Safety Profile of Cabozantinib

Faculty review the key safety findings from CABINET, emphasizing that no unexpected signals emerged relative to prior experience with cabozantinib in other malignancies. The most common adverse events included fatigue, diarrhea, hand-foot syndrome and rash, and hypertension, consistent with the established class effects of tyrosine kinase inhibitors. The panel also notes electrolyte abnormalities, with hypomagnesemia among the most frequent laboratory findings appearing within weeks of initiation, alongside hypothyroidism and the need for regular blood count monitoring. Speakers draw on cross-tumor experience in hepatocellular, renal, and thyroid cancers, observing that the toxicity profile in neuroendocrine tumors mirrors what clinicians already recognize. The discussion highlights that the median delivered dose in the trial was 40 mg, reflecting real-world tolerability, and faculty welcome having trial data confirming that dose-reduced therapy retains benefit. This evidence reassures clinicians that lower dosing can maintain efficacy while improving tolerability for patients in clinical practice.