Why some patients are not advised to take cabozantinib long-term

Cabozantinib is a multi-target tyrosine kinase inhibitor that is widely used to treat malignant tumors such as renal cell carcinoma, hepatocellular carcinoma, and medullary thyroid carcinoma. Although the efficacy is remarkable, some patients are not suitable for long-term use. The reasons mainly involve the following aspects:

Cabozantinib may cause cumulative toxicity. During long-term use, common adverse reactions such as hand-foot syndrome, hypertension, proteinuria, fatigue, stomatitis and other symptoms may worsen, affecting the patient's quality of life and even leading to treatment interruption. Some toxic effects are cumulative, and long-term exposure may lead to serious consequences, such as abnormal liver function or increased risk of bleeding.

Some patients have poor tolerance to the drug. Although the initial efficacy is obvious, the dose may become intolerable after continued use, requiring frequent dose reductions or interruptions, affecting the continuity and efficacy of treatment. In addition, individual differences are large, and some patients develop intolerable side effects after taking the drug for several months, limiting the feasibility of long-term use.

Long-term use of cabozantinib may lead to drug resistance issues. Some patients develop tumors that are resistant to cabozantinib during treatment, resulting in weakened efficacy or disease progression. At this time, it is difficult to obtain any benefit from continuing to take it, and it is necessary to consider switching to other targeted drugs or treatment strategies.

Elderly patients or patients with other underlying diseases are at higher risk when taking cabozantinib for a long time. For example, those with cardiovascular disease and liver and kidney dysfunction are more likely to develop serious complications during medication. Therefore, doctors will evaluate the risks and benefits based on the patient's specific situation and decide whether it is suitable for long-term use.

Reference materials:https://www.drugs.com/