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Identification
NameCabozantinib
Accession NumberDB08875
TypeSmall Molecule
GroupsApproved
DescriptionCabozantinib was approved in 2012 and is a non-specific tyrosine kinase inhibitor. It is marketed as Cometriq, which is indicated for the treatment of metastatic medullary thyroid cancer. It's label includes a black box warning of gastrointestinal perforations, fistulas, and hemorrhage. The FDA approved cabozantinib as Cabometyx for patients with advanced renal cell carcinoma in April 2016.
Structure
Thumb
SynonymsNot Available
External Identifiers
  • BMS 907351
  • BMS907351
  • XL 184
  • XL-184
  • XL184
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
CabometyxTablet20 mg/1OralExelixis2016-04-25Not applicableUs
CabometyxTablet40 mg/1OralExelixis2016-04-25Not applicableUs
CabometyxTablet60 mg/1OralExelixis2016-04-25Not applicableUs
CometriqCapsule20 mg/1OralExelixis2012-11-292016-10-13Us
CometriqKitExelixis2012-11-29Not applicableUs
CometriqCapsule20 mgOralTmc Pharma Services Ltd. 2014-03-21Not applicableEu
CometriqCapsule20 mg/1OralExelixis2012-11-29Not applicableUs
CometriqCapsule20 mgOralTmc Pharma Services Ltd. 2014-03-21Not applicableEu
CometriqKitExelixis2012-11-29Not applicableUs
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixturesNot Available
Salts
Name/CASStructureProperties
Cabozantinib malate
1140909-48-3
Thumb
  • InChI Key: HFCFMRYTXDINDK-WNQIDUERSA-N
  • Monoisotopic Mass: 635.191522341
  • Average Mass: 635.601
DBSALT001762
Categories
UNII1C39JW444G
CAS number849217-68-1
WeightAverage: 501.514
Monoisotopic: 501.169999048
Chemical FormulaC28H24FN3O5
InChI KeyONIQOQHATWINJY-UHFFFAOYSA-N
InChI
InChI=1S/C28H24FN3O5/c1-35-24-15-21-22(16-25(24)36-2)30-14-11-23(21)37-20-9-7-19(8-10-20)32-27(34)28(12-13-28)26(33)31-18-5-3-17(29)4-6-18/h3-11,14-16H,12-13H2,1-2H3,(H,31,33)(H,32,34)
IUPAC Name
N'1-{4-[(6,7-dimethoxyquinolin-4-yl)oxy]phenyl}-N1-(4-fluorophenyl)cyclopropane-1,1-dicarboxamide
SMILES
COC1=CC2=C(C=C1OC)C(OC1=CC=C(NC(=O)C3(CC3)C(=O)NC3=CC=C(F)C=C3)C=C1)=CC=N2
Pharmacology
IndicationFor the treatment of metastatic medullary thyroid cancer and for the treatment of patients with advanced renal cell carcinoma (RCC) who have received prior anti-angiogenic therapy.
Structured Indications
Clinical Trials
PhaseStatusPurposeConditionsCount
1Active Not RecruitingTreatmentChildhood Solid Neoplasm / Childhood Thyroid Gland Medullary Carcinoma / Recurrent Childhood Central Nervous System Neoplasm / Recurrent Melanoma / Recurrent Thyroid Gland Carcinoma / Thyroid Gland Medullary Carcinoma1
1Active Not RecruitingTreatmentMultiple Myeloma (MM)1
1Active Not RecruitingTreatmentPancreatic Cancers1
1Active Not RecruitingTreatmentProstate Cancers1
1CompletedTreatmentAdenocarcinoma, Prostate1
1CompletedTreatmentCancers / Lymphoma NOS / Thyroid Carcinoma1
1CompletedTreatmentCancers / Non-Small-Cell Lung Carcinoma (NSCLC) / Tumors, Solid1
1CompletedTreatmentFollicular Thyroid Cancer / Huerthle Cell Thyroid Cancer / Papillary Thyroid Cancer / Renal Cell Carcinoma (RCC)1
1CompletedTreatmentGiant Cell Glioblastoma / Glioblastomas / Gliosarcoma1
1CompletedTreatmentHealthy / Hepatic Impairment1
1CompletedTreatmentHealthy / Renal Impairments1
1RecruitingTreatmentAdult Solid Neoplasm / Advanced Malignant Neoplasm / Infection, Human Immunodeficiency Virus / Metastatic Malignant Neoplasm / Recurrent Malignant Neoplasm / Unresectable Malignant Neoplasm1
1RecruitingTreatmentCcRCC / Clear Cell Renal Cell Carcinoma / Kidney Cancer / RCC / Renal Cell Carcinoma (RCC)1
