Cabozantinib Dose Modification

A discussion regarding the significance of dose modification to mitigate toxicity burden.
PUBLISHED June 24, 2019


Transcript: 

Steven Gallant: By the middle of June I could tell that I was getting stronger. I could feel a difference, even though I kept losing weight. And the scale would tell me, every day I’d lose another pound, but I felt myself getting stronger and I felt the endurance starting to get better. September was key for us.

Karl J. D’Silva, M.D.: Right, because we were trying to get the second or the third treatment.

Steven Gallant: That’s when we made the decision on dropping that one day.

Karl J. D’Silva, M.D.: Yes.

Steven Gallant: I knew, physically I could tell I was ready because I had upped my walking to about a mile. One time I walked a mile out and I couldn’t get back home, I had to call for a ride. I just pushed myself and went too far. But in September we decided to drop that one day. I knew the first two I missed that day, man I knew. It was amazing. It was like a switch went on, and I went right into the gym. That’s when I started pushing really hard. I remember when I sat with you in September and I said, “I was always a Type A personality, how do you feel about me pushing to the point of maybe throwing up in my workouts to being just so intense, how did you feel about me pushing that hard?”

Karl J. D’Silva, M.D.: Right. Because the dosage is 60 mg daily every day, and we gave him the full dose, and that was so impactful on his body because it basically melted his tumor pretty well. I remember the first CT [computed tomography] scan in three months, there was more than 70% reduction in the size of your tumor.

Steven Gallant: Right.

Karl J. D’Silva, M.D.: And then again in September, there was further reduction in the size of the tumor. I was feeling relieved. He felt that he could take one day off, and I said, OK, fine, why not if that’s going to make him happy. But the treatment was followed very strictly as per the clinical trials, and we definitely saw the results. And I’m glad to see you here actually because from the day you were diagnosed and now it’s almost one year, four months, you’re still on the drug and you’re doing very well.

Steven Gallant: Yes.

Karl J. D’Silva, M.D.: How much do you weigh now? You’re over 200 pounds now.

Transcript Edited for Clarity

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