Cabozantinib, as a multi-target tyrosine kinase inhibitor, has shown significant efficacy in various cancer treatments, and its broad-spectrum anti-cancer properties make it an important choice in targeted therapy.

1. Clinical treatment effect

(1) Thyroid medullary carcinoma: The median progression free survival was 11.2 months, significantly prolonged by 7.2 months compared to the placebo group.

(2) Renal cell carcinoma: The objective remission rate of monotherapy is 17%, which can be increased to 48% when combined with immunotherapy.

(3) Hepatocellular carcinoma: The median overall survival with second-line treatment is 10.2 months, which is 2.2 months longer than the control group.

2. Characteristics of the mechanism of action

(1) Multi target inhibition: Simultaneously targeting 9 kinases such as MET and VEGFR to block tumor angiogenesis and metastasis.

(2) Synergistic effect: Combined with immunotherapy, it can improve the tumor microenvironment and enhance anti-tumor activity.

3. Factors affecting therapeutic efficacy

(1) Gene expression: Patients with MET or RET gene abnormalities have a higher response rate.

(2) Medication plan: Combination therapy shows a significant improvement in efficacy compared to monotherapy.

(3) Tolerance: About 60% of patients require dose adjustment, which affects the sustained efficacy.

4. Special population effects

(1) Pediatric patients: Differentiated thyroid cancer patients over 12 years old show comparable efficacy to adults.

(2) Liver dysfunction: Moderate damage patients need to reduce dosage, otherwise it may affect the efficacy and safety.