1RecruitingTreatmentColorectal Cancers1
1RecruitingTreatmentMalignant Reproductive System Neoplasm / Malignant Urinary System Neoplasm / Metastatic Urethral Neoplasm / Metastatic Urothelial Carcinoma of the Renal Pelvis and Ureter / Progressive Neoplastic Disease / Recurrent Bladder Carcinoma / Recurrent Urethra Carcinoma / Recurrent Urothelial Carcinoma of the Renal Pelvis and Ureter / Regional Urothelial Carcinoma of the Renal Pelvis and Ureter / Solid Neoplasms / Stage III Bladder Urothelial Carcinoma / Stage III Urethral Cancer / Stage IV Bladder Urothelial Carcinoma / Stage IV Urethral Cancer / Urethral Urothelial Carcinoma1
1RecruitingTreatmentRefractory Acute Myeloid Leukemia / Relapsed Acute Myeloid Leukemia1
1TerminatedTreatmentRecurrent Melanoma / Stage IIIA Melanoma / Stage IIIB Melanoma / Stage IIIC Melanoma / Stage IV Melanoma / Unspecified Adult Solid Tumor, Protocol Specific1
1, 2Active Not RecruitingTreatmentRelapsed Or Refractory Multiple Myeloma1
1, 2CompletedTreatmentNon-Small-Cell Lung Carcinoma (NSCLC)1
1, 2RecruitingTreatmentProstatic Neoplasms1
2Active Not RecruitingDiagnosticBone Metastases / Castrate-resistant Prostate Cancer (CRPC) / Recurrent Prostate Cancer / Stage IV Prostate Cancer1
2Active Not RecruitingTreatmentBile Duct Cancer / Cholangiocarcinoma of the Extrahepatic Bile Duct / Intrahepatic Cholangiocarcinoma1
2Active Not RecruitingTreatmentCarcinoma, Urothelial / Neoplasms, Kidney / Ureteral Neoplasms / Urethral Neoplasms / Urinary Bladder Neoplasms1
2Active Not RecruitingTreatmentClear Cell Renal Cell Carcinoma / Metastatic Renal Cell Cancer / Stage III Renal Cell Cancer / Stage IV Renal Cell Cancer1
2Active Not RecruitingTreatmentFallopian Tube Clear Cell Adenocarcinoma / Ovarian Clear Cell Adenocarcinoma / Recurrent Fallopian Tube Carcinoma / Recurrent Ovarian Carcinoma / Recurrent Primary Peritoneal Carcinoma1
2Active Not RecruitingTreatmentProstate Cancer Metastatic1
2Active Not RecruitingTreatmentProstate Cancers1
2Active Not RecruitingTreatmentRecurrent Fallopian Tube Carcinoma / Recurrent Ovarian Carcinoma / Recurrent Primary Peritoneal Carcinoma1
2Active Not RecruitingTreatmentRecurrent Non-Small Cell Lung Carcinoma / Stage IV Non-Small Cell Lung Cancer2
2Active Not RecruitingTreatmentRecurrent Uveal Melanoma / Stage IIIA Uveal Melanoma / Stage IIIB Uveal Melanoma / Stage IIIC Uveal Melanoma / Stage IV Uveal Melanoma1
2CompletedTreatmentAstrocytic Tumors1
2CompletedTreatmentCancer, Breast1
2CompletedTreatmentCancers / Tumors, Solid1
2CompletedTreatmentGlioblastoma Multiforme1
2Not Yet RecruitingTreatmentAdrenal Cortex Carcinoma / Adult Alveolar Soft Part Sarcoma / Adult Clear Cell Sarcoma of Soft Parts / Adult Hepatocellular Carcinoma / Adult Rhabdomyosarcoma / Adult Soft Tissue Sarcoma / Childhood Alveolar Soft Part Sarcoma / Childhood Central Nervous System Neoplasm / Childhood Clear Cell Sarcoma of Soft Parts / Childhood Hepatocellular Carcinoma / Childhood Rhabdomyosarcoma / Childhood Soft Tissue Sarcoma / Childhood Solid Neoplasm / Hepatoblastomas / Hepatocellular Carcinomas / Recurrent Adrenal Cortex Carcinoma / Recurrent Adult Hepatocellular Carcinoma / Recurrent Adult Soft Tissue Sarcoma / Recurrent Alveolar Soft Part Sarcoma / Recurrent Childhood Central Nervous System Neoplasm / Recurrent Childhood Hepatocellular Carcinoma / Recurrent Childhood Soft Tissue Sarcoma / Recurrent Ewing Sarcoma / Recurrent Hepatoblastoma / Recurrent Renal Cell Carcinoma / Recurrent Rhabdomyosarcoma / Recurrent Solid Neoplasm / Renal Cell Carcinoma (RCC) / Sarcoma, Ewing's / Thyroid Gland Medullary Carcinoma / Wilms Tumor1
