New Frontiers in Neuroendocrine Tumors (NETs): Treatment Advances and Insights From the Phase 3 CABINET Study

Panelists discuss how neuroendocrine tumors (NETs), once considered rare, are increasingly recognized due to improved diagnostics and their complex, often delayed presentation, highlighting the importance of clinician awareness and the growing significance of NETs in oncology.

Panelists discuss how management of advanced neuroendocrine tumors (NETs) has evolved with therapies like somatostatin analogues and peptide receptor radionuclide therapy, while emphasizing the importance of personalized treatment strategies and ongoing innovation in response to tumor progression and individual variability in outcomes.

Panelists discuss the complexities of managing neuroendocrine tumors (NETs), highlighting challenges in patient communication, treatment sequencing, and systemic barriers related to drug approvals, while emphasizing the need for personalized care and broader access to versatile therapies like peptide receptor radionuclide therapy.

Panelists discuss the rationale and design of the CABINET trial evaluating cabozantinib in neuroendocrine tumors (NETs), emphasizing the drug’s multitargeted anti-angiogenic activity, the study’s credibility as a cooperative group-led effort, and the use of progression-free survival as an appropriate primary end point given the disease’s indolent nature and complex treatment landscape

Panelists discuss the CABINET trial’s findings that cabozantinib significantly improved progression-free survival in both pancreatic and extrapancreatic neuroendocrine tumors, highlighting its efficacy in a heavily pretreated, real-world population and noting the trial’s inclusive design, crossover protocol, and implications for broader clinical use.

Panelists discuss the CABINET trial’s safety findings, noting that while cabozantinib showed a manageable toxicity profile similar to other cancers, its use in heavily pretreated neuroendocrine tumor patients—especially post peptide receptor radionuclide therapy—requires careful dose management due to adverse effects like cytopenias and palmar-plantar erythrodysesthesia, prompting interest in alternative dosing strategies to improve tolerability

Panelists discuss cabozantinib’s role in the neuroendocrine tumor treatment landscape, emphasizing its utility as a third-line option post somatostatin analogues and systemic therapy, while highlighting its efficacy in heavily pretreated patients, the importance of careful sequencing—especially relative to PRRT—and considerations for ideal patient selection, including those with grade 3 well-differentiated tumors.

Panelists emphasized that managing cabozantinib treatment in NET patients requires a proactive, multidisciplinary approach, including dose adjustments, patient education, and close follow-up, to effectively manage adverse effects and ensure durable treatment.

Panelists discuss how the field of neuroendocrine tumors (NETs) is advancing with the emergence of new therapies, including alpha therapies, somatostatin receptor-targeting approaches, and research into high-grade NETs, while highlighting the importance of staying updated on evolving treatments to improve patient outcomes.