Dr. Ezra Cohen on the Pharmacokinetics of Cabozantinib
Ezra Cohen, MD
Published Online: Sunday, September 30, 2012
Ezra E.W. Cohen, MD, Associate Professor, Section of Hematology/Oncology, Department of Medicine, Co-Director, Head and Neck Cancer Program, Director, Hematology/Oncology Fellowship Program, University of Chicago Medical Center, discusses an analysis of the phase III EXAM trial that examined the efficacy and pharmacokinetics of cabozantinib (XL184) for patients with advanced medullary thyroid cancer (MTC).
Cohen explains that one of the aspects of the study was to examine if the presence of mutations in the proto-oncogene RET effected the activity of cabozantinib, an active inhibitor of the RET tyrosine kinase, which is theorized to be one of the main drivers in MTC. Regardless of the presence of RET mutations all patients benefited from treatment with cabozantinib and only a slight difference was observed between those with or without a RET mutation.
The pharmacokinetics of cabozantinib are fairly well understood; however, the impact of dose size and drug exposure on efficacy was further examined in the EXAM trial. Cohen explains that evidence from this study seems to suggest that exposure levels did not alter the efficacy of cabozantinib. Overall, this agent demonstrates very robust activity across multiple patient groups.
Head and neck cancer patients who participated in a swallow preservation protocol were less likely to suffer from the detrimental effects associated with dysphagia, a common complication associated with radiation therapy and chemoradiation therapy.