2Not Yet RecruitingTreatmentMetastatic Gastrointestinal Stromal Tumor1
2RecruitingTreatmentBrain Tumor - Metastatic / Cancer, Breast1
2RecruitingTreatmentCancer, Breast1
2RecruitingTreatmentCarcinoid Tumors / Pancreatic Neuroendocrine Tumors (pNET)1
2RecruitingTreatmentDifferentiated Thyroid Cancer (DTC) / Poorly Differentiated Thyroid Cancer1
2RecruitingTreatmentEndometrial Adenosquamous Carcinoma / Endometrial Clear Cell Adenocarcinoma / Endometrial Mixed Adenocarcinoma / Endometrial Serous Adenocarcinoma / Metastatic Endometrioid Adenocarcinoma / Recurrent Uterine Corpus Carcinoma / Stage IVA Uterine Corpus Cancer / Stage IVB Uterine Corpus Cancer1
2RecruitingTreatmentLung Cancers / Solid Tumor (Not Breast or Prostate Cancers)1
2RecruitingTreatmentMetastases to the Brain / Non Small Cell Lung Cancer (NSCLC)1
2RecruitingTreatmentMetastatic Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor / Metastatic Osteosarcoma / Recurrent Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor / Recurrent Osteosarcoma1
2RecruitingTreatmentNeurofibromatosis / NF1 / Plexiform Neurofibromas1
2RecruitingTreatmentNeuroendocrine Carcinoma of the Skin / Skin Cancers1
2RecruitingTreatmentNon-Small-Cell Lung Carcinoma (NSCLC)1
2RecruitingTreatmentProstate Cancers1
2RecruitingTreatmentRecurrent Renal Cell Carcinoma / Stage III Renal Cell Cancer / Stage IV Renal Cell Cancer / Type 1 Papillary Renal Cell Carcinoma / Type 2 Papillary Renal Cell Carcinoma1
2RecruitingTreatmentRefractory Soft Tissue Sarcomas1
2RecruitingTreatmentUterine Sarcoma1
2SuspendedTreatmentPoorly Differentiated Thyroid Gland Carcinoma / Recurrent Thyroid Gland Carcinoma / Stage I Thyroid Gland Follicular Carcinoma / Stage I Thyroid Gland Papillary Carcinoma / Stage II Thyroid Gland Follicular Carcinoma / Stage II Thyroid Gland Papillary Carcinoma / Stage III Thyroid Gland Follicular Carcinoma / Stage III Thyroid Gland Papillary Carcinoma / Stage IVA Thyroid Gland Follicular Carcinoma / Stage IVA Thyroid Gland Papillary Carcinoma / Stage IVB Thyroid Gland Follicular Carcinoma / Stage IVB Thyroid Gland Papillary Carcinoma / Stage IVC Thyroid Gland Follicular Carcinoma / Stage IVC Thyroid Gland Papillary Carcinoma / Tall Cell Variant Thyroid Gland Papillary Carcinoma / Thyroid Gland Oncocytic Follicular Carcinoma1
2TerminatedTreatmentCastration Resistant Prostate Cancer (CRPC) / Prostate Cancers / Prostatic Neoplasms1
3Active Not RecruitingTreatmentRenal Cell Carcinoma (RCC)1
3Active Not RecruitingTreatmentThyroid Cancers1
3CompletedTreatmentCastration Resistant Prostate Cancer (CRPC) / Pain / Prostate Cancers / Prostatic Neoplasms1
3RecruitingTreatmentHepatocellular Carcinomas1
3TerminatedTreatmentCastration Resistant Prostate Cancer (CRPC) / Pain / Prostate Cancers / Prostatic Neoplasms1
Not AvailableActive Not RecruitingTreatmentAdenocarcinoma of the Prostate / Hormone-Resistant Prostate Cancer / Recurrent Prostate Cancer / Stage IV Prostate Cancer1
Not AvailableApproved for MarketingNot AvailableMedullary Thyroid Cancer (MTC)1
Not AvailableRecruitingDiagnosticAdvanced Cancers / Endocrine Tumors1
Not AvailableRecruitingTreatmentAdenocarcinoma of the Prostate / Castration-Resistant Prostate Cancer (CRPC) / Recurrent Prostate Cancer / Stage III Prostate Cancer / Stage IV Prostate Cancer1
Not AvailableRecruitingTreatmentNeuroendocrine Tumors1
PharmacodynamicsCabozantinib suppresses metastasis, angiogenesis, and oncognesis by inhibiting receptor tyrosine kinases.
