Subsets of Patients With NETs Show Better Response to Cabozantinib

Lowell B. Anthony, MD, chief of the Division of Medical Oncology and co-director of the Radiopharmaceutical Therapy Program at UK Markey Cancer Center, discusses the potential benefits of cabozantinib for patients for different types of patients with neuroendocrine tumors (NETs).

Patients who progressed on first- or second-line therapy were the population evaluated in the CABINET trial (NCT03375320). Anthony suggests that patients with pancreatic and pulmonary NETs, particularly those with somatostatin receptor–negative tumors, may be ideal candidates.

There was a lack of effective drugs in this area previously, but the addition of tyrosine kinase inhibitors has added a new treatment option. Clinical practices will likely benefit from this expansion of the therapeutic choices for patients with NETs, according to Anthony.

TRANSCRIPTION

0:10 | In terms of subtypes of neuroendocrine tumors that might benefit from cabozantinib, at this point, it would be those who may have failed first, sometimes second line of therapy. So that's one group that clearly can benefit, because that is the CABINET trial patient [population]. So translating this into real-world data or relevance, I think those patients with pancreatic neuroendocrine tumors would be potentially ideal. Those with lung, pulmonary neuroendocrine tumors—this is an area where we've had limited drugs available, particularly if they are somatostatin receptor negative on that initial dotatate PET scan.

1:02 | Now with the intestinal type of primary neuroendocrine tumors as part of that extrapancreatic group, we now have a whole new class of drugs. Whereas before we had the “cold” somatostatin analogs and then the [radionuclide therapy], then we had mTOR inhibitors, and now we have tyrosine kinase, so it really adds an additional option. I think this is probably where the clinical practices—the private practices where most of these patients are treated—will really benefit in having a new line of treatment for those patients.