile of cabozantinib in RCC patients and offers guidance for the management of 
      these AEs. We discuss the underlying mechanisms of these AEs and, based on our 
      experiences with cabozantinib and other multikinase inhibitors, we present 
      approaches to manage toxicity. Prophylactic and therapeutic solutions are 
      available to help with the management of toxicity associated with cabozantinib, 
      and adequate interventions can ensure optimum adherence and maximize patient 
      outcomes. IMPLICATIONS FOR PRACTICE: Cabozantinib leads to improved survival 
      outcomes in renal cell carcinoma patients compared with everolimus. However, 
      management of the adverse event profile is crucial to achieve optimum adherence 
      and outcomes with the use of cabozantinib. This review aims to provide 
      appropriate guidance that will minimize the impact of adverse events and help to 
      maximize the utility of this agent in patients with advanced renal cell 
      carcinoma.
CI  - (c) AlphaMed Press 2017.
FAU - Schmidinger, Manuela
AU  - Schmidinger M
AD  - Clinical Division of Oncology, Department of Medicine I, Medical University of 
      Vienna, Vienna, Austria manuela.schmidinger@meduniwien.ac.at.
FAU - Danesi, Romano
AU  - Danesi R
AD  - Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and 
      Experimental Medicine, University of Pisa, Pisa, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20171116
PL  - England
TA  - Oncologist
JT  - The oncologist
JID - 9607837
RN  - 0 (Anilides)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Pyridines)
RN  - 1C39JW444G (cabozantinib)
RN  - EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-2)
SB  - IM
MH  - Anilides/*adverse effects/pharmacokinetics/therapeutic use
MH  - Antineoplastic Agents/*adverse effects/pharmacokinetics/therapeutic use
MH  - Carcinoma, Renal Cell/*drug therapy
MH  - Drug-Related Side Effects and Adverse 
      Reactions/pathology/physiopathology/prevention & control/*therapy
MH  - Humans
MH  - Kidney Neoplasms/*drug therapy
MH  - Medication Adherence
MH  - Protein Kinase Inhibitors/adverse effects/pharmacokinetics/therapeutic use
MH  - Pyridines/*adverse effects/pharmacokinetics/therapeutic use
MH  - Quality of Life
MH  - Vascular Endothelial Growth Factor Receptor-2/antagonists & inhibitors
PMC - PMC5905684
OTO - NOTNLM
OT  - Adverse events management
OT  - Cabozantinib
OT  - Renal cell carcinoma
COIS- Disclosures of potential conflicts of interest may be found at the end of this 
      article.
EDAT- 2017/11/18 06:00
MHDA- 2019/09/13 06:00
PMCR- 2019/03/01
CRDT- 2017/11/18 06:00
PHST- 2017/07/17 00:00 [received]
PHST- 2017/10/19 00:00 [accepted]
PHST- 2017/11/18 06:00 [pubmed]
PHST- 2019/09/13 06:00 [medline]
PHST- 2017/11/18 06:00 [entrez]
PHST- 2019/03/01 00:00 [pmc-release]
AID - theoncologist.2017-0335 [pii]
AID - ONCO12321 [pii]
AID - 10.1634/theoncologist.2017-0335 [doi]
PST - ppublish
SO  - Oncologist. 2018 Mar;23(3):306-315. doi: 10.1634/theoncologist.2017-0335. Epub 
      2017 Nov 16.