CABINET: Does Cabozantinib Benefit Patients With Advanced Pancreatic Neuroendocrine Tumors?

The randomized, phase 3 CABINET trial analyzed the benefits of cabozantinib for previously treated patients with advanced pancreatic neuroendocrine tumors (pNET). Researchers found that cabozantinib can improve the progression-free survival (PFS) rate for patients.

Dr. Jennifer Chan, of the Dana-Farber Cancer Institute, presented the double-blinded study at the European Society for Medical Oncology Congress 2023.

Researchers evaluated the efficacy of cabozantinib in patients with advanced pNET or advanced extrapancreatic neuroendocrine tumors (epNET).

Participating patients had to demonstrate measurable disease determined using the Response Evaluation Criteria in Solid Tumors version 1.1. They also had to show disease progression following a minimum of 1 US Food and Drug Administration–approved line of prior therapy, not including somatostatin analogs.

The 290 patients participating in the study were placed into the pNET group (n=93) or the epNET group (n=197) based on their diagnosis. Investigators randomly selected patients in each group, using a 2:1 ratio, to receive either cabozantinib 60 mg daily or placebo daily.

In each group, more than half of the patients previously underwent treatment with everolimus or prior Lu-177 dotatate.

The study’s primary end point was PFS. Secondary end points included response rate and overall survival. If a patient in the placebo group experienced disease progression, they were unblinded and allowed to switch treatment to open-label therapy with cabozantinib.

In the epNET group, with a median follow-up of 13.9 months, patients who took cabozantinib experienced a median PFS rate of 8.3 months in contrast with 3.2 months for those who took placebo. In the pNET group, with a median follow-up of 16.7 months, patients who received cabozantinib experienced a median PFS rate of 11.4 months, compared with 3.0 months for the placebo group.

Researchers concluded that physicians could use cabozantinib as a new treatment for patients with previously treated, progressive neuroendocrine tumors. “Given that there is no standard treatment for patients with progressive disease, these results showing notable improvements in progression-free survival are highly encouraging for patients and their physicians,” said Chan.