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Hepatology. 2019 Jan 25. doi: 10.1002/hep.30521. [Epub ahead of print]

Medical treatment of advanced hepatocellular carcinoma patients: the issue is not the right drug, but the right patient.

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Department of Internal Medicine, University of Pavia, and Division of Translational Oncology, I.R.C.C.S. Istituti Clinici Scientifici Maugeri, Pavia, Italy.
Unit of Palliative Care, Division of Medical Oncology, I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Division of Medical Oncology, Azienda Ospedaliero-Universitaria, Parma, Italy.


On July 5th , 2018, the final results of the CELESTIAL trial were published on the authoritative pages of the New England Journal of Medicine (1); in this placebo-controlled, phase III trial, previously treated patients with advanced hepatocellular carcinoma (HCC) were randomized in a 2 to 1 fashion to receive either the multikinase inhibitor Cabozantinib (targeting, among the others, Vascular Endothelial Growth Factor Receptors [VEGFRs], MET, and AXL), or placebo. The study succeeded in demonstrating a reduction in the risk of death of 24% in favor of Cabozantinib; indeed, median overall survival (OS) was 10.2 months with Cabozantinib and 8.0 months with placebo (Hazard Ratio [HR] = 0.76, 95% confidence interval [CI] = 0.63 to 0.92, p=0.005) (1). This article is protected by copyright. All rights reserved.


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