Cabozantinib (Cabometyx)


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
  • 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
  • 1 year

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