Cabometyx (cabozantinib) vs Afinitor (everolimus)

Cabometyx (cabozantinib) is a tyrosine kinase inhibitor that targets multiple pathways involved in tumor growth and angiogenesis, and is commonly used in the treatment of advanced renal cell carcinoma (RCC) and hepatocellular carcinoma. Afinitor (everolimus), on the other hand, is an mTOR inhibitor that also treats advanced RCC, typically after other treatments have failed, and has applications in various other types of tumors, including breast and pancreatic neuroendocrine tumors. When deciding between Cabometyx and Afinitor, it is important to consider the specific type of cancer, the patient's overall health, previous treatments, potential side effects, and the mechanism of action of each drug, as well as consulting with a healthcare provider for a personalized treatment plan.

Difference between Cabometyx and Afinitor

Metric	Cabometyx (cabozantinib)	Afinitor (everolimus)
Generic name	Cabozantinib	Everolimus
Indications	Renal cell carcinoma, hepatocellular carcinoma, medullary thyroid cancer	Renal cell carcinoma, subependymal giant cell astrocytoma, renal angiomyolipoma, breast cancer, neuroendocrine tumors, tuberous sclerosis complex
Mechanism of action	Tyrosine kinase inhibitor	mTOR inhibitor
Brand names	Cabometyx, Cometriq	Afinitor, Zortress
Administrative route	Oral	Oral
Side effects	Diarrhea, fatigue, nausea, decreased appetite, hypertension, vomiting, weight loss, dysphonia	Stomatitis, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, asthenia
Contraindications	Hypersensitivity to cabozantinib or any component of the formulation	Hypersensitivity to everolimus or other rapamycin derivatives, or any component of the formulation
Drug class	Tyrosine kinase inhibitor	mTOR inhibitor
Manufacturer	Exelixis, Inc.	Novartis Pharmaceuticals Corporation

Efficacy

Cabometyx (Cabozantinib) Efficacy in Kidney Cancer

Cabometyx, with the active ingredient cabozantinib, is a medication that has shown efficacy in the treatment of advanced renal cell carcinoma (RCC), which is the most common type of kidney cancer. Cabozantinib is a tyrosine kinase inhibitor that targets multiple pathways involved in tumor growth and angiogenesis. The efficacy of Cabometyx in kidney cancer was demonstrated in a clinical trial known as METEOR. The trial showed that cabozantinib significantly improved progression-free survival compared to everolimus, a standard treatment at the time. Patients treated with cabozantinib experienced a median progression-free survival of 7.4 months compared to 3.8 months for those on everolimus.

Furthermore, Cabometyx has also been shown to improve overall survival in patients with advanced RCC. In the METEOR trial, the median overall survival was 21.4 months for patients taking cabozantinib, compared to 16.5 months for those taking everolimus. This marked improvement in overall survival highlights the potential of Cabometyx as a significant therapeutic option for patients with this challenging disease.

Afinitor (Everolimus) Efficacy in Kidney Cancer

Afinitor, containing the active substance everolimus, is an mTOR inhibitor used in the treatment of various cancers, including advanced renal cell carcinoma. Everolimus has been shown to be effective in patients with advanced RCC who have failed previous treatment with sunitinib or sorafenib, which are other targeted therapies. In a pivotal study known as RECORD-1, patients treated with Afinitor had a median progression-free survival of 4.9 months, compared to 1.9 months for those given a placebo. This demonstrated that everolimus could delay disease progression in patients with RCC who had progressed on other therapies.

While Afinitor has been a valuable treatment option for kidney cancer, its efficacy must be considered in the context of newer treatments like Cabometyx. As newer agents have become available, the role of everolimus in the treatment landscape of RCC has evolved. It remains an important option, particularly in certain patient populations and in cases where other treatments are not suitable or have been exhausted. However, direct comparisons, such as those from the METEOR trial, have shown that some newer agents may offer more significant benefits in terms of progression-free and overall survival.

Regulatory Agency Approvals

Cabometyx

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia

Afinitor

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia

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