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Darlifarnib + cabozantinib is an investigational combination therapy consisting of darlifarnib (formerly KO-2806), an oral, next-generation farnesyltransferase inhibitor (FTI), and cabozantinib (Cabometyx), a marketed multi-targeted receptor tyrosine kinase inhibitor. Developed by Kura Oncology, darlifarnib is designed to enhance the antitumor and antiangiogenic effects of cabozantinib and overcome adaptive resistance to VEGFR tyrosine kinase inhibitors (TKIs). Mechanistically, darlifarnib inhibits farnesyltransferase, which blocks the farnesylation of RHEB, thereby preventing the hyperactivation of the mTORC1 signaling pathway in endothelial and tumor cells. This combination is being evaluated in the Phase 1a/1b FIT-001 trial (NCT06026410) for the treatment of advanced renal cell carcinoma (RCC), particularly clear cell RCC (ccRCC), in both cabozantinib-naive and cabozantinib-pretreated patients.
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