Mechanism of actionCabozantinib inhibits specific receptor tyrosine kinases such as VEGFR-1, -2 and -3, KIT, TRKB, FLT-3, AXL, RET, MET, and TIE-2.
TargetKindPharmacological actionActionsOrganismUniProt ID
Hepatocyte growth factor receptorProteinyes
antagonist
HumanP08581 details
Vascular endothelial growth factor receptor 2Proteinyes
antagonist
HumanP35968 details
Proto-oncogene tyrosine-protein kinase receptor RetProteinyes
antagonist
HumanP07949 details
Related Articles
AbsorptionAfter oral administration, peak plasma concentration was achieved in 2-5 hours.
Volume of distribution

The volume of distribution is 349L.

Protein bindingCabozantinib has extensive plasma protein binding (≥ 99.7%).
Metabolism

Cabozantinib is metabolized mostly by CYP3A4 and, to a minor extent, by CYP2C9. Both enzyme produce an N-oxide metabolite.

Route of eliminationCabozantinib is eliminated mostly by the feces (54%) and also by the urine (27%).
Half lifeCabozantinib has a long half-life of 55 hours.
Clearance

At steady state, the clearance is 4.4 L/hr.

ToxicityCabozantinib has a black box warning of serious gastrointestinal fistulas and perforations, and potentially fatal hemoptysis and gastrointestinal hemorrhage.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
Interactions
Drug Interactions
DrugInteractionDrug group
AbirateroneThe metabolism of Cabozantinib can be decreased when combined with Abiraterone.Approved
AcetyldigitoxinAcetyldigitoxin may decrease the cardiotoxic activities of Cabozantinib.Approved
AmiodaroneThe serum concentration of Cabozantinib can be increased when it is combined with Amiodarone.Approved, Investigational
AnvirzelAnvirzel may decrease the cardiotoxic activities of Cabozantinib.Investigational
AprepitantThe serum concentration of Cabozantinib can be increased when it is combined with Aprepitant.Approved, Investigational
AtazanavirThe serum concentration of Cabozantinib can be increased when it is combined with Atazanavir.Approved, Investigational
AtomoxetineThe metabolism of Cabozantinib can be decreased when combined with Atomoxetine.Approved
BevacizumabBevacizumab may increase the cardiotoxic activities of Cabozantinib.Approved, Investigational
BexaroteneThe serum concentration of Cabozantinib can be decreased when it is combined with Bexarotene.Approved, Investigational
BoceprevirThe serum concentration of Cabozantinib can be increased when it is combined with Boceprevir.Approved
BortezomibThe metabolism of Cabozantinib can be decreased when combined with Bortezomib.Approved, Investigational
BosentanThe serum concentration of Cabozantinib can be decreased when it is combined with Bosentan.Approved, Investigational
CabazitaxelThe risk or severity of adverse effects can be increased when Cabazitaxel is combined with Cabozantinib.Approved
CapecitabineThe metabolism of Cabozantinib can be decreased when combined with Capecitabine.Approved, Investigational
CarbamazepineThe serum concentration of Cabozantinib can be decreased when it is combined with Carbamazepine.Approved, Investigational
CeritinibThe serum concentration of Cabozantinib can be increased when it is combined with Ceritinib.Approved
CholecalciferolThe metabolism of Cabozantinib can be decreased when combined with Cholecalciferol.Approved, Nutraceutical
ClarithromycinThe serum concentration of Cabozantinib can be increased when it is combined with Clarithromycin.Approved
ClemastineThe metabolism of Cabozantinib can be decreased when combined with Clemastine.Approved
ClotrimazoleThe metabolism of Cabozantinib can be decreased when combined with Clotrimazole.Approved, Vet Approved
CobicistatThe serum concentration of Cabozantinib can be increased when it is combined with Cobicistat.Approved
ConivaptanThe serum concentration of Cabozantinib can be increased when it is combined with Conivaptan.Approved, Investigational
CrizotinibThe metabolism of Cabozantinib can be decreased when combined with Crizotinib.Approved
CyclophosphamideCyclophosphamide may increase the cardiotoxic activities of Cabozantinib.Approved, Investigational
CyclosporineThe metabolism of Cabozantinib can be decreased when combined with Cyclosporine.Approved, Investigational, Vet Approved
DabrafenibThe serum concentration of Cabozantinib can be decreased when it is combined with Dabrafenib.Approved
DarunavirThe serum concentration of Cabozantinib can be increased when it is combined with Darunavir.Approved
DasatinibThe serum concentration of Cabozantinib can be increased when it is combined with Dasatinib.Approved, Investigational
DeferasiroxThe serum concentration of Cabozantinib can be decreased when it is combined with Deferasirox.Approved, Investigational
DelavirdineThe metabolism of Cabozantinib can be decreased when combined with Delavirdine.Approved
DeslanosideDeslanoside may decrease the cardiotoxic activities of Cabozantinib.Approved
DexamethasoneThe serum concentration of Cabozantinib can be decreased when it is combined with Dexamethasone.Approved, Investigational, Vet Approved
DigitoxinDigitoxin may decrease the cardiotoxic activities of Cabozantinib.Approved
