Details of the Drug Combination

General Information of Drug Combination (ID: DCSRGUI)

• Drug Combination Name: Lenvatinib + Cabozantinib
• Indication: Differentiated Thyroid Gland Carcinoma; Status: Phase 1 [1]
• Component Drugs:
  Lenvatinib (DMB1IU4): Small molecular drug
  Cabozantinib (DMIYDT4): Small molecular drug

Molecular Interaction Atlas of This Drug Combination

Indication(s) of Lenvatinib

Disease Entry	ICD 11	Status	REF
Thyroid cancer	2D10	Approved	[2]
Thyroid gland follicular carcinoma	N.A.	Approved	[3]
Thyroid gland papillary carcinoma	N.A.	Approved	[3]
Hepatocellular carcinoma	2C12.02	Phase 3	[4]
Renal cell carcinoma	2C90	Phase 3	[5]
Melanoma	2C30	Phase 2	[4]
Solid tumour/cancer	2A00-2F9Z	Phase 1/2	[5]
Ovarian cancer	2C73	Phase 1	[6]
Non-small-cell lung cancer	2C25.Y	Application submitted	[5]

Lenvatinib Interacts with 1 DTT Molecule(s)

DTT Name	DTT ID	UniProt ID	Mode of Action	REF
Vascular endothelial growth factor receptor 2 (KDR)	TTUTJGQ	VGFR2_HUMAN	Inhibitor	[6]

Lenvatinib Interacts with 1 DTP Molecule(s)

DTP Name	DTP ID	UniProt ID	Mode of Action	REF
P-glycoprotein 1 (ABCB1)	DTUGYRD	MDR1_HUMAN	Substrate	[9]

Indication(s) of Cabozantinib

Disease Entry	ICD 11	Status	REF
Medullary thyroid gland carcinoma	N.A.	Approved	[7]
Thyroid cancer	2D10	Approved	[8]
Ovarian cancer	2C73	Phase 2	[8]

Cabozantinib Interacts with 2 DTT Molecule(s)

DTT Name	DTT ID	UniProt ID	Mode of Action	REF
Proto-oncogene c-Met (MET)	TTNDSF4	MET_HUMAN	Inhibitor	[10]
Vascular endothelial growth factor receptor 2 (KDR)	TTUTJGQ	VGFR2_HUMAN	Inhibitor	[10]

Cabozantinib Interacts with 2 DME Molecule(s)

DME Name	DME ID	UniProt ID	Mode of Action	REF
Cytochrome P450 3A4 (CYP3A4)	DE4LYSA	CP3A4_HUMAN	Metabolism	[11]
Cytochrome P450 2C9 (CYP2C9)	DE5IED8	CP2C9_HUMAN	Metabolism	[12]

Cabozantinib Interacts with 2 DOT Molecule(s)

DOT Name	DOT ID	UniProt ID	Mode of Action	REF
Hepatocyte growth factor receptor (MET)	OT7K55MU	MET_HUMAN	Decreases Phosphorylation	[13]
Alanine aminotransferase 1 (GPT)	OTOXOA0Q	ALAT1_HUMAN	Increases Secretion	[14]

References

• [1] ClinicalTrials.gov (NCT02592356) Effect of Cabozantinib S-Malate or Lenvatinib Mesylate on Weight and Body Composition in Patients With Metastatic Endocrine Cancer
• [2] FDA Approved Drug Products from FDA Official Website. 2018. Application Number: (ANDA) 208627.
• [3] Lenvatinib FDA Label
• [4] Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
• [5] Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
• [6] Emerging drugs for ovarian cancer. Expert Opin Emerg Drugs. 2008 Sep;13(3):523-36.
• [7] Cabozantinib FDA Label
• [8] URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 5887).
• [9] Influence of CYP3A4/5 and ABC transporter polymorphisms on lenvatinib plasma trough concentrations in Japanese patients with thyroid cancer. Sci Rep. 2019 Apr 1;9(1):5404.
• [10] Clinical pipeline report, company report or official report of Exelixis (2011).
• [11] Practical management of adverse events associated with cabozantinib treatment in patients with renal-cell carcinoma. Onco Targets Ther. 2017 Oct 19;10:5053-5064.
• [12] FDA Label of Cabozantinib. The 2020 official website of the U.S. Food and Drug Administration.
• [13] ROS-dependent DNA damage contributes to crizotinib-induced hepatotoxicity via the apoptotic pathway. Toxicol Appl Pharmacol. 2019 Nov 15;383:114768. doi: 10.1016/j.taap.2019.114768. Epub 2019 Oct 19.
• [14] Cytotoxicity of 34 FDA approved small-molecule kinase inhibitors in primary rat and human hepatocytes. Toxicol Lett. 2018 Jul;291:138-148. doi: 10.1016/j.toxlet.2018.04.010. Epub 2018 Apr 12.