TheraRadar
Data updated: May 26, 2026

COMETRIQ (cabozantinib s-malate)

Genetic Support Trial Activity: Growth 25 active trials
Oncology Approved 2012-11-29

COMETRIQ (cabozantinib s-malate) is a kinase inhibitor approved for the treatment of medullary thyroid cancer (MTC). The medication is specifically indicated for patients whose MTC is characterized as progressive and metastatic. It serves as a targeted therapeutic option for managing this specific form of thyroid malignancy.

Source: FDA Label • EXELIXIS

How COMETRIQ Works

Cabozantinib inhibits the tyrosine kinase activity of multiple receptors, including RET, MET, VEGFR-1, -2, and -3, as well as KIT, TRKB, and FLT-3. It also targets AXL, ROS1, TYRO3, MER, and TIE-2, which are involved in both normal cellular functions and pathologic processes. By inhibiting these receptor tyrosine kinases, the drug interferes with oncogenesis, metastasis, tumor angiogenesis, and the maintenance of the tumor microenvironment. This multi-kinase inhibition also addresses biological pathways associated with drug resistance.

Development Insights

National Cancer Institute (NCI) conducting 31 trials (78%)
415 indications explored (Broad Platform)
stage iv renal cell cancer ajcc v8 (7 trials)
metastatic papillary renal cell carcinoma (4 trials)
advanced hepatocellular carcinoma (4 trials)
2
Indications
--
Phase 3 Trials
1
Priority Reviews
13
Years on Market

Details

Status
Prescription
First Approved
2012-11-29
Patent Cliff
2032

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Routes
ORAL
Dosage Forms
CAPSULE

Companies

Active Ingredient: CABOZANTINIB S-MALATE

COMETRIQ Approval History

2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
18 FDA actions from 2012 to 2025 · 1 indication expansions
Oct 2025 SUPPL
Label · Labeling
Aug 2023 SUPPL
Label · Labeling
Oct 2020 SUPPL
Label · Labeling

What COMETRIQ Treats

1 indications

COMETRIQ is approved for 1 conditions since its original approval in 2012. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Medullary Thyroid Cancer
Source: FDA Label

COMETRIQ Target & Pathway

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Target

VEGFR (Vascular Endothelial Growth Factor Receptor) Growth Factor Receptor

Receptors on blood vessel cells that respond to VEGF signals to form new blood vessels. Cancer cells exploit this pathway to ensure blood supply for tumor growth. Blocking VEGFRs prevents tumor angiogenesis and limits cancer progression.

Pathway Context

VEGFR on blood vessels is activated by VEGF to promote angiogenesis

VEGF (Vascular Endothelial Growth Factor) ligand

A signaling protein that stimulates the formation of new blood vessels (angiogenesis). Tumors need blood supply to grow, so they secrete VEGF to create new vessels. Blocking VEGF starves tumors of oxygen and nutrients, inhibiting their growth.

COMETRIQ Competitive Set

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Three rings of competition based on shared molecular targets and treated indications.

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Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to COMETRIQ

FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.

CAPRELSA
VANDETANIB
1 shared
Sanofi
Shared indications:
Medullary Thyroid Cancer
RESNIBEN
CABOZANTINIB
1 shared
AZURITY
Shared indications:
Medullary Thyroid Cancer
RETEVMO
SELPERCATINIB
1 shared
Eli Lilly
Shared indications:
Medullary Thyroid Cancer
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Clinical Trial Registry

