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When neuroendocrine tumors progress despite treatment (i.e., somatostatin analogue therapy, sunitinib, everolimus, chemotherapy, and Lu-177 dotatate), patients have limited options. Investigators now report results of the randomized, phase-3 CABINET trial comparing the multitargeted tyrosine kinase inhibitor cabozantinib (60 mg/day) with placebo in 298 patients with treatment-refractory pancreatic or extrapancreatic neuroendocrine cancers (pancreatic primaries, 32%; extrapancreatic primaries, 68%). Most tumors were grade 2 (64%), followed by grade 1 (24%) and grade 3 (8%). Nearly all patients had prior somatostatin analogue therapy (95%), and most had previous treatment with Lu-177 dotatate (59%) and everolimus (72%).
The primary endpoint of…