CABOMETYX (cabozantinib)
SELF-ADMINISTRATION
FDA Approved Indications:
- Treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy
Prior authorization criteria:
- Prescribed by oncologist, AND
- Patient is at least 18 years of age, AND
- Patient has advanced renal cell carcinoma, AND
- Patient has received prior antiangiogenic therapy, AND
- Not recommended for use in patients with severe hepatic impairment
Dosing:
- 60 mg orally once daily
- Do not substitute Cabometyx tablets with caboozantinib capsules (Cometriq)
- Stop Cabometyx at least 28 days prior to scheduled surgery, including dental surgery
- Withhold Cabometyx fo NCI CTCAE Grade 4 adverse reactions, and for Grade 3 or intolerable Grade 2 adverse reactions that cannot be managed with a dose reuction or supportive care
- Permanently discontinue Cabometyx for any of the following: development of unmanageable fistual or GI perforation, severe hemorrhage, arterial thromboembolic event, hypertensive crisis or severe hypertension despite optimal medical management, nephrotic syndrome, or reversible posterior leukoencephalopathy syndrome
- Patients taking a strong CYP3A4 inhbitor: reduce the daily Cabometyx dose by 20mg
- Patients taking a strong CYP3A4 inducer: increase the daily Cabometyx dose by 20mg as tolerated (total daily dose should not exceed 80mg)
- Patients with mild or moderate (Child-Pugh A or B) hepatic impairment: reduce Cabometyx dose
Approval:
- 1 year