cabozantinib

ASCO2011でのphase2の発表が衝撃的でした。cabozantinibですが再燃前立腺癌で骨転移は86%で奏効。64%に骨痛改善。軟部組織転移巣は84%で縮小。夢のような治療薬になるのでしょうか？？

米食品医薬品局（FDA）は2012年11月29日、転移を有する甲状腺髄様癌の治療薬承認していますが、前立腺癌に対してはまだ治験中ですね。

2つのphase3が走っていて、2014年にデータ解析にはいるようです。

Study of Cabozantinib (XL184) Versus Prednisone in Men With Metastatic Castration-resistant Prostate Cancer Previously Treated With Docetaxel and Abiraterone or MDV3100 (COMET-1)

Study of Cabozantinib (XL184) Versus Mitoxantrone Plus Prednisone in Men With Previously Treated Symptomatic Castration-resistant Prostate Cancer (COMET-2)

Cabozantinibは、腫瘍細胞の生存、浸潤、転移にかかわるMET遺伝子と、その活性化を助長するVGEFR2経路の両方を阻害する薬剤で、これが承認されれば、再燃前立腺癌ではじめての分子標的薬となります。

気になる副作用もあるようです（MedlinePlusより）

Cabozantinib may cause you to develop a fistula (abnormal connection between 2 organs inside your body, or between an organ and the outside of your body) or a tear in the wall of your stomach or intestine. These conditions are serious and may be life-threatening. Call your doctor immediately if you experience severe stomach pain or if you begin to cough, gag, or choke, especially while you are eating or drinking.

Cabozantinib may cause serious or life-threatening bleeding. Tell your doctor if you have recently had any episodes of unusual or heavy bleeding and if you have been coughing up blood. If you experience any of the following symptoms, call your doctor immediately: coughing up blood or blood clots, vomiting material that is bloody or that looks like coffee grounds, blood in stool, black and tarry stools, heavy menstrual bleeding, or other unusual bruising or bleeding.

Talk to your doctor about the risks of taking cabozantinib.