DigoxinDigoxin may decrease the cardiotoxic activities of Cabozantinib.Approved
DihydroergotamineThe metabolism of Cabozantinib can be decreased when combined with Dihydroergotamine.Approved
DiltiazemThe metabolism of Cabozantinib can be decreased when combined with Diltiazem.Approved
DocetaxelThe risk or severity of adverse effects can be increased when Docetaxel is combined with Cabozantinib.Approved, Investigational
DoxycyclineThe metabolism of Cabozantinib can be decreased when combined with Doxycycline.Approved, Investigational, Vet Approved
DronedaroneThe metabolism of Cabozantinib can be decreased when combined with Dronedarone.Approved
EfavirenzThe serum concentration of Cabozantinib can be decreased when it is combined with Efavirenz.Approved, Investigational
EnzalutamideThe serum concentration of Cabozantinib can be decreased when it is combined with Enzalutamide.Approved
ErythromycinThe metabolism of Cabozantinib can be decreased when combined with Erythromycin.Approved, Vet Approved
Eslicarbazepine acetateThe serum concentration of Cabozantinib can be decreased when it is combined with Eslicarbazepine acetate.Approved
EtravirineThe serum concentration of Cabozantinib can be decreased when it is combined with Etravirine.Approved
FloxuridineThe metabolism of Cabozantinib can be decreased when combined with Floxuridine.Approved
FluconazoleThe metabolism of Cabozantinib can be decreased when combined with Fluconazole.Approved
FluorouracilThe metabolism of Cabozantinib can be decreased when combined with Fluorouracil.Approved
FluvastatinThe metabolism of Cabozantinib can be decreased when combined with Fluvastatin.Approved
FluvoxamineThe metabolism of Cabozantinib can be decreased when combined with Fluvoxamine.Approved, Investigational
FosamprenavirThe metabolism of Cabozantinib can be decreased when combined with Fosamprenavir.Approved
FosaprepitantThe serum concentration of Cabozantinib can be increased when it is combined with Fosaprepitant.Approved
FosphenytoinThe serum concentration of Cabozantinib can be decreased when it is combined with Fosphenytoin.Approved
Fusidic AcidThe serum concentration of Cabozantinib can be increased when it is combined with Fusidic Acid.Approved
GemfibrozilThe metabolism of Cabozantinib can be decreased when combined with Gemfibrozil.Approved
IdelalisibThe serum concentration of Cabozantinib can be increased when it is combined with Idelalisib.Approved
ImatinibThe metabolism of Cabozantinib can be decreased when combined with Imatinib.Approved
IndinavirThe serum concentration of Cabozantinib can be increased when it is combined with Indinavir.Approved
IrbesartanThe metabolism of Cabozantinib can be decreased when combined with Irbesartan.Approved, Investigational
IsavuconazoniumThe metabolism of Cabozantinib can be decreased when combined with Isavuconazonium.Approved, Investigational
IsradipineThe metabolism of Cabozantinib can be decreased when combined with Isradipine.Approved
ItraconazoleThe serum concentration of Cabozantinib can be increased when it is combined with Itraconazole.Approved, Investigational
IvacaftorThe serum concentration of Cabozantinib can be increased when it is combined with Ivacaftor.Approved
KetoconazoleThe serum concentration of Cabozantinib can be increased when it is combined with Ketoconazole.Approved, Investigational
LeflunomideThe metabolism of Cabozantinib can be decreased when combined with Leflunomide.Approved, Investigational
LopinavirThe serum concentration of Cabozantinib can be increased when it is combined with Lopinavir.Approved
LosartanThe metabolism of Cabozantinib can be decreased when combined with Losartan.Approved
LovastatinThe metabolism of Cabozantinib can be decreased when combined with Lovastatin.Approved, Investigational
LuliconazoleThe serum concentration of Cabozantinib can be increased when it is combined with Luliconazole.Approved
LumacaftorThe serum concentration of Cabozantinib can be decreased when it is combined with Lumacaftor.Approved
MifepristoneThe serum concentration of Cabozantinib can be increased when it is combined with Mifepristone.Approved, Investigational
MitotaneThe serum concentration of Cabozantinib can be decreased when it is combined with Mitotane.Approved
ModafinilThe serum concentration of Cabozantinib can be decreased when it is combined with Modafinil.Approved, Investigational
NafcillinThe serum concentration of Cabozantinib can be decreased when it is combined with Nafcillin.Approved
NefazodoneThe serum concentration of Cabozantinib can be increased when it is combined with Nefazodone.Approved, Withdrawn
NelfinavirThe serum concentration of Cabozantinib can be increased when it is combined with Nelfinavir.Approved
NetupitantThe serum concentration of Cabozantinib can be increased when it is combined with Netupitant.Approved
NevirapineThe serum concentration of Cabozantinib can be decreased when it is combined with Nevirapine.Approved
NicardipineThe metabolism of Cabozantinib can be decreased when combined with Nicardipine.Approved
NilotinibThe metabolism of Cabozantinib can be decreased when combined with Nilotinib.Approved, Investigational
