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Cabozantinib tripled the time without progression in neuroendocrine tumours that had outgrown other treatments, leading to a 2025 approval.
CABINET, Alliance trial A021602, NCT03375320, sponsored by the Alliance, the NCI and Exelixis and reported in the New England Journal of Medicine in 2024, showed that cabozantinib roughly tripled the time without progression in neuroendocrine tumours that had outgrown other treatments, leading to FDA approval in March 2025. It randomised 298 patients in separate pancreatic and extra-pancreatic cohorts to cabozantinib or placebo and met its primary progression-free survival endpoint in both, with an ESMO 2025 subgroup analysis showing a large reduction in progression risk in lung and thymic tumours. OnCo links it to neuroendocrine tumours, cabozantinib and the Alliance for Clinical Trials in Oncology. Whether cabozantinib's benefit holds against, or in sequence with, radioligand therapy is the open question.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
298 enrolled.
Shares CABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours, Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Pancreatic neuroendocrine tumours, Neuroendocrine tumours.
Shares Lung neuroendocrine tumours (typical and atypical carcinoid), Small intestinal neuroendocrine tumours, Neuroendocrine tumours.