Emily Menendez

GI Oncology Now

The phase 3 CABINET study began in 2018 to determine the efficacy of cabozantinib in patients with advanced extra-pancreatic neuroendocrine tumors (epNETs) or pancreatic NET (pNET) whose disease had progressed after prior therapy. Cabozantinib was found to improve progression-free survival (PFS) in this patient population, with <a href="https://meetings.asco.org/abstracts-presentations/246520" target="_blank" rel="noopener">new findings presented</a> at the 2025 ASCO Annual Meeting on the health-related quality of life (HRQOL) data from the trial.The researchers categorized patients with unresectable, locally advanced, or metastatic epNET or pNET 2:1 to receive cabozantinib 60 mg daily or placebo. HRQOL was measured using the EORTC QLQ-C30, QLQ-GI.NET21, Patient Global Impression of Change (PGIC), and PRO-CTCAE questionnaires.Optional participation was conducted via paper surveys at baseline and every 12 weeks until disease progression or new anticancer therapy. The treatment arms were compared at week 12 using linear mixed models to determine mean changes from baseline.A clinically meaningful change was defined as an 8-point difference on the EORTC QLQ-C30 Global Health Status (GHS)/QOL scale for both within-arm improvements and between-arm comparisons. The Patient Global Impression of Change (PGIC) was categorized as improved versus unchanged or worsened, and differences were assessed using Chi-squared tests. Patient-reported adverse events (AEs), collected via PRO-CTCAE, were adjusted for baseline and analyzed using Fisher&rsquo;s exact tests.A total of 172 patients (113 cabozantinib, 59 placebo) with epNET and 81 patients (53 cabozantinib, 28 placebo) with pNET consented to survey participation. Of 640 expected surveys across baseline, week 12, and week 24, 524 (82%) were completed.In patients with epNET, C30 GHS/QOL was significantly improved at week 12 in patients receiving cabozantinib (mean change 9.5, standard error (SE) 2.2, P&lt;0.001) but not placebo (mean change 0.2, SE 3.1, P=0.95), resulting in significantly different mean changes from baseline between arms (P=0.02).For patients with pNET, the QHS/QOL was significantly improved at week 12 in patients receiving cabozantinib (mean change 8.0, SE 3.0, P=0.008) but not placebo (mean change 6.8, SE 4.4, P=0.12); mean changes from baseline did not statistically differ between arms (P=0.82).In the C30 Physical, Role, Emotional, Cognitive, and Social Function, no significant differences in mean changes from baseline at week 12 were seen between treatment arms in either of the epNET or pNET cohorts.In both cohorts at week 12, patients who received cabozantinib reported improved overall status based on PGIC more often than patients who received a placebo (epNET: 38% vs 19%, P=0.04; pNET: 57% vs 18%, P=0.006).The rates of patient-reported AEs were significantly higher in patients who received cabozantinib over placebo for diarrhea (68% vs 53%), hand-foot syndrome (57% vs 26%), mouth or throat sores (47% vs 27%), and dysgeusia (67% vs 37%).While cabozantinib is linked to patient-reported AEs that are consistent with its known safety profile, global HRQOL was maintained. A higher number of patients who received cabozantinib over placebo reported improved overall status, supporting cabozantinib as a treatment option for patients with previously treated advanced NET.

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Cabozantinib was found to improve progression-free survival in patients with advanced extra-pancreatic neuroendocrine tumors or pancreatic NET.