OlaparibThe metabolism of Cabozantinib can be decreased when combined with Olaparib.Approved
OmeprazoleThe metabolism of Cabozantinib can be decreased when combined with Omeprazole.Approved, Investigational, Vet Approved
OsimertinibThe serum concentration of Cabozantinib can be increased when it is combined with Osimertinib.Approved
OuabainOuabain may decrease the cardiotoxic activities of Cabozantinib.Approved
PaclitaxelThe risk or severity of adverse effects can be increased when Paclitaxel is combined with Cabozantinib.Approved, Vet Approved
PalbociclibThe serum concentration of Cabozantinib can be increased when it is combined with Palbociclib.Approved
PentobarbitalThe serum concentration of Cabozantinib can be decreased when it is combined with Pentobarbital.Approved, Vet Approved
PhenobarbitalThe serum concentration of Cabozantinib can be decreased when it is combined with Phenobarbital.Approved
PhenytoinThe serum concentration of Cabozantinib can be decreased when it is combined with Phenytoin.Approved, Vet Approved
PosaconazoleThe serum concentration of Cabozantinib can be increased when it is combined with Posaconazole.Approved, Investigational, Vet Approved
PrimidoneThe serum concentration of Cabozantinib can be decreased when it is combined with Primidone.Approved, Vet Approved
PyrimethamineThe metabolism of Cabozantinib can be decreased when combined with Pyrimethamine.Approved, Vet Approved
QuinineThe metabolism of Cabozantinib can be decreased when combined with Quinine.Approved
RanolazineThe metabolism of Cabozantinib can be decreased when combined with Ranolazine.Approved, Investigational
RifabutinThe serum concentration of Cabozantinib can be decreased when it is combined with Rifabutin.Approved
RifampicinThe serum concentration of Cabozantinib can be decreased when it is combined with Rifampicin.Approved
RifapentineThe serum concentration of Cabozantinib can be decreased when it is combined with Rifapentine.Approved
RitonavirThe serum concentration of Cabozantinib can be increased when it is combined with Ritonavir.Approved, Investigational
SaquinavirThe serum concentration of Cabozantinib can be increased when it is combined with Saquinavir.Approved, Investigational
SecobarbitalThe metabolism of Cabozantinib can be increased when combined with Secobarbital.Approved, Vet Approved
SildenafilThe metabolism of Cabozantinib can be decreased when combined with Sildenafil.Approved, Investigational
SiltuximabThe serum concentration of Cabozantinib can be decreased when it is combined with Siltuximab.Approved
SimeprevirThe serum concentration of Cabozantinib can be increased when it is combined with Simeprevir.Approved
SorafenibThe metabolism of Cabozantinib can be decreased when combined with Sorafenib.Approved, Investigational
St. John's WortThe serum concentration of Cabozantinib can be decreased when it is combined with St. John's Wort.Nutraceutical
StiripentolThe serum concentration of Cabozantinib can be increased when it is combined with Stiripentol.Approved
SulfadiazineThe metabolism of Cabozantinib can be decreased when combined with Sulfadiazine.Approved, Vet Approved
SulfamethoxazoleThe metabolism of Cabozantinib can be decreased when combined with Sulfamethoxazole.Approved
SulfisoxazoleThe metabolism of Cabozantinib can be decreased when combined with Sulfisoxazole.Approved, Vet Approved
TelaprevirThe serum concentration of Cabozantinib can be increased when it is combined with Telaprevir.Approved
TelithromycinThe serum concentration of Cabozantinib can be increased when it is combined with Telithromycin.Approved
TicagrelorThe metabolism of Cabozantinib can be decreased when combined with Ticagrelor.Approved
TiclopidineThe metabolism of Cabozantinib can be decreased when combined with Ticlopidine.Approved
TocilizumabThe serum concentration of Cabozantinib can be decreased when it is combined with Tocilizumab.Approved
TolbutamideThe metabolism of Cabozantinib can be decreased when combined with Tolbutamide.Approved
TrastuzumabTrastuzumab may increase the cardiotoxic activities of Cabozantinib.Approved, Investigational
TrimethoprimThe metabolism of Cabozantinib can be decreased when combined with Trimethoprim.Approved, Vet Approved
Valproic AcidThe metabolism of Cabozantinib can be decreased when combined with Valproic Acid.Approved, Investigational
ValsartanThe metabolism of Cabozantinib can be decreased when combined with Valsartan.Approved, Investigational
VenlafaxineThe metabolism of Cabozantinib can be decreased when combined with Venlafaxine.Approved
VerapamilThe metabolism of Cabozantinib can be decreased when combined with Verapamil.Approved
VoriconazoleThe serum concentration of Cabozantinib can be increased when it is combined with Voriconazole.Approved, Investigational
ZafirlukastThe metabolism of Cabozantinib can be decreased when combined with Zafirlukast.Approved, Investigational
ZiprasidoneThe metabolism of Cabozantinib can be decreased when combined with Ziprasidone.Approved
Food Interactions
  • Avoid grapefruit juice. Combination may increase levels of cabozantinib. Also avoid all other strong CYP3A4 inhibitors.
