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Cabozantinib monotherapy linked to cutaneous adverse events

In patients with urothelial carcinoma, cabozantinib monotherapy appeared to yield at least one cutaneous adverse event in most patients, according to recent findings.

In the single-institution study, researchers evaluated 41 patients with metastatic, progressive urothelial carcinoma who were enrolled in an open-label, nonrandomized, phase 2 clinical trial of cabozantinib. The primary outcome of the trial was the response rate of cabozantinib. All study participants were between the ages of 41 and 82 years.

Participants underwent an oral cabozantinib regimen consisting of 60 mg/day in each 28-day cycle. The duration of treatment ranged from 2 weeks to 20 months. Patients were seen for follow-up visits between October 2012 and June 2012, and at each visit they were clinically examined and asked about the onset of any dermal reactions. Those who reported or demonstrated skin reactions underwent subsequent full-body examination with photo documentation.

The researchers found that of the 41 patients who underwent cabozantinib therapy, at least one cutaneous toxic effect was seen in 30 patients (73%). Adverse skin events reported included hand-foot skin reaction (54%), generalized dilution of pigment and/or hair depigmentation (44%), xerosis (20%), scrotal erythema/ulceration (15%) and hemorrhagic nail splinters (12%).

Forty-four percent of the patients experienced two or more cutaneous adverse events. Of the 30 patients who experienced adverse events, the events occurred during the first month of cabozantinib treatment in 57% of the patients and by the second month of treatment in 80%. Decreased dose was needed to control symptoms in 30% of patients, and treatment discontinuation was needed in 13%.

According to the researchers, early detection and immediate treatment of skin reactions to cabozantinib and similar medications will optimize adherence to these promising treatments.

Disclosure: The researchers report no relevant disclosures.