Cabozantinib's Effects on Thyroid Profile

Clinical Presentation and Monitoring

Grade 3 or 4 treatment-related adverse events occurred in 57% of patients receiving cabozantinib in the COSMIC-311 trial, though specific thyroid dysfunction rates weren't highlighted in this guideline, as reported by the European Society for Medical Oncology 1, 2

Cabozantinib is available in two formulations: tablets (60 mg daily) for differentiated thyroid cancer (DTC) and capsules (140 mg daily) for medullary thyroid cancer (MTC), according to the National Comprehensive Cancer Network 1, 3
These formulations are not bioequivalent and should not be used interchangeably, as stated by the American Society of Clinical Oncology 1, 3
Dose reductions are commonly required to manage adverse events, with 56% of patients in the COSMIC-311 trial requiring initial dose reduction and 22% requiring a secondary dose reduction, as reported by the European Society for Medical Oncology 1, 2

Only 5% of patients in the COSMIC-311 trial discontinued treatment due to treatment-related adverse events in general, according to the European Society for Medical Oncology 1, 2
Understanding the potential for thyroid dysfunction is important when considering cabozantinib as a therapeutic option, particularly in the second-line setting after progression on other MKIs, as recommended by the National Comprehensive Cancer Network 1, 3
The risk-benefit profile should be considered in the context of cabozantinib's demonstrated efficacy in improving progression-free survival in patients with radioiodine-refractory DTC, as reported by the American Society of Clinical Oncology 1, 3