Using Guidelines and CABINET Data to Inform Treatment Sequencing in Progressive Pancreatic Neuroendocrine Tumor

In this combined segment, Dr Shaheen explains how clinical guidelines and emerging trial data work together to inform treatment sequencing decisions in progressive pancreatic NETs. She describes guidelines as a framework rather than a rigid pathway, offering structure while allowing flexibility based on patient and disease characteristics.

Dr Shaheen reviews how recommendations from expert societies support the use of multiple systemic options following SSA and PRRT, without mandating a single preferred sequence. She emphasizes that guideline based care requires interpretation, particularly in patients with intermediate grade disease and preserved performance status.

The discussion then transitions to the CABINET trial and its relevance to real world practice. Dr Shaheen outlines how cabozantinib demonstrated meaningful activity in previously treated neuroendocrine tumors, positioning it as an important consideration in later line settings. She explains how this data helps clinicians feel more confident incorporating cabozantinib into sequencing discussions, especially for patients with progressive disease after standard options.

Rather than presenting CABINET as a standalone data point, Dr Shaheen integrates it into the broader guideline context. She highlights how trial results reinforce existing recommendations while expanding the range of evidence supported choices.

This segment illustrates how guidelines and clinical trial data function synergistically. Guidelines provide the structure, while studies like CABINET supply practical evidence that shapes confidence and timing of therapy selection. Dr Shaheen reinforces that optimal sequencing emerges from combining both, always filtered through the lens of individual patient needs.