Overall Survival and Early Trial Termination

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. Speakers contextualize this within the broader neuroendocrine field, observing that overall survival benefit is historically difficult to demonstrate given prolonged survival, frequent crossover, and lengthy follow-up periods, with few agents approved on the basis of overall survival alone. The discussion frames cabozantinib as an additional tool whose sequencing remains an open question. Faculty address the early termination directly, clarifying that the trial was stopped at planned interim analysis because it met its efficacy criteria, not because of safety concerns or enrollment difficulty. They emphasize that early completion reflects a strong activity signal and should not be misinterpreted as a limitation of the data.