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Learn more about liver cancer*

*hepatocellular carcinoma (HCC)

What is liver cancer?

Liver cancer (also known as hepatocellular carcinoma or HCC) is a disease in which cancer cells develop in the liver. These cells often form a mass of tissue known as a tumor.

HCC is the most common form of liver cancer. It begins in the cells of the liver, known as hepatocytes.

What are the stages of liver cancer?

Like many cancers, liver cancer can progress or worsen. These phases of progression are called stages. Healthcare professionals assign stages to cancer to evaluate how severe the cancer is and how best to treat it. Liver cancer is staged from I to IV and these stages are defined as follows:

The tumor is only in the liver and is smaller than 2 cm OR larger than 2 cm

One tumor that is larger than 2 cm and has grown into blood vessels, OR more than one tumor but none larger than 5 cm. None of the tumors have spread to lymph nodes or to other parts of the body

More than one tumor, with at least one larger than 5 cm, OR one or more tumors that have grown into a large vein of the liver. None of the tumors have spread to lymph nodes or to other parts of the body

A tumor or tumors that have spread to nearby lymph nodes OR to other organs, such as the lung or bones

Liver cancer spreads when cancer cells break away from the tumor and travel. These cells can invade nearby lymph nodes, tissues, and organs as well as other parts of the body. When liver cancer spreads to lymph nodes or other organs (Stage IV), it is considered advanced liver cancer.

What are the treatment options?

The choice of therapy for liver cancer depends on the stage of your cancer, how well your liver is working, and your overall health. Your healthcare team members will work together to choose the treatment that is right for you.

You may hear the term first-line treatment. It means the first treatment given for a disease. It is often part of a standard set of treatments, such as surgery followed by chemotherapy and radiation.
When that first-line treatment doesn’t work or stops working, your doctor may start you on a second-line treatment.

In addition to your doctor, your team may include some of the following healthcare professionals who treat people with liver cancer: hepatobiliary (liver) surgeons, surgical oncologists, gastroenterologists, radiation oncologists, nurses, and registered dietitians.

The team will consider the treatments that are available, including:

Surgery

removing the whole liver and replacing it with a healthy liver (liver transplant) or removing the part with cancer.

Surgery is an option only with early-stage cancer that has not spread to lymph nodes or other organs.

Resectable means able to be removed by surgery
Inoperable describes a condition that cannot be treated by surgery

Ablation

a procedure designed to destroy the cancer in your liver using heat, lasers, or microwaves.

Embolization

a procedure that blocks the flow of blood into the blood vessel that feeds the tumor to stop the cancer from growing.

Targeted Therapy

a category of treatment including drugs that target specific features of cancer cells that help them grow. They may also affect normal cells, causing side effects. Tyrosine kinase inhibitors (TKI) are one type of targeted therapy used to treat liver cancer.

TKIs block proteins known to send signals that tell cancer cells to grow. Without these signals, the tumor may stop growing or shrink.

Radiation Therapy

a procedure that uses high-energy rays to destroy cancer cells in the liver.

CABOMETYX is a type of therapy called a tyrosine kinase inhibitor. You may hear your doctor refer to it as a TKI.

LEARN MORE ABOUT

How CABOMETYX may help you

CABOMETYX is proven to help certain people with liver cancer who have been previously treated with the medicine sorafenib.

INDICATIONS AND IMPORTANT SAFETY INFORMATION

IMPORTANT SAFETY INFORMATION

What are the possible side effects of CABOMETYX?

CABOMETYX may cause serious side effects, including:

Bleeding (hemorrhage). CABOMETYX can cause severe bleeding that may lead to death. Tell your healthcare provider right away if you get any signs of bleeding during treatment with CABOMETYX, including:

Coughing up blood or blood clots
Vomiting blood or if your vomit looks like coffee grounds
Red or black (looks like tar) stools
Menstrual bleeding that is heavier than normal
Any unusual or heavy bleeding

A tear in your stomach or intestinal wall (perforation) or an abnormal connection between 2 parts of your body (fistula). Tell your healthcare provider right away if you get tenderness or pain in your stomach area (abdomen) that is severe or that does not go away.

Blood clots, stroke, heart attack, and chest pain. Get emergency help right away if you get:

Swelling or pain in your arms or legs
Shortness of breath
Feel lightheaded or faint
Sweating more than usual
Numbness or weakness of your face, arm, or leg, especially on one side of your body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking
Dizziness, loss of balance or coordination
A sudden severe headache

High blood pressure (hypertension). Hypertension is common with CABOMETYX and sometimes can be severe. Your healthcare provider will check your blood pressure before starting CABOMETYX and regularly during treatment with CABOMETYX. If needed, your healthcare provider may prescribe medicine to treat your high blood pressure. Tell your healthcare provider if you develop severe headaches, nose bleeds, tiredness or confusion, vision changes, chest pain, trouble breathing, irregular heartbeat, or blood in your urine.

