New Section: Pharmacology of Cabozantinib

Urologic Indications for Cabozantinib:

In urology, cabozantinib is approved for metastatic renal cell carcinoma (RCC) (Abre numa nova janela): as a combination with nivolumab in the first line and as monotherapy (in selected first-line settings and after prior therapy).

• First-line therapy with nivolumab (Abre numa nova janela) combined with cabozantinib: In the CheckMate-9ER trial, the combination improved progression-free survival (16 vs. 8 months), objective response rate, complete response rate, and overall survival (47 vs. 36 months) compared with sunitinib across IMDC risk groups (Motzer et al., 2025).

• First-line therapy with cabozantinib monotherapy: An option for patients with intermediate or poor prognosis who have contraindications to immune checkpoint inhibitors. In the CABOSUN trial, progression-free survival (9 vs. 5 months) was longer with cabozantinib than with sunitinib (Choueiri et al., 2018).

• Second-line and later therapy for metastatic RCC: In the METEOR trial, cabozantinib improved progression-free survival and overall survival (21 vs. 19 months) compared with everolimus after prior VEGF-targeted therapy (Choueiri et al., 2015).