39 trials
Trial Sponsor ID Phase Status Title
NCT04310007 NCI-2020-01541 NCI-2020-01541, EA5191 Ph 2 active not recruiting Testing the Addition of the Pill Chemotherapy, Cabozantinib, to the Standard Immune Therapy Nivolumab Compared to Standard Chemotherapy for Non-small Cell Lung Cancer
NCT04071223 NCI-2019-05619 NCI-2019-05619, A031801 Ph 2 active not recruiting Testing the Addition of a New Anti-cancer Drug, Radium-223 Dichloride, to the Usual Treatment (Cabozantinib) for Advanced Renal Cell Cancer That Has Spread to the Bone, RadiCaL Study
NCT05111574 NCI-2021-11794 NCI-2021-11794, A091903 Ph 2 recruiting Using Nivolumab Alone or With Cabozantinib to Prevent Mucosal Melanoma Return After Surgery
NCT02496208 NCI-2014-02379 NCI-2014-02379, 15-C-0160 Ph 1 active not recruiting Cabozantinib S-malate and Nivolumab With or Without Ipilimumab in Treating Patients With Metastatic Genitourinary Tumors
NCT05136196 NCI-2021-12653 NCI-2021-12653, S2101 Ph 2 recruiting 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
NCT05691478 NCI-2022-08567 NCI-2022-08567, AOST2032 Ph 2, Ph 3 recruiting A Study to Test the Addition of the Drug Cabozantinib to Chemotherapy in Patients With Newly Diagnosed Osteosarcoma
NCT03866382 NCI-2019-01266 NCI-2019-01266, A031702 Ph 2 recruiting Testing the Effectiveness of Two Immunotherapy Drugs (Nivolumab and Ipilimumab) With One Anti-cancer Targeted Drug (Cabozantinib) for Rare Genitourinary Tumors
NCT06811116 NCI-2025-00837 NCI-2025-00837, 25-082 Ph 1, Ph 2 recruiting 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
NCT05904080 NCI-2023-04469 NCI-2023-04469, A092105 Ph 2 recruiting Testing Nivolumab and Ipilimumab Immunotherapy With or Without the Targeted Drug Cabozantinib in Recurrent, Metastatic, or Incurable Nasopharyngeal Cancer
NCT05411081 NCI-2022-04668 NCI-2022-04668, S2200 Ph 2 active not recruiting Testing Cabozantinib With or Without Atezolizumab in Patients With Advanced Papillary Kidney Cancer, PAPMET2 Trial
NCT05092958 NCI-2021-11166 NCI-2021-11166, A032001 Ph 3 active not recruiting Testing the Addition of the Anti-cancer Drug, Cabozantinib, to the Usual Immunotherapy Treatment, Avelumab, in Patients With Metastatic Urothelial Cancer, MAIN-CAV Study
NCT04339738 results posted NCI-2020-02153 NCI-2020-02153, A091902 Ph 2 active not recruiting Testing the Addition of Nivolumab to Chemotherapy in Treatment of Soft Tissue Sarcoma
NCT03375320 results posted NCI-2017-02297 NCI-2017-02297, A021602 Ph 3 active not recruiting Testing Cabozantinib in Patients With Advanced Pancreatic Neuroendocrine and Carcinoid Tumors
NCT01708954 results posted NCI-2012-01938 NCI-2012-01938, ECOG-E1512 Ph 2 active not recruiting Erlotinib Hydrochloride and Cabozantinib-s-Malate Alone or in Combination as Second or Third Line Therapy in Treating Patients With Stage IV Non-small Cell Lung Cancer
NCT04878029 STUDY00002329 NCI-2021-01365, STUDY00002329 Ph 1 recruiting Cabozantinib in Combination With Enfortumab Vedotin for Locally Advanced or Metastatic Urothelial Cancer
NCT03367741 results posted NCI-2017-02211 NCI-2017-02211, PHL-099 Ph 2 active not recruiting Cabozantinib S-malate and Nivolumab in Treating Patients With Advanced, Recurrent, or Metastatic Endometrial Cancer
NCT02243605 results posted NCI-2014-01927 NCI-2014-01927, CABONE Ph 2 active not recruiting Cabozantinib S-malate in Treating Patients With Relapsed Osteosarcoma or Ewing Sarcoma
NCT02867592 results posted NCI-2016-01258 NCI-2016-01258, ADVL1622 Ph 2 active not recruiting Cabozantinib-S-Malate in Treating Younger Patients With Recurrent, Refractory, or Newly Diagnosed Sarcomas, Wilms Tumor, or Other Rare Tumors
NCT03914300 results posted NCI-2019-02220 NCI-2019-02220, OSU-19088 Ph 2 active not recruiting Testing the Combination of Cabozantinib, Nivolumab, and Ipilimumab (CaboNivoIpi) for Advanced Differentiated Thyroid Cancer
NCT04079712 results posted NCI-2019-05864 NCI-2019-05864, 10315 Ph 2 active not recruiting Testing the Combination of XL184 (Cabozantinib), Nivolumab, and Ipilimumab for Poorly Differentiated Neuroendocrine Tumors
NCT04514484 NCI-2020-05956 NCI-2020-05956, 2020-12258 Ph 1 active not recruiting Testing the Combination of the Anti-cancer Drugs XL184 (Cabozantinib) and Nivolumab in Patients With Advanced Cancer and HIV
NCT05122546 21133 NCI-2021-05559, 21133 Ph 1 active not recruiting CBM588 in Combination With Nivolumab and Cabozantinib for the Treatment of Advanced or Metastatic Kidney Cancer
NCT06006013 STUDY00005532 NCI-2023-04952, STUDY00005532 Ph 2 recruiting Cabozantinib in Combination With Pembrolizumab for the Treatment of Patients With Locally Advanced, Metastatic, or Unresectable Adrenal Cortical Cancer
NCT05092373 2021-0299 NCI-2021-11360, 2021-0299 Ph 1 recruiting Phase I Study of Tumor Treating Fields (TTF) in Combination With Cabozantinib or With Pembrolizumab and Nab-Paclitaxel in Patients With Advanced Solid Tumors Involving the Abdomen or Thorax
NCT01935934 results posted NCI-2013-00890 NCI-2013-00890, PHL-086 Ph 2 completed Cabozantinib S-Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer
NCT02302833 results posted 2014-0081 NCI-2014-02607, 2014-0081 Ph 2 completed Cabozantinib S-malate in Treating Patients With Metastatic Pheochromocytomas or Paragangliomas That Cannot Be Removed by Surgery
NCT04220229 results posted RG1003562 NCI-2019-08661, 10051 Ph 1, Ph 2 terminated Cabozantinib With Radiation Therapy for the Treatment of Sarcomas of the Extremities
NCT05168618 AtezoCab HCI143814 NCI-2021-13110, HCI143814 Ph 2 recruiting Cabozantinib and Atezolizumab for the Treatment of Metastatic Castration-Resistant Prostate Cancer
NCT02761057 results posted NCI-2015-01707 NCI-2015-01707, S1500 Ph 2 completed Testing Cabozantinib, Crizotinib, Savolitinib and Sunitinib in Kidney Cancer Which Has Progressed
NCT01709435 results posted NCI-2012-01890 NCI-2012-01890, P121149 Ph 1 completed Cabozantinib S-Malate in Treating Younger Patients With Recurrent or Refractory Solid Tumors
NCT04442581 results posted RG1007034 NCI-2020-03968, 10548 Ph 2 terminated Cabozantinib and Pembrolizumab for the First-Line Treatment of Advanced Liver Cancer
NCT01822522 results posted NCI-2013-00740 NCI-2013-00740, AMC-087 Ph 1 completed Cabozantinib S-Malate in Treating Patients With Advanced Solid Tumors and Human Immunodeficiency Virus
NCT05327738 STUDY00023365 NCI-2022-01840, STUDY00023365 Ph 2 withdrawn Yttrium Y 90 Glass Microspheres, Atezolizumab, and Cabozantinib for the Treatment of Unresectable or Locally Advanced Hepatocellular Carcinoma
NCT01835145 results posted NCI-2013-00821 NCI-2013-00821, CALGB-A091201 Ph 2 completed Cabozantinib-S-Malate Compared With Temozolomide or Dacarbazine in Treating Patients With Metastatic Melanoma of the Eye That Cannot Be Removed by Surgery
NCT01835158 results posted NCI-2013-00820 NCI-2013-00820, A031203 Ph 2 completed Cabozantinib-s-malate or Sunitinib Malate in Treating Patients With Previously Untreated Locally Advanced or Metastatic Kidney Cancer
NCT02315430 results posted NCI-2014-02411 NCI-2014-02411, NRG-GY001 Ph 2 completed Cabozantinib-S-Malate in Treating Patients With Recurrent or Progressive Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
NCT01716715 results posted NCI-2012-02058 NCI-2012-02058, GOG-0186K Ph 2 completed Cabozantinib or Paclitaxel in Treating Patients With Persistent or Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cavity Cancer
NCT01866410 results posted NCI-2013-01085 NCI-2013-01085, PHII-125 Ph 2 completed Cabozantinib-S-Malate and Erlotinib Hydrochloride in Treating Patients With Previously Treated Metastatic Non-Small Cell Lung Cancer
NCT01811212 results posted NCI-2013-00554 NCI-2013-00554, 2012C0101 Ph 2 completed Cabozantinib-S-Malate in Treating Patients With Refractory Thyroid Cancer
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Active Pipeline

