Lung and Thymic Subgroup Analysis and Safety

The panel addresses the lung and thymic subgroup analysis from CABINET, a population with historically limited treatment evidence. Within this 49-patient subset, cabozantinib demonstrated progression-free survival of 8.3 months versus 2.8 months with placebo, with a favorable hazard ratio that reinforces its role in lung neuroendocrine tumors. Faculty compare these results with prior everolimus data, noting that most patients had already received everolimus and discussing how best to sequence the two agents based on patient comorbidities such as diabetes and hypertension. The conversation explores safety scenarios specific to this population, including vascular involvement, bleeding and wound-healing risk, and management of patients with peritoneal disease and obstruction. Faculty express measured reassurance about bleeding risk in neuroendocrine tumors while remaining attentive to individual circumstances. They also caution that many lung tumors express somatostatin receptors heterogeneously, limiting radioligand therapy utility and supporting cabozantinib as a valuable option in selected patients.