Andrew E. Hendifar, MD

The panel focuses on the use of cabozantinib in grade 3 neuroendocrine tumors, a population increasingly encountered in clinical practice, possibly reflecting more standardized Ki-67 testing across community settings.

Faculty review the key safety findings from CABINET, emphasizing that no unexpected signals emerged relative to prior experience with cabozantinib in other malignancies.

The panel interprets the overall survival data from CABINET and the implications of the trial's early termination. Faculty note that overall survival remains immature and is confounded by permitted placebo crossover, emphasizing that the study was not powered for this endpoint and that progression-free survival was the primary measure.

Faculty present the progression-free survival findings from CABINET across both cohorts, emphasizing the encouraging and practice-changing results in a heavily pretreated population. In the pancreatic neuroendocrine tumor cohort, median progression-free survival exceeded 13 months with cabozantinib versus roughly 4 months with placebo.

The panel reviews the design of the CABINET trial, a large phase 3, randomized, double-blind, placebo-controlled study evaluating cabozantinib in advanced neuroendocrine tumors. Faculty describe the trial's ambitious and inclusive structure, enrolling both pancreatic and extra-pancreatic cohorts, with the extra-pancreatic group encompassing lung, thymic, gastrointestinal, small bowel, and unknown primary tumors. Patients were randomized 2:1 to cabozantinib 60 mg daily versus placebo. The discussion notes that the protocol was modified after launch to require progression on at least one prior approved therapy, reflecting the evolving treatment landscape. Faculty emphasize the broad eligibility, including grades 1 through 3 well-differentiated disease, and compare baseline characteristics with landmark neuroendocrine trials. They highlight that this was a modern-era study, with many patients having received prior radioligand therapy, everolimus, sunitinib, or capecitabine, underscoring how the heavily pretreated population reflects contemporary real-world sequencing and sets the trial apart from earlier studies.

Learn how NET therapy is tailored—surgery when curable, somatostatin analogs first, then PRRT, targeted drugs, and liver-directed options.

The panel examines how treatment is selected across the disease course in neuroendocrine tumors, beginning with the distinction between early-stage and advanced disease.

A multidisciplinary panel of oncologists opens this OncLive Peer Exchange on evolving strategies in neuroendocrine tumor management, introducing the faculty and framing the discussion around CABINET trial data and current clinical practice.

Discover the future of cancer treatment with innovative therapies and groundbreaking research in radiopharmaceuticals and theranostics.

Experts discuss the promising future of CAR-T therapy and radioligand treatments for neuroendocrine tumors, highlighting new trials and potential breakthroughs.

Experts discuss the challenges of sequencing treatments like cabozantinib and managing side effects in patients with metastatic disease.

Dr. Chauhan discusses the groundbreaking CABINET trial, revealing its impact on treating neuroendocrine tumors and the future of oncology research.

Experts discuss treatment options for a young patient with pancreatic neuroendocrine tumor and liver metastases, focusing on targeted therapies.

Doctor Hendifer discusses the diverse therapies for neuroendocrine neoplasms, emphasizing individualized treatment based on patient needs and disease characteristics.

Experts discuss advanced treatment options for neuroendocrine tumors, highlighting PRRT, mTOR inhibitors, and emerging therapies for improved patient outcomes.

Oncology treatment decisions hinge on tumor biology and patient factors, emphasizing a multidisciplinary approach for optimal care.

Experts discuss treatment strategies for neuroendocrine tumors, emphasizing personalized approaches based on tumor grade, symptoms, and patient health.

Explore the complexities of treating neuroendocrine tumors, focusing on patient-specific strategies and the role of somatostatin analogs.

Experts discuss key factors influencing disease prognosis, emphasizing differentiation, growth pace, and disease burden in treatment decisions.

Experts discuss the evolution of neuroendocrine tumor classification, highlighting its clinical implications and the importance of standardized treatment approaches.

Experts discuss the evolution of neuroendocrine tumor classification, highlighting its impact on diagnosis, treatment, and clinical implications.

Imaging Modalities for Neuroendocrine Tumors

Classification of Neuroendocrine Tumors

Andrew E. Hendifar, MD, medical oncology lead for the Gastrointestinal Disease Research Group, Cedars-Sinai Medical Center, discusses the future treatment landscape for patients with neuroendocrine tumors (NETs).

Andrew E. Hendifar, MD, medical oncology lead for the Gastrointestinal Disease Research Group, Cedars-Sinai Medical Center, discusses a 92-gene assay of patients with neuroendocrine tumors (NETs).

Andrew E. Hendifar, MD, medical oncology lead for the Gastrointestinal Disease Research Group, Cedars-Sinai Medical Center, discusses the current treatment landscape in pancreas cancer.

Andrew E. Hendifar, MD, medical oncology lead for the Gastrointestinal Disease Research Group, Cedars-Sinai Medical Center, discusses HALO-202 in metastatic pancreatic ductal adenocarcinoma.