Systemic Anti-Cancer Therapy Regimen Library
GU Renal cell Metastatic - cABOZANtinib and nivolumab
Treatment Overview
Continue until disease progression or unacceptable toxicity (up to 2 years for nivolumab).
Cycle 1 (and all further cycles) - 14 days
Cycle details
Cycle 1 (and all further cycles) - 14 days
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| cABOZANtinib | 40 mg Once daily | oral administration | 1 to 14 | |
| nivolumab | 240 mg flat dosing | intravenous | 1 | 30 minutes |
| cycliZINE | 50 mg Three times daily | oral administration | 1 | |
| loperamide | 2 mg | oral administration | 1 |
Full details
Cycle 1 (and all further cycles) - 14 days
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| cABOZANtinib | 40 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. |
|
| nivolumab | 240 mg flat dosing | intravenous | 30 minutes |
Instructions:
Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 1.2 micron in-line filter. |
| cycliZINE | 50 mg Three times daily | oral administration |
Instructions:
When required for nausea and/or vomiting.
|
|
| 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 | 40 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 |
| Hypersensitivity / Infusion related reaction risk: | Low - routine premedication not recommended |
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
Healthcare Logistics Cabometyx New Zealand datasheet 3 September 2022 https://www.medsafe.govt.nz/profs/Datasheet/c/Cabometyxtab.pdf (accessed 30 September 2022).
Bristol-Myers Squibb (NZ) Limited. Opdivo New Zealand Data Sheet 2 September 2022 https://www.medsafe.govt.nz/profs/Datasheet/o/opdivoinf.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.