CABINET Trial Design and Patient Population

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.