# CABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours

Source: https://onco.cc/key-papers/paper-cabinet-cabozantinib-nejm-2024/  
OnCo record `paper-cabinet-cabozantinib-nejm-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cabozantinib delayed progression in previously treated advanced neuroendocrine tumours of both pancreatic and extra-pancreatic origin compared with placebo, adding a new option after somatostatin analogues, everolimus or radioligand therapy.

## Summary

Two parallel phase 3 placebo-controlled trials of cabozantinib in 298 patients with progressive advanced neuroendocrine tumours: 203 with extra-pancreatic (including lung and small bowel) and 95 with pancreatic tumours, all previously treated.

Median progression-free survival was 8.4 versus 3.9 months in extra-pancreatic tumours (hazard ratio 0.38) and 13.8 versus 4.4 months in pancreatic tumours (hazard ratio 0.23); hypertension, fatigue and diarrhoea were common.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: New England Journal of Medicine
- Year: 2025
- DOI: 10.1056/NEJMoa2403991
- Authors: Chan JA, Geyer S, Zemla T, et al.
- Findings: Extra-pancreatic: median progression-free survival 8.4 vs 3.9 months; hazard ratio 0.38.; Pancreatic: 13.8 vs 4.4 months; hazard ratio 0.23.
- What it means: Cabozantinib is approved for previously treated neuroendocrine tumours of any origin and is a standard later-line choice, including for lung carcinoids.
- Caveats: Trials stopped early at interim analysis; overall survival not powered.; Dose reductions needed in most patients.

## Sources

- N Engl J Med 2025: https://doi.org/10.1056/NEJMoa2403991
- PubMed: https://pubmed.ncbi.nlm.nih.gov/39282913/

## Connected records

- cancers: [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/)
- drugs: [Cabozantinib](https://onco.cc/drugs/cabozantinib/)
- trials: [CABINET (Alliance A021602)](https://onco.cc/trials/cabinet/)
- journals: [New England Journal of Medicine](https://onco.cc/journals/nejm/)

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