after you have joined the study, you are assigned a random group. the randomization decides whether you will receive cabozantinib plus best supportive care (bsc) or bsc alone.

if you are placed in the cabozantinib arm, you will be given the medication to take at home.

if you are placed in the bsc only arm, you will continue to receive supportive care without the study drug.

for participants receiving cabozantinib, the prescribed dose is one 60 mg film‑coated tablet taken by mouth once each day.

the tablet is swallowed with water and can be taken with or without food.

you will continue taking the tablet every day until disease progression, death, or a decision is made to stop because of side effects.

on the day you take the first tablet, study staff will ask you to rate how acceptable and how pleasant the medicine tastes using a five‑point facial scale and a visual analog scale.

this assessment helps determine whether the medicine is suitable for children and adolescents.

blood samples are collected on cycle 1 day 1 (the first day you take the tablet) and again on cycle 2 day 1 (approximately 28 days later).

these samples measure how much of the drug is in your blood at steady state, including the minimum, average, and maximum concentrations.

you will attend clinic visits at scheduled intervals. during each visit, health professionals will check for side effects, perform physical examinations, and may draw blood for laboratory tests.

imaging studies (such as scans) are performed to evaluate disease status. the first major assessment occurs at 4 months after randomization, followed by another at 1 year, and then periodically until the study ends (approximately 34 months).

any new symptom or health problem that appears from the time of screening until 30 days after the last dose is recorded as a treatment‑emergent adverse event.

serious adverse events are followed until they are resolved or stable, even after the medication is stopped.

you will keep taking the daily tablet as long as the disease does not progress, you do not experience unacceptable toxicity, and you remain alive.

the expected maximum duration of treatment is about 34 months, but it may be shorter if progression or other stopping criteria occur.

after stopping the medication, you will continue to be followed for overall survival. the study records whether participants are alive at 1 year and up to the final study cut‑off (approximately 34 months after randomization).