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Ongoing clinical trials by development phase

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Key Completed Trials

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Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

COMETRIQ FDA Label Details

Indications & Usage

FDA Label (PDF)

COMETRIQ is indicated for the treatment of Medullary Thyroid Cancer.

View full patent landscape →
8 OB patents · 3 families · 292 international docs across 34 countries

COMETRIQ Patents & Exclusivity

Latest Patent: Feb 2032

Patents (8 active)

US12128039 Expires Feb 10, 2032
US11298349 Expires Feb 10, 2032
US9717720 Expires Feb 10, 2032
US8877776 Expires Oct 8, 2030
US11098015 Expires Jan 15, 2030
US11091440 Expires Jan 15, 2030
US11091439 Expires Jan 15, 2030
US7579473 Expires Aug 14, 2026
Source: FDA Orange Book

Pro Intelligence Preview

Deep insights for COMETRIQ

Revenue Insights

  • Quarterly revenue tracking
  • Historical trend analysis

Patent Timeline

  • Cliff: 2032
  • 32 active patents

Trial Analysis

  • 40 total trials
  • Stage: Growth

Competitive Landscape

  • 3 similar drugs
  • Same target/indication analysis
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Full approval history • All patents • Revenue trends • Competitor analysis

Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.

How We Calculate These Metrics

Trial Activity Stage

Measures the current development activity pattern based on trial phases, status, and trends. Important: This measures R&D activity, not commercial lifecycle.

Trial statuses: "Active" means recruiting or ongoing. "Completed" means reached planned endpoint. "Terminated" means stopped early—often due to safety, efficacy, or business reasons.

  • Growth: High proportion of early-phase trials (Phase 1/2), active development
  • Expansion: Significant Phase 3 activity, approaching or pursuing approvals
  • Mature: Substantial Phase 4 post-marketing studies
  • Stable: Mixed phase distribution, steady development
  • Declining: Low active trial ratio, reduced R&D investment