Diarrhea. Diarrhea is common with CABOMETYX and can be severe. If needed, your healthcare provider may prescribe medicine to treat your diarrhea. Tell your healthcare provider right away if you have frequent loose, watery bowel movements.

A skin problem called hand-foot skin reaction. Hand-foot skin reactions are common and can be severe. Tell your healthcare provider right away if you have rashes, redness, pain, swelling, or blisters on the palms of your hands or soles of your feet.

Protein in your urine and possible kidney problems. Symptoms may include swelling in your hands, arms, legs, or feet. Your healthcare provider will check you for this problem during treatment with CABOMETYX.

Severe jaw bone problems (osteonecrosis). Your healthcare provider should examine your mouth before you start and during treatment with CABOMETYX. Tell your dentist that you are taking CABOMETYX. It is important for you to practice good mouth care during treatment with CABOMETYX. Tell your healthcare provider right away if you develop any symptoms of jaw problems, including: jaw pain, toothache, or sores on your gums.

Wound healing problems. Wound healing problems have happened in people who take CABOMETYX. Tell your healthcare provider if you plan to have any surgery before or during treatment with CABOMETYX.

You should stop taking CABOMETYX at least 3 weeks before planned surgery.
Your healthcare provider should tell you when you may start taking CABOMETYX again after surgery.

Reversible posterior leukoencephalopathy syndrome (RPLS). A condition called reversible posterior leukoencephalopathy syndrome can happen during treatment with CABOMETYX. Tell your healthcare provider right away if you have headaches, seizures, confusion, changes in vision, or problems thinking.

Change in thyroid function. CABOMETYX can cause changes in your thyroid function, including changes to thyroid hormone levels in your blood. Your healthcare provider will do blood tests to check your thyroid function before and during treatment with CABOMETYX.

Decreased calcium level in your blood (hypocalcemia). CABOMETYX can cause you to have a decreased amount of calcium in your blood. Your healthcare provider will do blood tests to check you for this problem and give you calcium if needed. Tell your healthcare provider right away if you get any of the following signs or symptoms:

Muscle stiffness or muscle spasms
Numbness or tingling in your fingers, toes, or around your mouth
Seizures
Sudden weight gain
Swelling of your arms, hands, legs, and ankles

Your healthcare provider may change your dose, temporarily stop, or permanently stop treatment with CABOMETYX if you have certain side effects.

The most common side effects of CABOMETYX include:

Tiredness
Decreased appetite
Nausea and vomiting
Weight loss
Constipation

CABOMETYX may cause fertility problems in females and males, which may affect your ability to have children. Talk to your healthcare provider if you have concerns about fertility.

These are not all of the possible side effects of CABOMETYX. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before you take CABOMETYX, tell your healthcare provider about all of your medical conditions, including if you:

Have had a liver problem other than liver cancer.
Have a recent history of bleeding, including coughing up or vomiting blood, or black tarry stools.
Have an open or healing wound.
Have high blood pressure.
Have a low calcium level in your blood (hypocalcemia).
Plan to have any surgery, dental procedure, or have had a recent surgery. You should stop treatment with CABOMETYX at least 3 weeks before planned surgery.
Are pregnant, or plan to become pregnant. CABOMETYX can harm your unborn baby.
- If you are able to become pregnant, your healthcare provider will check your pregnancy status before you start treatment with CABOMETYX.
- Females who are able to become pregnant should use effective birth control (contraception) during treatment and for 4 months after your final dose of CABOMETYX.
- Talk to your healthcare provider about birth control methods that may be right for you.
- If you become pregnant or think you are pregnant, tell your healthcare provider right away.
Are breastfeeding or plan to breastfeed. It is not known if CABOMETYX passes into your breast milk. Do not breastfeed during treatment and for 4 months after your final dose of CABOMETYX.

Tell your healthcare provider about all the medicines you take, including prescription or over-the-counter medicines, vitamins, and herbal supplements. CABOMETYX and certain other medicines may affect each other, causing side effects.

What should I avoid while taking CABOMETYX?

Avoid drinking grapefruit juice, eating grapefruit, or taking supplements that contain grapefruit or St. John’s wort during treatment with CABOMETYX.

Please see the Patient Information in the full Prescribing Information.

INDICATION

What is CABOMETYX?

CABOMETYX is a prescription medicine used to treat:

People with liver cancer (hepatocellular carcinoma) who have been previously treated with the medicine sorafenib.