Last reviewed 2026-04-20 · How we verify

Cometriq (Cabometyx)

Cometriq blocks the VEGFR2 pathway to prevent tumor growth and angiogenesis.

Cabometyx, marketed by Exelixis, is a targeted therapy for progressive, metastatic medullary thyroid cancer, with a key composition patent expiring in 2028. Its mechanism of blocking the VEGFR2 pathway to inhibit tumor growth and angiogenesis provides a strong therapeutic profile, distinguishing it from other same-class competitors like sunitinib and sorafenib. The primary risk lies in the increasing availability of generics for off-patent competitors, which could erode market share and revenue.

At a glance

Mechanism of action

In vitro biochemical and/or cellular assays have shown that cabozantinib inhibits the tyrosine kinase activity of RET, MET, VEGFR-1, -2 and -3, KIT, TRKB, FLT-3, AXL, ROS1, TYRO3, MER, and TIE-2. These receptor tyrosine kinases are involved in both normal cellular function and pathologic processes such as oncogenesis, metastasis, tumor angiogenesis, drug resistance, and maintenance of the tumor microenvironment.

Approved indications

• Progressive, Metastatic Medullary Thyroid Cancer

Common side effects

• diarrhea
• stomatitis
• palmar-plantar erythrodysesthesia (PPE)
• decreased weight
• decreased appetite
• nausea
• fatigue
• oral pain
• hair color changes
• dysgeusia
• hypertension
• abdominal pain

Drug interactions

• Strong CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, atazanavir, indinavir, nefazodone, nelfinavir, ritonavir, saquinavir, telithromycin, voriconazole)
• Foods or Nutritional Supplements that Inhibit Cytochrome P450 (e.g., grapefruit, grapefruit juice)
• Strong CYP3A4 Inducers (e.g., phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, St. John’s Wort)
• MRP2 Inhibitors (e.g., abacavir, adefovir, cidofovir, furosemide, lamivudine, nevirapine, ritonavir, probenecid, saquinavir, tenofovir)

Key clinical trials

• Cabozantinib S-malate in Treating Patients With Relapsed Osteosarcoma or Ewing Sarcoma (PHASE2)
• Comparing Retreatment of 177Lu-DOTATATE PRRT Versus the Usual Treatment in Patients With Metastatic Unresectable Gastroenteropancreatic Neuroendocrine Tumors, NET RETREAT Trial (PHASE2)
• Cabozantinib S-malate and Nivolumab With or Without Ipilimumab in Treating Patients With Metastatic Genitourinary Tumors (PHASE1)
• BiCaZO: A Study Combining Two Immunotherapies (Cabozantinib and Nivolumab) to Treat Patients With Advanced Melanoma or Squamous Cell Head and Neck Cancer, an immunoMATCH Pilot Study (PHASE2)
• Testing Cabozantinib in Patients With Advanced Pancreatic Neuroendocrine and Carcinoid Tumors (PHASE3)
• A Study to Test the Addition of the Drug Cabozantinib to Chemotherapy in Patients With Newly Diagnosed Osteosarcoma (PHASE2,PHASE3)
• Testing the Addition of an Anti-cancer Drug, Sapanisertib, to the Usual Chemotherapy Treatment (Cabozantinib) in Metastatic Liver Cell Cancer With a Change in Genes for the Protein β-Catenin, The SAPHIRE Trial (PHASE1,PHASE2)
• Immunotherapy With Nivolumab and Ipilimumab Followed by Nivolumab or Nivolumab With Cabozantinib for Patients With Advanced Kidney Cancer, The PDIGREE Study (PHASE3)

Patents

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.

Competitive intelligence

For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:

• Cometriq CI brief — competitive landscape report
• Cometriq updates RSS · CI watch RSS
• Exelixis portfolio CI