Cabometyx^® (Cabozantinib) therapeutic indications

Cabometyx^® is indicated as monotherapy treatment of advanced renal cell carcinoma (RCC):

in first-line treatment of adult patients with intermediate or poor risk per IMDC criteria.
in adults following prior vascular endothelial growth factor (VEGF)-targeted therapy.

Cabometyx^® in combination with nivolumab for the first-line treatment of RCC in adults.

Nutrition and Cancer

A balanced diet is essential during a patient’s cancer treatment. Weight loss caused by cancer and the side effects of cancer treatment can reduce response to treatment and impact quality of life and overall survival.^1,2

The available nutritional information for patients living with cancer can be confusing and conflicting. In a national survey conducted in 2021:³

MALNUTRITION

Moderate to severe weight loss is present in 30–70% of patients with cancer depending on the site, type, stage and treatment modality.⁴

Malnutrition can be difficult to detect due to prevalence of obesity in the population, but there are techniques to assist with diagnosis:

Skeletal muscle assessment⁵
Malnutrition Screening Tool^2,6
Nutrition Focused Physical Examination⁷
Investigating Nutrition Impact Symptoms⁸

NUTRITIONAL ADVICE FOR PATIENTS: WHAT DIET SHOULD BE FOLLOWED?¹

It is important to encourage patients to follow a healthy, balanced diet during and after cancer treatment in order to maintain strength, avoid weight and muscle loss and support the immune system. This is also equally important if a patient experiences weight gain during their treatment.

A BUILD-UP DIET FOR PATIENTS EXPERIENCING WEIGHT OR MUSCLE LOSS¹

Whether a patient is underweight, overweight or a healthy weight, if they experience a reduced appetite and weight or muscle loss, they may benefit from following a diet that is high in protein and calories to build up their strength.

Some tips for patients may include:

Eating little and often (4–6 meals and snacks each day, rather than 3 main meals)
Avoiding diet or low-fat versions of food (instead, patients can be encouraged to eat foods such as whole milk, full fat cheese, yoghurt and butter)
Fortifying meals and foods like curries, soups, stews, pasta, scrambled eggs, scones and custards using double cream, butter, grated cheese, skimmed milk powder, oils, ground nuts, honey or jam
Choosing nourishing drinks like milk, smoothies, milky tea/coffee and hot chocolate

PATIENT RESOURCES FOR DIET AND NUTRITION¹

You may want to highlight some resources that outline nutritional advice from reliable sources for your patients.

These include:

Breakthrough Cancer Research

www.breakthroughcancerresearch.ie
This website houses four free information and recipe booklets made by dieticians

Irish Cancer Society

www.cancer.ie
Here, patients can download ‘Diet and cancer’ and ‘Coping with side effects of fatigue’

World Cancer Research Fund

www.wcrf-uk.org
Patients can download ‘Ryan Riley’s recipe booklet’ and ‘Eating well during cancer’

References

Department of Nutrition and Dietetics, St Vincent’s University Hospital. Eating Well During Cancer. NHS. Patient leaflet. 2023; Dublin, Ireland.
Arends J, et al. Clin Nutr. 2017;36(1):11–48.
Sullivan ES, et al. Clin Nutr. 2021;41:331–339.
Arends J, et al. Clin Nutr. 2017;36(5):1187-1196.
Heymsfield SB, et al. Appl Physiol Nutr Metab. 2023;48(10):751–756.
Serón-Arbeloa C, et al. Nutrients. 2022;14(12):2392.
Hummell AC, and Cummings M. Nutr Clin Pract. 2022;37(1):41–49.
Omlin A, et al. J Cachexia Sarcopenia Muscle. 2013;4(1):55–61.

For further information, please refer to the Prescribing Information or the Summary of Product Characteristics.

Cabometyx^® (Cabozantinib) therapeutic indications