Medical Information

The dosage of Cabozantinib should be adjusted according to the indications, dosage form, and individual patient conditions. It should be taken as a whole and avoided with grapefruit. Treatment should be continued until disease progression or intolerable toxicity occurs.

1. Conventional dosage regimen

(1) Thyroid medullary carcinoma: Adults take 140mg orally (1 80mg capsule+3 20mg capsules) once a day.

(2) Differentiated thyroid cancer: Adults and children aged 12 and above with a body surface area of ≥ 1.2 square meters should take 60mg per day; those with a body surface area of<1.2 square meters should take 40mg per day.

(3) Renal cell carcinoma: monotherapy at 60mg per day; reduced to 40mg per day when combined with nivolumab.

(4) Hepatocellular carcinoma: A fixed dose of 60mg per day for adults.

2. Adjustment for special populations

(1) Liver dysfunction: Mild to moderate medication should be administered with caution, and severe (Child Pugh C grade) should be avoided.

(2) Renal insufficiency: Mild to moderate without adjustment, severe or dialysis patients without data support.

(3) Children: Only available for patients aged 12 and above, dosage should be accurately calculated based on body surface area.

3. Medication precautions

(1) Time: Take at a fixed time every day. Capsules are recommended to be taken on an empty stomach, while tablets can be taken with food.

(2) Missed medication: If it is less than 12 hours before the next medication, it should be skipped and double supplementation is prohibited.

(3) Taboo: Avoid taking with strong CYP3A4 inhibitors (such as grapefruit) as it may increase the risk of toxicity.

4. Treatment cycle management

(1) Continuous medication: All indications require long-term treatment until disease progression or intolerable toxicity occurs.

(2) Combination therapy: The longest duration of using nivolumab in combination with renal cancer treatment is 2 years, and immune related adverse reactions need to be monitored simultaneously.