Cabozantinib is a new drug in development which is currently being studied in metastatic castrate resistant prostate cancer (mCRPC), a form of advanced prostate cancer that has spread beyond the prostate and has become resistant to hormone therapy.

What is cabozantinib and who might benefit?

Cabozantinib, also known as Cabometyx, is being studied in combination with an immunotherapy drug (atezolizumab). The aim of combining these two drugs is to help patients with mCRPC and prolong their overall survival.

Who is developing cabozantinib?

Cabozantinib is being developed by an American biotechnology company called Exelixis and the pharmaceutical company Ipsen.

What have they discovered so far?

Cabozantinib has previously been studied in patients with mCRPC whose disease had progressed after treatment with chemotherapy (Docetaxel) and novel hormone therapy drugs abiraterone (Zytiga) or enzalutamide (Xtandi). In a previous study a group of patients treated with a combination of cabozantinib and an immunotherapy drug (atezolizumab) saw some benefit with cancers shrinking in some patients.

How does cabozantinib work exactly?

Cabozantinib belongs to a group of drugs called tyrosine kinase inhibitors (TKI).

TKIs are small molecules that work by interfering with proteins in the body that are involved with the growth and spread of cancer cells, as well as the development of new blood vessels which supply cancer cells with nutrients.

Cabozantinib blocks three pathways involved in the growth and spread of cancer cells. Ultimately, this causes cancer cells to die which makes tumours more likely to stop growing and may lead some of them to shrink.

At what stage of development is cabozantinib?

Previous clinical trials have shown that the combination of cabozantinib with the immunotherapy drug (atezolizumab) is more effective at treating mCRPC than cabozantinib on its own.

An upcoming phase 3 clinical trial (called CONTACT-02) will now test whether cabozantinib combined with atezolizumab is more effective at prolonging a patient’s survival when compared against either enzalutamide (Xtandi) or abiraterone (Zytiga) alone in patients with mCRPC.

The estimated completion date for this clinical trial is July 2023. If these trials have a positive outcome and if regulatory approval in the UK is successful cabozantinib could become available for the treatment of mCRPC sometime in late 2024-2025, however there remain many hurdles to be overcome.

How can I find out more?

To find out more about the CONTACT-02 clinical trial you can click here.

To find out more about cabozantinib.

To find out more about atezolizumab.

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