Cabometyx (cabozantinib) vs Lenvima (lenvatinib)

Cabometyx (cabozantinib) and Lenvima (lenvatinib) are both oral tyrosine kinase inhibitors used in the treatment of certain types of cancer, but they have different FDA-approved indications and mechanisms of action. Cabometyx is primarily used for advanced renal cell carcinoma, hepatocellular carcinoma, and medullary thyroid cancer, and it targets MET, VEGFR, and AXL pathways. Lenvima, on the other hand, is approved for use in differentiated thyroid cancer, renal cell carcinoma in combination with everolimus, and endometrial carcinoma, and it inhibits the activities of VEGFR, FGFR, PDGFR, RET, and KIT signaling pathways. When deciding between the two, it is important to consider the specific type of cancer being treated, the patient's overall health, and the side effect profile of each medication, in consultation with a healthcare professional.

Difference between Cabometyx and Lenvima

Metric	Cabometyx (cabozantinib)	Lenvima (lenvatinib)
Generic name	Cabozantinib	Lenvatinib
Indications	Renal cell carcinoma, hepatocellular carcinoma, medullary thyroid cancer	Thyroid cancer, renal cell carcinoma, hepatocellular carcinoma, endometrial carcinoma
Mechanism of action	Tyrosine kinase inhibitor	Tyrosine kinase inhibitor
Brand names	Cabometyx	Lenvima
Administrative route	Oral	Oral
Side effects	Diarrhea, fatigue, nausea, decreased appetite, hypertension, etc.	Hypertension, fatigue, diarrhea, decreased appetite, weight loss, etc.
Contraindications	None known	None known
Drug class	Tyrosine kinase inhibitor	Tyrosine kinase inhibitor
Manufacturer	Exelixis	Eisai

Efficacy

Cabometyx (cabozantinib) Efficacy in Thyroid Cancer

Cabometyx (cabozantinib) is a medication that has demonstrated efficacy in the treatment of certain types of thyroid cancer. Specifically, it has been approved for the treatment of progressive, metastatic medullary thyroid cancer (MTC). The efficacy of cabozantinib in this setting was established in a pivotal phase III clinical trial known as the EXAM study, which showed that cabozantinib significantly improved progression-free survival compared to placebo. Patients treated with cabozantinib experienced a median progression-free survival of 11.2 months, compared to 4.0 months for those receiving placebo, indicating a substantial delay in disease progression.

In addition to medullary thyroid cancer, cabozantinib has shown promise in the treatment of differentiated thyroid cancer (DTC) after prior therapy. In a phase II clinical trial, cabozantinib demonstrated antitumor activity in patients with radioiodine-refractory DTC who had progressed after prior VEGFR-targeted therapy. The results indicated a partial response rate and disease control rate that supported further investigation into its use for this indication.

Lenvima (lenvatinib) Efficacy in Thyroid Cancer

Lenvima (lenvatinib) is another targeted therapy that has been approved for the treatment of certain types of thyroid cancer. It is indicated for the treatment of locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (RAI-R DTC). The approval of lenvatinib was based on a phase III clinical trial, known as the SELECT study, which demonstrated that lenvatinib significantly extended progression-free survival compared to placebo. Patients treated with lenvatinib had a median progression-free survival of 18.3 months versus 3.6 months for those on placebo, representing a marked improvement in disease management.

Lenvatinib has also been evaluated in a phase II study for the treatment of advanced medullary thyroid cancer (MTC). While the study showed some clinical activity, the results were not as robust as those seen in differentiated thyroid cancer. Therefore, lenvatinib's primary indication remains in the treatment of RAI-R DTC, where it has established itself as a significant therapeutic option for patients with this challenging condition.

Regulatory Agency Approvals

Cabometyx

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

Lenvima

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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