References
Synthesis ReferenceNot Available
General References
  1. Durante C, Russo D, Verrienti A, Filetti S: XL184 (cabozantinib) for medullary thyroid carcinoma. Expert Opin Investig Drugs. 2011 Mar;20(3):407-413. doi: 10.1517/13543784.2011.559163. [PubMed:21314233 ]
  2. Choueiri TK, Escudier B, Powles T, Mainwaring PN, Rini BI, Donskov F, Hammers H, Hutson TE, Lee JL, Peltola K, Roth BJ, Bjarnason GA, Geczi L, Keam B, Maroto P, Heng DY, Schmidinger M, Kantoff PW, Borgman-Hagey A, Hessel C, Scheffold C, Schwab GM, Tannir NM, Motzer RJ: Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma. N Engl J Med. 2015 Nov 5;373(19):1814-23. doi: 10.1056/NEJMoa1510016. Epub 2015 Sep 25. [PubMed:26406150 ]
  3. Krajewska J, Olczyk T, Jarzab B: Cabozantinib for the treatment of progressive metastatic medullary thyroid cancer. Expert Rev Clin Pharmacol. 2016;9(1):69-79. doi: 10.1586/17512433.2016.1102052. Epub 2015 Nov 4. [PubMed:26536165 ]
  4. Grullich C: Cabozantinib: a MET, RET, and VEGFR2 tyrosine kinase inhibitor. Recent Results Cancer Res. 2014;201:207-14. doi: 10.1007/978-3-642-54490-3_12. [PubMed:24756794 ]
External Links
ATC CodesL01XE26
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (194 KB)
MSDSNot Available
ADMET
Predicted ADMET featuresNot Available
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
TabletOral20 mg/1
TabletOral40 mg/1
TabletOral60 mg/1
CapsuleOral20 mg/1
CapsuleOral20 mg
Kit
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US7579473 No2004-09-242024-09-24Us
US8877776 No2010-10-082030-10-08Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
water solubilityCOMETRIQ is practically insoluble in water.From FDA label.
Predicted Properties
PropertyValueSource
Water Solubility0.00199 mg/mLALOGPS
logP4.01ALOGPS
logP4.66ChemAxon
logS-5.4ALOGPS
pKa (Strongest Acidic)13.46ChemAxon
pKa (Strongest Basic)5.9ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count5ChemAxon
Hydrogen Donor Count2ChemAxon
Polar Surface Area98.78 Å2ChemAxon
Rotatable Bond Count8ChemAxon
Refractivity136.12 m3·mol-1ChemAxon
Polarizability51.49 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as diarylethers. These are organic compounds containing the dialkyl ether functional group, with the formula ROR', where R and R' are aryl groups.
KingdomOrganic compounds
Super ClassOrganic oxygen compounds
ClassOrganooxygen compounds
Sub ClassEthers
Direct ParentDiarylethers
Alternative Parents
Substituents
  • Diaryl ether
  • Quinoline
  • Anilide
  • Phenoxy compound
  • Anisole
  • Phenol ether
  • N-arylamide
  • Alkyl aryl ether
  • Fluorobenzene
  • Halobenzene
  • Aryl fluoride
  • Aryl halide
  • Cyclopropanecarboxylic acid or derivatives
  • Benzenoid
  • Pyridine
  • Monocyclic benzene moiety
  • Heteroaromatic compound
  • Carboxamide group
  • Secondary carboxylic acid amide
  • Azacycle
  • Organoheterocyclic compound
  • Carboxylic acid derivative
  • Organonitrogen compound
  • Carbonyl group
  • Organic oxide
  • Organic nitrogen compound
  • Hydrocarbon derivative
  • Organofluoride
  • Organohalogen compound
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptors

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Protein tyrosine kinase activity
Specific Function:
Receptor tyrosine kinase that transduces signals from the extracellular matrix into the cytoplasm by binding to hepatocyte growth factor/HGF ligand. Regulates many physiological processes including proliferation, scattering, morphogenesis and survival. Ligand binding at the cell surface induces autophosphorylation of MET on its intracellular domain that provides docking sites for downstream sig...
