Figures & data
Figure 1 Median time to first occurrence for AEs of clinical interest in patients receiving cabozantinib during the METEOR study.
Notes:
aRates for any grade except hemorrhage. Safety-analysis set (n=331); data cutoff May 22, 2015. AEs of clinical interest include those associated with TKIs, VEGF-pathway inhibition, or potentially serious complications.Citation23 Rates for some AEs may vary from those reported in Choueiri et al,Citation7 because of adjudication and reconciliation during independent review. For AE rates >5%, the size of the marker is proportional to the rate.
Abbreviations: AEs, adverse events; GI, gastrointestinal; IQR, interquartile range: PPES, palmar–plantar erythrodysesthesia syndrome; TE, thromboembolism; TKIs, tyrosine-kinase inhibitors.
Abbreviations: AEs, adverse events; GI, gastrointestinal; IQR, interquartile range: PPES, palmar–plantar erythrodysesthesia syndrome; TE, thromboembolism; TKIs, tyrosine-kinase inhibitors.
Figure 2 Cabozantinib-dosing algorithm.
Notes:
aFor patients with mild–moderate hepatic impairment or for patients requiring concomitant treatment with a strong CYP3A4 inhibitor, reduce starting dose to 40 mg. For patients requiring concomitant treatment with a strong CYP3A4 inducer, increase starting dose to 80 mg. Data from these studies.Citation12,Citation13,Citation30
Abbreviations: AEs, adverse events; GI, gastrointestinal; RPLS, reversible posterior leukoencephalopathy syndrome.
Abbreviations: AEs, adverse events; GI, gastrointestinal; RPLS, reversible posterior leukoencephalopathy syndrome.
Figure 3 Common AEs experienced by patients in the cabozantinib arm of the METEOR study (safety-analysis set, n=331).Citation7
Notes:
aInstrumental ADL: preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc. Self-care ADL: bathing, dressing and undressing, feeding self, using the toilet, taking medications, and not bedridden. Data cutoff May 22, 2015. National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 descriptions for grades 1–3 are shown.Citation31 There were no grade ≥4 events for hypertension, diarrhea, vomiting, stomatitis, or decreased appetite. Grade 3 is the most severe grade for PPES, fatigue, and nausea. Individual icons reproduced from the Noun Project (https://thenounproject.com).
Abbreviations: ADL, activities of daily living; AE, adverse event; BP, blood pressure; Gr, grade; TPN, total parenteral nutrition; PPES, palmar–plantar erythrodysesthesia syndrome; WNL, within normal limits.
Abbreviations: ADL, activities of daily living; AE, adverse event; BP, blood pressure; Gr, grade; TPN, total parenteral nutrition; PPES, palmar–plantar erythrodysesthesia syndrome; WNL, within normal limits.
Table 1 Summary of prophylactic and supportive-care strategies for patients treated with cabozantinib
Figure 4 Examples of palmar–plantar erythrodysesthesia syndrome resulting from treatment with cabozantinib in patients with solid tumors.
Notes: Erythema, hyperkeratosis, and callus formation at sites of friction of hands (A) and feet (B).Citation77 Bullae, hyperkeratosis, and erythema on medial surface (C) and plantar surface (D) of feet.Citation48
A and B Republished with permission of Dove Medical Press, from The treatment landscape in thyroid cancer: a focus on cabozantinib, Weitzman SP, Cabanillas ME, Volume 7, 2015; permission conveyed through Copyright Clearance Center, Inc.Citation77
C and D Reproduced with permission from JAMA Dermatology, 2015, Volume 151 (Issue 2): pages 170–177]. Copyright© 2015 American Medical Association. All rights reserved.Citation48
