{"entity":{"id":"paper-exam-cabozantinib-mtc-elisei-jco-2013","kind":"paper","name":"EXAM: cabozantinib in progressive medullary thyroid cancer","aka":[],"tldr":"Cabozantinib, a kinase inhibitor blocking RET, MET and VEGF receptors, delayed progression by more than seven months compared with placebo in progressive medullary thyroid cancer, at the cost of considerable toxicity.","summary":"Phase 3 placebo-controlled trial of 330 patients with progressive metastatic medullary thyroid cancer randomised 2:1 to cabozantinib 140 mg daily or placebo.\n\nMedian progression-free survival was 11.2 versus 4.0 months (hazard ratio 0.28) and response 28 versus 0 percent, with benefit regardless of RET status; diarrhoea, hand-foot syndrome, weight loss and fistula were notable toxicities.","asOf":"2026-09-17","links":[{"label":"J Clin Oncol 2013","url":"https://doi.org/10.1200/JCO.2012.48.4659"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/24002501/"}],"tags":[],"related":[],"cancers":["medullary-thyroid-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":["cabozantinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["exam"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2013,"doi":"10.1200/JCO.2012.48.4659","pmid":"24002501","authors":"Elisei R, Schlumberger MJ, Müller SP, et al.","paperType":"rct","findings":["Median progression-free survival 11.2 vs 4.0 months; hazard ratio 0.28.","Objective response 28 percent vs 0 percent."],"whatItMeans":"Cabozantinib is an option for progressive medullary thyroid cancer, now mainly for RET-negative disease or after selpercatinib.","caveats":["No overall survival benefit overall, though RET M918T carriers may have benefited.","High dose with frequent reductions."],"changedPractice":true,"participants":330},"route":"/key-papers/paper-exam-cabozantinib-mtc-elisei-jco-2013/","neighbours":{"cancer":[{"id":"medullary-thyroid-cancer","kind":"cancer","name":"Medullary thyroid cancer","route":"/cancers/medullary-thyroid-cancer/"}],"drug":[{"id":"cabozantinib","kind":"drug","name":"Cabozantinib","route":"/drugs/cabozantinib/"}],"trial":[{"id":"exam","kind":"trial","name":"EXAM","route":"/trials/exam/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}