Thorvardur R. Halfdanarson, MD

A panelist discusses how treatment sequencing for neuroendocrine tumors (NETs) is less important than ensuring patients receive all available treatments, highlighting cabozantinib as a reasonable second- or third-line option with manageable adverse effects like hypertension and liver function abnormalities.

A panelist discusses how NCCN guidelines now include cabozantinib as a category 1 recommendation for gastrointestinal (GI) neuroendocrine tumors (NETs) after prior treatment with everolimus or lutetium-177 dotatate, with slightly different recommendations for pancreatic, lung, and thymic NETs.

A panelist discusses how the CABINET trial showed significant progression-free survival benefits for cabozantinib compared with placebo (particularly in pancreatic neuroendocrine tumors (NETs), why progression-free survival (PFS) is a meaningful end point for NETs, and that safety findings revealed familiar adverse effects requiring dose reductions in about two-thirds of patients.

A panelist discusses how the CABINET trial was a National Cancer Institute (NCI)–supported study conducted by the Alliance for Clinical Trials in Oncology that enrolled patients with well-differentiated grade 1 through 3 pancreatic or extrapancreatic neuroendocrine tumors who had progressed after somatostatin analogue therapy and at least 1 other FDA-approved therapy.

A panelist discusses how first-line treatment options for neuroendocrine tumors depend on tumor grade, disease extent, and symptoms, ranging from observation for asymptomatic cases to somatostatin analogues, chemotherapy, and the newly approved cabozantinib.

A panelist discusses how neuroendocrine tumors are defined by World Health Organization (WHO) classification, graded based on Ki-67 proliferative index, diagnosed through imaging (often incidentally), and most commonly found in the small bowel, lungs, and pancreas.