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Systemic Anti-Cancer Therapy Regimen Library

Home > GU Renal cell Metastatic - cABOZANtinib

GU Renal cell Metastatic - cABOZANtinib

Treatment Overview

Cycle 1 (and all further cycles) - 30 days

Cycle length:
30

Cycle details

Cycle 1 (and all further cycles) - 30 days

Medication Dose Route Days Max Duration
cABOZANtinib 60 mg Once daily oral administration 1 to 30
cycliZINE 50 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

Full details

Cycle 1 (and all further cycles) - 30 days

Day: 1

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.
cycliZINE 50 mg Three times daily oral administration
Instructions:

When required for nausea and/or vomiting.

  • Warning: may cause drowsiness.
  • Consider starting dose at 25 mg and increasing as tolerated/required.
  • The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.
  • Note that domperidone is not recommended in combination with cABOZANtinib due to potential risk of QT prolongation.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 3

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 4

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 5

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 6

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 7

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 8

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 9

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 10

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 11

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 12

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 13

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 14

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 15

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 16

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 17

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 18

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 19

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 20

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 21

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 22

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 23

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 24

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 25

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 26

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 27

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 28

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 29

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Day: 30

Medication Dose Route Max duration Details
cABOZANtinib 60 mg Once daily oral administration
Instructions:

Swallow whole do not crush or chew. Take each dose on an empty stomach - one hour before OR two hours after food.

Grapefruit or grapefruit juice may interact with this medicine, discuss with your pharmacist.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Medium to high

Emetogenicity: MEDIUM to HIGH—Routine antiemetic premedication may not be required for continuous dosing of oral anti-cancer medicines with MEDIUM to HIGH emetic risk; an individualised approach is appropriate. 

References

Choueiri TK, Escudier B, Powles T, et al. Cabozantinib versus everolimus in advanced renal-cell carcinoma. N Engl J Med 2015;373:1814-1823. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26406150., PMID: 26406150

Choueiri TK, Escudier B, Powles T, et al. Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial. Lancet Oncol 2016;17:917-927. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27279544., PMID: 27279544

Choueiri TK, Halabi S, Sanford BL, et al. Cabozantinib versus sunitinib as initial targeted therapy for patients with metastatic renal cell carcinoma of poor or intermediate risk: the alliance A031203 CABOSUN trial. J Clin Oncol 2017;35:591-597. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28199818., PMID: 28199818

Motzer RJ, Escudier B, Powles T, et al. Long-term follow-up of overall survival for cabozantinib versus everolimus in advanced renal cell carcinoma. Br J Cancer 2018;118:1176-1178. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29576624., PMID: 29576624

Amzal B, Fu S, Meng J, et al. Cabozantinib versus everolimus, nivolumab, axitinib, sorafenib and best supportive care: A network metaanalysis of progression-free survival and overall survival in second line treatment of advanced renal cell carcinoma. PLoS One 2017;12:e0184423. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28886175., PMID: 28886175

Pal SK, Tangen C, Thompson IM, Jr., et al. A comparison of sunitinib with cabozantinib, crizotinib, and savolitinib for treatment of advanced papillary renal cell carcinoma: a randomised, open-label, phase 2 trial. Lancet 2021;397:695-703. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33592176., PMID: 33592176

Healthcare Logistics Cabometyx New Zealand datasheet 3 September 2022 https://www.medsafe.govt.nz/profs/Datasheet/c/Cabometyxtab.pdf (accessed 30 September 2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.