CABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours
Cabozantinib delayed progression in previously treated advanced neuroendocrine tumours of both pancreatic and extra-pancreatic origin compared with placebo, adding a new option after somatostatin analogues, everolimus or radioligand therapy.
Overview
Two parallel phase 3 placebo-controlled trials of cabozantinib in 298 patients with progressive advanced neuroendocrine tumours: 203 with extra-pancreatic (including lung and small bowel) and 95 with pancreatic tumours, all previously treated.
Median progression-free survival was 8.4 versus 3.9 months in extra-pancreatic tumours (hazard ratio 0.38) and 13.8 versus 4.4 months in pancreatic tumours (hazard ratio 0.23); hypertension, fatigue and diarrhoea were common.
- Extra-pancreatic: median progression-free survival 8.4 vs 3.9 months; hazard ratio 0.38.
- Pancreatic: 13.8 vs 4.4 months; hazard ratio 0.23.
Cabozantinib is approved for previously treated neuroendocrine tumours of any origin and is a standard later-line choice, including for lung carcinoids.
- Trials stopped early at interim analysis; overall survival not powered.
- Dose reductions needed in most patients.
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