Dr. Jennifer Chan from Dana Farber Cancer Institute announces the updated findings
On Sept 16, 2024, LACNETS interviewed incoming NANETS president, Dr. Jennifer Chan from Dana Farber Cancer Institute following her presentation on the updated, results of the CABINET trial at the medical and scientific meeting, ESMO (the European Society for Medical Oncology) Congress 2024 in Barcelona, Spain. The presentation was titled “Cabozantinib Versus Placebo for Advanced Neuroendocrine Tumors (NET) after Progression on Prior Therapy (CABINET Trial/Alliance A021602): Updated Results Including Progression Free-Survival (PFS) by Blinded Independent Central Review (BICR) and Subgroup Analyses.”
Last year, LACNETS interviewed Dr. Jennifer Chan at the ESMO Congress 2023 in Madrid, Spain when she first shared the initial CABINET trial data that showed cabozantinib (CABOMETYX®) helped those with advanced pancreatic NET and extrapancreatic NET (NET outside the pancreas). The results suggested that cabozantinib may be an effective option to treat NET patients, even those who have already tried other therapies. Watch the 2023 interview here.
Watch our latest interview on Sept 16, 2024 with Dr. Jennifer Chan at ESMO (the European Society for Medical Oncology) Congress 2024 in Barcelona, Spain. (Read the complete transcript below.)
Cabozantinib is an oral tyrosine kinase inhibitor. The data shows that cabozantinib effectively slowed the progression of neuroendocrine tumors across various primary sites, including pancreatic, extra-pancreatic (NETs outside the pancreas including GI and lung origin). The trial included patients with well-differentiated neuroendocrine tumors of grades 1, 2, and 3. The updated data focused on blinded, independent central review scans, safety profiles, and subgroup analyses. Dr. Chan emphasized the potential for Cabozantinib to offer a new treatment option, providing hope for both clinicians and patients.
Read more in latest NEJM article released Sept 16, 2024: Phase 3 Trial of Cabozantinib to Treat Advanced Neuroendocrine Tumors.
Visit our Clinical Trials Guide for more information about the CABINET Randomized, Double-Blinded Phase III Study of Cabozantinib Versus Placebo in Patients with Advanced NETs After Progression on Prior Therapy >>
TRANSCRIPT
Lisa Yen 00:00
I'm Lisa yen. I'm the LACNETS Director of Programs and Outreach, and I'm here with Dr Jennifer Chan, here in Barcelona, Spain, at ESMO 2024. Dr Chan is a NET expert, medical oncologist from Dana Farber Cancer Institute in Boston, and the incoming NANETS president. Dr Chan, just discussed some exciting trial and so Dr Chan, I'd love to hear from you what you shared today at ESMO 2024.
Dr. Jennifer Chan 00:29
Thanks for having me with you. We presented the updated results of the CABINET trial. Last fall, we had focused on the initial results, and we were here now to present the final results. What we found was that Cabozantinib, which is an oral, what we call multi kinase inhibitor. These types of drugs, can work to inhibit the growth of blood vessels in the tumors and also can work to slow growth. But what we found was that Cabozantinib was able to effectively slow the progression, slow the growth of cancer. So we found this to be true for patients that had neuroendocrine tumors that may have started in a very wide range of primary sites. So we specifically looked at pancreas neuroendocrine tumors, and then also what we call extra-pancreatic neuroendocrine tumor. So this really includes neuroendocrine tumor tumors that start outside the pancreas. So most commonly it's in the GI tract. We also had about 20% of patients in the trial who had lung neuroendocrine tumor tumors. Some patients with unknown primary tumors. Some patients with kind of rarer sites, like the thymus and even other sites in addition to that. So it was, again, a very broad range of patients. And what we found was that in both the pancreas group as well as the extra-pancreas group, that this was an effective treatment. So it really, I think it can be considered an option, I hope, in the future, for a wide and a large number of patients.
Lisa Yen 00:42
Wow, a wide range of patients, including lung. That's really exciting since I know that that population sometimes feels a little left out because there's not a lot of options. Can you speak also to the different types of grades that it might be used for?
Dr. Jennifer Chan 02:15
Yeah. So all of these were what we call well-differentiated neuroendocrine tumors. But within well-differentiated, there's grade one, grade two, grade three. So grade one is the tumors that look under the microscope to be not quite as proliferative, not as much signal for growth. And then on the flip side is the high grade, the grade three, where there's more evidence of under the microscope proliferation. So we included all grades. Mostly, it was grade one and grade two. Grade two, probably of all the patients, was the highest category, but there also were patients with grade three disease, and as we looked at the data, we saw signals that cabozantinib should work even in all of the grades that we were including.
Lisa Yen 02:53
Yeah, so this trial closed last August, and you talked about this at ESMO last year in October in Madrid. So, why are we talking about it again? What is new and different that you're presenting and sharing with us?
Dr. Jennifer Chan 03:09
That's a great question. So we presented data that focused on what we call the primary endpoint. As we started the trial, we kind of had to find what we were going to be looking for in terms of how we measure growth and what kind of scans we were looking for. So this year, we were looking at a different set of scans, what we call these blinded, independent, central review scans, whereas at ESMO last year, we were looking at the scans that patients' doctors were looking at. So it was a second radiology set of images that we were looking at, the ones that when we designed the trial, we said, "these were going to be the primary ones to look at." So this was important for us to have the primary, what we call end point results. We also had more information about the safety and side effect profiles that patients were experiencing, and then some of these subgroup analyzes that I just talked about.
Lisa Yen 03:58
Yeah, I know you've dedicated quite a number of years, about a decade of your life to this trial and this work. What's important of all this data, what's it going to mean to patients?
Dr. Jennifer Chan 04:09
I think it means possibly new treatment option. I think again, that's what we started this trial to do, was to see if we could find a newer and a newer, effective treatment. So I think the data is quite compelling that this is potentially something that more patients might have as an option for the future. So it gives me a lot of hope as a clinician, that will be able to offer more treatment. And I hope also gives some hope to patients as well.
Lisa Yen 04:32
It gives me hope to as a caregiver. Thank you so much. And so what are what's your takeaway, or your hope for the future coming up?
Dr. Jennifer Chan 04:41
Yeah, I think we're still in the field, trying again to find even more treatments. We're trying to right now we are individualizing treatment. I think hopefully we also will have some studies that help us to understand how they compare, how these treatments compare to one another. And I think it's all just good in the long run to be able to have more options, to understand how to use these options. And I think it's, I guess the take home message also, as you hear about this, is to bring it back to your own oncologist. I think we want you to be able to understand the data and to understand, as you talk with your medical team about what that might mean for you.
Lisa Yen 05:15
Yeah, more hope. Deeper understanding and hopefully a better overall quality of life for all of us. Thank you so much for all you do. Thank you for joining us today.
Dr. Jennifer Chan 05:24
Thank you for having me.
This blog is for educational purposes only and does not constitute medical advice. It does not provide a medical professional’s opinion or advice, nor is it an endorsement of particular treatments. You are advised to seek appropriate licensed medical/professional help and discuss your individual care and treatment plan with your medical team.
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