Gene Name:
MET
Uniprot ID:
P08581
Molecular Weight:
155540.035 Da
References
  1. Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Muller T, Ratain MJ, Salgia R: Activity of XL184 (Cabozantinib), an oral tyrosine kinase inhibitor, in patients with medullary thyroid cancer. J Clin Oncol. 2011 Jul 1;29(19):2660-6. doi: 10.1200/JCO.2010.32.4145. Epub 2011 May 23. [PubMed:21606412 ]
  2. Yakes FM, Chen J, Tan J, Yamaguchi K, Shi Y, Yu P, Qian F, Chu F, Bentzien F, Cancilla B, Orf J, You A, Laird AD, Engst S, Lee L, Lesch J, Chou YC, Joly AH: Cabozantinib (XL184), a novel MET and VEGFR2 inhibitor, simultaneously suppresses metastasis, angiogenesis, and tumor growth. Mol Cancer Ther. 2011 Dec;10(12):2298-308. doi: 10.1158/1535-7163.MCT-11-0264. Epub 2011 Sep 16. [PubMed:21926191 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Vascular endothelial growth factor-activated receptor activity
Specific Function:
Tyrosine-protein kinase that acts as a cell-surface receptor for VEGFA, VEGFC and VEGFD. Plays an essential role in the regulation of angiogenesis, vascular development, vascular permeability, and embryonic hematopoiesis. Promotes proliferation, survival, migration and differentiation of endothelial cells. Promotes reorganization of the actin cytoskeleton. Isoforms lacking a transmembrane domai...
Gene Name:
KDR
Uniprot ID:
P35968
Molecular Weight:
151525.555 Da
References
  1. Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Muller T, Ratain MJ, Salgia R: Activity of XL184 (Cabozantinib), an oral tyrosine kinase inhibitor, in patients with medullary thyroid cancer. J Clin Oncol. 2011 Jul 1;29(19):2660-6. doi: 10.1200/JCO.2010.32.4145. Epub 2011 May 23. [PubMed:21606412 ]
  2. Yakes FM, Chen J, Tan J, Yamaguchi K, Shi Y, Yu P, Qian F, Chu F, Bentzien F, Cancilla B, Orf J, You A, Laird AD, Engst S, Lee L, Lesch J, Chou YC, Joly AH: Cabozantinib (XL184), a novel MET and VEGFR2 inhibitor, simultaneously suppresses metastasis, angiogenesis, and tumor growth. Mol Cancer Ther. 2011 Dec;10(12):2298-308. doi: 10.1158/1535-7163.MCT-11-0264. Epub 2011 Sep 16. [PubMed:21926191 ]
Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
antagonist
General Function:
Transmembrane receptor protein tyrosine kinase activity
Specific Function:
Receptor tyrosine-protein kinase involved in numerous cellular mechanisms including cell proliferation, neuronal navigation, cell migration, and cell differentiation upon binding with glial cell derived neurotrophic factor family ligands. Phosphorylates PTK2/FAK1. Regulates both cell death/survival balance and positional information. Required for the molecular mechanisms orchestration during in...
Gene Name:
RET
Uniprot ID:
P07949
Molecular Weight:
124317.465 Da
References
  1. Kurzrock R, Sherman SI, Ball DW, Forastiere AA, Cohen RB, Mehra R, Pfister DG, Cohen EE, Janisch L, Nauling F, Hong DS, Ng CS, Ye L, Gagel RF, Frye J, Muller T, Ratain MJ, Salgia R: Activity of XL184 (Cabozantinib), an oral tyrosine kinase inhibitor, in patients with medullary thyroid cancer. J Clin Oncol. 2011 Jul 1;29(19):2660-6. doi: 10.1200/JCO.2010.32.4145. Epub 2011 May 23. [PubMed:21606412 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
no
Actions
substrate
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
Kind
Protein
Organism
Human
Pharmacological action
no
Actions
substrate
General Function:
Steroid hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. This enzyme contributes to the wide pharmacokinetics variability of the metabolism of drugs such as S-warfarin, diclofenac, phenyto...
Gene Name:
CYP2C9
Uniprot ID:
P11712
Molecular Weight:
55627.365 Da
Comments
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Drug created on May 12, 2013 18:12 / Updated on January 16, 2017 02:44