Cabozantinib S-Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer

Exclusion Criteria

• •Patients who have had chemotherapy (including investigational cytotoxic chemotherapy), biologic agents (e.g., cytokines or antibodies) or radiotherapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C) before the first dose of study treatment or those who have not recovered from adverse events due to agents administered more than 4 weeks earlier
• •Prior treatment with cabozantinib
• •The subject has received radiation therapy:
• •* To bone metastasis within 14 days before the first dose of study treatment
• •* To any other site(s) within 28 days before the first dose of study treatment
• •The subject has received radionuclide treatment within 6 weeks of the first dose of study treatment
• •The subject has received prior treatment with a small molecule kinase inhibitor or a hormonal therapy (including investigational kinase inhibitors or hormones) within 14 days or five half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment
• •The subject has received any other type of investigational agent within 28 days before the first dose of study treatment
• •The subject has not recovered to baseline or Common Terminology Criteria for Adverse Events (CTCAE) =\< grade 1 from related toxicity to all prior therapies except alopecia and other non-clinically significant adverse events (AEs)
• •Any other prior malignancy from which the patient has been disease free for less than 3 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer, carcinoma in situ of any site or any other cancer
• •Patients with known brain metastases should be excluded from this clinical trial
• •The subject has prothrombin time (PT)/international normalized ratio (INR) or partial thromboplastin time (PTT) test \>= 1.3 x the laboratory ULN =\< 7 days before the first dose of study treatment
• •Therapeutic anticoagulation with warfarin, antiplatelet agents (e.g., clopidogrel), thrombin, or Factor Xa inhibitors is not allowed; therapeutic anticoagulation with low molecular weight heparin (LMWH) is allowed as well as prophylactic anticoagulation using low dose aspirin (=\< 81 mg/day), low-dose warfarin (=\< 1 mg/day), and LMWH
• •The subject requires chronic concomitant treatment of strong CYP3A4 inducers (e.g., dexamethasone, phenytoin, carbamazepine, rifampin, rifabutin, rifapentine, phenobarbital, and St. John's wort)
• •The subject has experienced any of the following:
• •* Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment
• •* Hemoptysis of \>= 0.5 teaspoon (2.5 mL) of red blood within 3 months before the first dose of study treatment
• •* Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment
• •The subject has tumor in contact with, invading or encasing any major blood vessels
• •The subject has evidence of tumor invading the gastrointestinal (GI) tract (esophagus, stomach, small or large bowel, rectum or anus), or any evidence of endotracheal or endobronchial tumor within 28 days before the first dose of cabozantinib
• •The subject has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions:
• •* Cardiovascular disorders including:
• •* Congestive heart failure (CHF): New York Heart Association (NYHA) class III (moderate) or class IV (severe) at the time of screening
• •* Concurrent uncontrolled hypertension defined as sustained blood pressure (BP) \> 140 mmHg systolic, or \> 90 mmHg diastolic despite optimal antihypertensive treatment within 7 days of the first dose of study treatment
• •* Any history of congenital long QT syndrome
• •* Any of the following within 6 months before the first dose of study treatment:
• •* Unstable angina pectoris
• •* Clinically-significant cardiac arrhythmias
• •* Stroke (including transient ischemic attack \[TIA\], or other ischemic event)
• •* Myocardial infarction
• •Gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation including:
• •* Any of the following within 28 days before the first dose of study treatment
• •* Intra-abdominal tumor/metastases invading GI mucosa
• •* Active peptic ulcer disease,
• •* Inflammatory bowel disease (including ulcerative colitis and Crohn's disease), diverticulitis, cholecystitis, symptomatic cholangitis or appendicitis
• •* Malabsorption syndrome
• •* Any of the following within 6 months before the first dose of study treatment:
• •* Abdominal fistula
• •* Gastrointestinal perforation
• •* Bowel obstruction or gastric outlet obstruction
• •* Intra-abdominal abscess; note: complete resolution of an intra-abdominal abscess must be confirmed prior to initiating treatment with cabozantinib even if the abscess occurred more than 6 months before the first dose of study treatment
• •Other disorders associated with a high risk of fistula formation including percutaneous endoscopic gastrostomy (PEG) tube placement within 3 months before the first dose of study therapy
• •Other clinically significant disorders such as:
• •* Active uncontrolled infection requiring intravenous systemic treatment within 14 days before the first dose of study treatment
• •* Serious non-healing wound/ulcer/bone fracture within 28 days before the first dose of study treatment
• •* History of organ transplant
• •* Concurrent uncompensated hypothyroidism or thyroid dysfunction within 7 days before the first dose of study treatment
• •* History of major surgery as follows:
• •* Major surgery within 3 months of the first dose of cabozantinib if there were no wound healing complications or within 6 months of the first dose of cabozantinib if there were wound complications
• •* Minor surgery within 1 month of the first dose of cabozantinib if there were no wound healing complications or within 3 months of the first dose of cabozantinib if there were wound complications
• •* In addition, complete wound healing from prior surgery must be confirmed at least 28 days before the first dose of cabozantinib irrespective of the time from surgery
• •The subject is unable to swallow tablets
• •The subject has a corrected QT interval calculated by the Fridericia formula (QTcF) \> 500 ms =\< 7 days before the first dose of study treatment
• •The subject is unable or unwilling to abide by the study protocol or cooperate fully with the investigator or designee
• •History of allergic reactions attributed to compounds of similar chemical or biologic composition to XL184
• •Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with XL184
• •Known human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible