Current role of cabozantinib in metastatic castration-resistant prostate cancer

Over 80% of men with castration-resistant prostate cancer have bone metastases. This condition can dramatically impact quality of life and is associated with short-term survival. Consequently, the development of bone-targeted therapies is a relevant topic on prostate cancer management. Hepatocyte growth factor receptor and vascular endothelial growth factor signaling pathways have been identified to play a role in prostate cancer progression and bone metastasis and are potential targets for therapeutic intervention. Early-phase studies have shown encouraging responses in bone metastases and pain control with cabozantinib, a multi-tyrosine kinase inhibitor targeting hepatocyte growth factor receptor and vascular endothelial growth factor receptor. Despite striking responses seen in some patients, preliminary results from a pivotal Phase III study have failed to produce survival benefit. This review encompasses preclinical and clinical data of cabozantinib in metastatic castration-resistant prostate cancer highlighting future research options for this agent.