Cabozantinib: from studies to clinical practice

Disseminated renal cell carcinoma is an immunogenic tumor in which cytokine immunotherapy is usually used as the second-line treatment. It is associated with a low frequency of objective responses and short progression-free survival. Modern studies resulted in more effective treatment regimens based on new high-affinity TKI multikinases (cabozantinib, lenvatinib), as well as immuno-oncological drugs that can specifically block intercellular transmission of anti-immunogenic signal (PD-1 inhibitors) (nivolumab, pembrolizumab) or its ligand type 1 (PD-L1) (avelumab), antigen type 4 associated with anticytotoxic T-lymphocyte (ipilimumab)). Cabozantinib is a 2nd generation multikinase inhibitor that blocks the receptors of growth factors MET, AXL, and VEGFR-2, which are involved in tumorigenesis and responsible for resistance to traditional antiangiogenic therapy in renal cell carcinoma. Registration studies have shown that cabozantinib together with combined targeted therapy is more effective in patients with favorable and intermediate prognosis, while the PD-1 inhibitor (nivolumab) – in patients with poor and intermediate prognosis.Objective: to analyze the results of cabozantinib studies and its possible use in the sequential treatment of disseminated renal cell carcinoma