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Cabozantinib + dostarlimab is an investigational combination therapy being studied primarily for the treatment of recurrent gynecologic cancers, including carcinosarcoma. Cabozantinib is a small molecule tyrosine kinase inhibitor that targets multiple kinases involved in tumor angiogenesis and growth, notably vascular endothelial growth factor receptors (VEGFRs), MET, and AXL. Dostarlimab is a humanized monoclonal antibody that acts as an immune checkpoint inhibitor by binding to the programmed cell death protein 1 (PD-1) receptor on T cells, blocking its interaction with PD-L1 and PD-L2 ligands to enhance anti-tumor immune responses. The rationale for combining these agents lies in their complementary mechanisms: inhibition of angiogenesis by cabozantinib may improve immune cell infiltration into tumors, potentially enhancing the efficacy of immunotherapy with dostarlimab[1][3][8]. This combination is currently under investigation in phase Ib/II clinical trials for patients with recurrent gynecologic carcinosarcoma and other gynecologic malignancies[2][4][10].
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