# Cabozantinib

Source: https://onco.cc/drugs/cabozantinib/  
OnCo record `cabozantinib` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A pill that blocks both blood-vessel growth and the MET escape pathway, used in kidney, liver, thyroid and, since 2025, neuroendocrine cancers.

## Summary

CELESTIAL: OS 10.2 vs 8.0 months after sorafenib in HCC (HR 0.76). CheckMate 9ER: with nivolumab, first-line RCC. CABINET (2024-25): PFS 13.8 vs 4.4 months in pancreatic NETs and 8.4 vs 3.9 months in extra-pancreatic NETs after prior therapy, leading to FDA approval in March 2025; ESMO 2025 subgroup showed an 81% reduction in progression risk in lung and thymic NETs. COSMIC-312 (with atezolizumab, first-line HCC) improved PFS but not OS.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Cabometyx
- Modality: Small-molecule multi-kinase inhibitor (MET, VEGFR2, AXL, RET)
- Mechanism: Oral inhibitor of MET, VEGFR2, AXL, RET, KIT and FLT3; MET/AXL inhibition counters anti-VEGF resistance.
- Approvals: US 2012: Medullary thyroid cancer (Cometriq); US 2016: Advanced RCC; US 2019: HCC previously treated with sorafenib; US 2025: Advanced pancreatic and extra-pancreatic neuroendocrine tumours after prior therapy (CABINET); US 2017: First-line advanced RCC (CABOSUN); US 2021: First-line advanced RCC with nivolumab (CheckMate 9ER); EU 2014: Cometriq for medullary thyroid cancer; 21 Mar 2014. Cabometyx (RCC) Sep 2016
- Dosing: Oral; 60 mg daily (Cabometyx tablets)
- Toxicity (grade 3+): Hand-foot skin reaction 17%; Hypertension 16%; Diarrhoea 10%

## Notes

- In kidney cancer: CABOSUN (first line versus sunitinib, PFS benefit), METEOR (second line versus everolimus, OS 21.4 versus 16.5 months), CheckMate 9ER (with nivolumab, OS benefit), COSMIC-313 (triplet, no OS gain) and CONTACT-03 (no benefit from adding atezolizumab). The dose is 40 mg daily with nivolumab, and about 65 percent of patients have a grade 3 or higher event; the long half-life of about 99 hours matters when toxicity appears.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Cabozantinib
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Cabozantinib

## Connected records

- cancers: [Adrenocortical carcinoma](https://onco.cc/cancers/adrenocortical/), [Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable)](https://onco.cc/cancers/advanced-adrenocortical-carcinoma/), [Advanced hepatocellular carcinoma (BCLC C)](https://onco.cc/cancers/hcc-advanced/), [Chromophobe renal cell carcinoma](https://onco.cc/cancers/chromophobe-rcc/), [Clear cell renal cell carcinoma](https://onco.cc/cancers/clear-cell-rcc/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Medullary thyroid cancer](https://onco.cc/cancers/medullary-thyroid-cancer/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://onco.cc/cancers/multiple-endocrine-neoplasia/), [Multiple endocrine neoplasia type 2 (MEN2A and MEN2B)](https://onco.cc/cancers/men2-syndrome/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Osteosarcoma](https://onco.cc/cancers/osteosarcoma/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Papillary renal cell carcinoma](https://onco.cc/cancers/papillary-rcc/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/), [Renal cell carcinoma](https://onco.cc/cancers/rcc/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/), [TFE3-rearranged (translocation) renal cell carcinoma](https://onco.cc/cancers/tfe3-rearranged-renal-cell-carcinoma/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- technologies: [Anti-angiogenic therapy](https://onco.cc/technologies/antiangiogenic/), [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/), [Thyroglobulin, calcitonin and CEA in thyroid cancer follow-up](https://onco.cc/technologies/thyroid-cancer-markers/)
- targets: [AXL](https://onco.cc/targets/axl/), [MET](https://onco.cc/targets/met/), [RET](https://onco.cc/targets/ret/), [RON receptor (MST1R)](https://onco.cc/targets/ron/), [TIE2 receptor (TEK)](https://onco.cc/targets/tie2/), [VEGF / VEGFR](https://onco.cc/targets/vegf/)
- companies: [Exelixis](https://onco.cc/companies/exelixis/), [Ipsen](https://onco.cc/companies/ipsen/)
- trials: [A Study of Bempegaldesleukin (NKTR-214: BEMPEG) in Combination With Nivolumab Compared With the Investigator's Choice of a Tyrosine Kinase Inhibitor (TKI) Therapy (Either Sunitinib or Cabozantinib Monotherapy) for Advanced Metastatic Renal Cell Carcinoma (RCC)](https://onco.cc/trials/nct03729245/), [A Study of Cabozantinib Compared With Placebo in Subjects With Radioiodine-refractory Differentiated Thyroid Cancer Who Have Progressed After Prior Va](https://onco.cc/trials/nct03690388/), [A Study of Combining Cabozantinib and Atezolizumab for Advanced/Metastatic NSCLC (Cabatezo-1)](https://onco.cc/trials/nct05859217/), [A Study to Evaluate the Safety, Tolerability, and Efficacy of Pumitamig Alone or in Combination With Other Agents in Participants With Advanced Renal ](https://onco.cc/trials/nct07293351/), [A Trial of Belzutifan (PT2977, MK-6482) in Combination With Cabozantinib in Patients With Clear Cell Renal Cell Carcinoma (ccRCC) (MK-6482-003)](https://onco.cc/trials/nct03634540/), [CABINET (Alliance A021602)](https://onco.cc/trials/cabinet/), [CABONE](https://onco.cc/trials/cabone/), [Cabozantinib in Patients With RET Fusion-Positive Advanced Non-Small Cell Lung Cancer and Those With Other Genotypes: ROS1 or NTRK Fusions or Increased MET or A](https://onco.cc/trials/nct01639508/), [Cabozantinib Plus Durvalumab With or Without Tremelimumab in Patients With Gastroesophageal Cancer and Other Gastrointestinal Malignancies](https://onco.cc/trials/nct03539822/), [CELESTIAL](https://onco.cc/trials/celestial/), [CheckMate 9ER](https://onco.cc/trials/checkmate-9er/), [COMET-1](https://onco.cc/trials/comet-1/), [CONTACT-03](https://onco.cc/trials/contact-03/), [COSMIC-313](https://onco.cc/trials/cosmic-313/), [EXAM](https://onco.cc/trials/exam/), [Extension Study for Participants in Studies That Include Belzutifan (MK-6482-043/LITESPARK-043)](https://onco.cc/trials/nct07405164/), [LITESPARK-011](https://onco.cc/trials/nct04586231/), [Long-Term Extension Study for Participants Previously Enrolled in an Exelixis-Sponsored Study](https://onco.cc/trials/nct07620574/), [Pan Tumor Rollover Study](https://onco.cc/trials/nct03899155/), [PAPMET (SWOG S1500)](https://onco.cc/trials/papmet/), [Study of Cabozantinib in Combination With Atezolizumab Versus Second NHT in Subjects With mCRPC](https://onco.cc/trials/nct04446117/), [Study of Cabozantinib in Combination With Atezolizumab Versus Sorafenib in Participants With Advanced Hepatocellular Carcinoma (HCC) Who Have Not Rece](https://onco.cc/trials/nct03755791/), [Study of Casdatifan and Cabozantinib Versus Placebo and Cabozantinib in Patients With Advanced Clear Cell Renal Cell Carcinoma](https://onco.cc/trials/nct07011719/)
- key papers: [Belzutifan plus lenvatinib versus cabozantinib in patients with previously treated advanced renal cell carcinoma (LITESPARK-011): an open-label, randomised, controlled, phase 3 trial](https://onco.cc/key-papers/paper-litespark-011-motzer-lancet-2026/), [CABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours](https://onco.cc/key-papers/paper-cabinet-cabozantinib-nejm-2024/), [EXAM: cabozantinib in progressive medullary thyroid cancer](https://onco.cc/key-papers/paper-exam-cabozantinib-mtc-elisei-jco-2013/), [PAPMET (SWOG 1500): cabozantinib versus sunitinib for metastatic papillary renal cell carcinoma](https://onco.cc/key-papers/paper-papmet-pal-lancet-2021/)
- pairings: [Caution: PD-1 rechallenge after progression on immunotherapy (RCC)](https://onco.cc/pairings/io-rechallenge-caution-rcc/), [IMDC risk → first-line regimen choice (RCC)](https://onco.cc/pairings/risk-directed-first-line-rcc/)
- people: [Toni K. Choueiri](https://onco.cc/people/toni-choueiri/)
- terms: [Anti-VEGF class toxicities (hypertension, proteinuria, bleeding, perforation)](https://onco.cc/terms/antiangiogenic-toxicities/), [Hand-foot syndrome and hand-foot skin reaction](https://onco.cc/terms/hand-foot-syndrome/), [Tyrosine kinase inhibitor (TKI)](https://onco.cc/terms/tki-term/)
- pathways: [Hepatocellular carcinoma (KEGG map)](https://onco.cc/pathways/hepatocellular-carcinoma-signalling/), [Renal cell carcinoma (KEGG map)](https://onco.cc/pathways/renal-cell-carcinoma-signalling/), [The angiogenic switch & tumour vessels](https://onco.cc/pathways/angiogenic-switch/), [Thyroid cancer (KEGG map)](https://onco.cc/pathways/thyroid-cancer-signalling/)
- roadmaps: [Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall](https://onco.cc/roadmaps/targeted-therapy-roadmap/)

---
JSON: https://onco.cc/api/v1/entities/cabozantinib.json