Cabozantinib (DB08875): A Comprehensive Monograph on its Pharmacology, Clinical Development, and Therapeutic Role

Section 1: Executive Summary and Drug Profile

1.1. Overview of Cabozantinib as a Multi-Targeted Tyrosine Kinase Inhibitor

Cabozantinib is an orally bioavailable small molecule that represents a significant therapeutic advance in the field of oncology. It functions as a potent, non-specific inhibitor of multiple receptor tyrosine kinases (RTKs), which are key mediators of cellular signaling pathways that drive cancer progression.[1] The fundamental mechanism of action of cabozantinib involves the simultaneous suppression of critical processes including tumor growth (oncogenesis), the formation of new tumor-supplying blood vessels (angiogenesis), and the spread of cancer to distant sites (metastasis).[1] This broad-spectrum activity against the core drivers of malignancy underpins its demonstrated efficacy across a diverse and expanding range of solid tumors, establishing it as a versatile and powerful agent in the modern anticancer armamentarium.

1.2. Key Identifiers, Formulations, and Brand Names (Cometriq® vs. Cabometyx®)

The drug is identified by its DrugBank ID DB08875 and Chemical Abstracts Service (CAS) Number 849217-68-1. During its development, it was also known by the codes XL184 and BMS-907351.[1] A crucial aspect of cabozantinib's clinical and commercial profile is the existence of two distinct brand names, which correspond to different formulations, approved dosages, and initial therapeutic indications.[8] Understanding this distinction is fundamental to appreciating its development history and appropriate clinical use.