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Copyright ©The Author(s) 2015.
World J Gastroenterol. May 14, 2015; 21(18): 5445-5453
Published online May 14, 2015. doi: 10.3748/wjg.v21.i18.5445
Table 1 Overview of important clinical trials
First author, Journal (Year)Study designEnrollment periodDrugsPatientsNo. Pts
Santoro, BJC (2013)Phase I, open-label, single-arm study (full-text), NCT008025552009.3- 2010.11 completedTivantinibAdvanced HCC, Child-Pugh A cirrhosis, previously treated with sorafenib or other therapy21
Santoro, Lancet Oncol (2013)Phase II double-blind, placebo-controlled, RCT (full-text), NCT009887412009.10.8- 2011.8.25 completedTivantinib vs placeboAdvanced HCC with or without MET-high tumors, who had progressed on or were unable to tolerate first-line systemic therapy107
Verslype/Cohn, JCO (2012, May/Feb)Phase II randomized discontinuation trial (abstract), NCT00940225CompletedPR: Continued open-label cabozantinib; SD: Cabozantinib vs placebo; PD: DiscontinuedAdvanced HCC, ≤ 1 prior systemic regimen, Child-Pugh A41
Novartis PharmaceuticalsPhase II, open label, single-arm study (registration), NCT01737827OngoingINC280Advanced HCC which could not be suitable for treatment with locoregional therapies or has progressed following locoregional therapy, c-MET pathway dysregulation56
Novartis PharmaceuticalsPhase II, double-blind, placebo-controlled RCT (registration), NCT01964235SuspendedINC280 vs placeboAdult patients with advanced HCC after progression or intolerance to sorafenib treatment, c-MET pathway dysregulation69
Merck KGaAPhase Ib/II, single-arm, trial (registration), NCT02115373OngoingMSC2156119JAdvanced HCC, MET+, Child-Pugh A, who have failed sorafenib treatment48
Qin, JCO (2014)Phase Ib/II RCT (abstract), NCT01988493OngoingPhase II: MSC2156119J vs sorafenibAsian patients, MET-positive, advanced HCC, Child-Pugh A158
O'Neil, JCO (2013)Phase Ib/II, open-label, study (abstract), NCT01271504OngoingPhase Ib: Golvatinib plus sorafenib; Phase II: Golvatinib plus sorafenib vs sorafenib aloneAdvanced HCC13
Yau, JCO (2012)Phase I/II trial (abstract), NCT00920192OngoingForetinibAdvanced HCC13
Santoro, JCO (2013)Phase III, double-blind, RCT (abstract), NCT01755767OngoingTivantinib vs placeboMET diagnostic-high inoperable HCC treated with one prior systemic therapy303
Abou-Alfa, JCO (2014)Phase III, double-blind, RCT (abstract), NCT01908426OngoingCabozantinib vs placeboAdvanced HCC who have received prior sorafenib760
Table 2 Adverse events related to tivantinib: An overview of data from phase I and II trials n (%)
Adverse eventRosen, (2011) n = 79
Yap, (2011) n = 51
Yamamoto, (2013) n = 47
Santoro, (2013) n = 21
Santoro, (2013) n = 71
All gradesGrade3All gradesGrade3All gradesGrade3All gradesGrade3All gradesGrade3
PancytopeniaNANANANANANANANA2 (2.8)2 (2.8)
LeukocytopeniaNA1 (1.3)2 (3.9)1 (2.6)22 (46.8)8 (17.0)8 (38)4 (19)5 (7.0)3 (4.2)
NeutropeniaNA2 (2.5)5 (9.8)4 (7.8)15 (31.9)9 (19.1)11 (52)8 (38)20 (28.2)12 (16.9)
Anemia6 (7.6)3 (3.8)3 (5.9)0 (0)12 (25.5)5 (10.6)10 (48)5 (24)11 (15.5)8 (11.3)
ThrombocytopeniaNA1 (1.3)2 (3.9)1 (2.6)NANA3 (14)0 (0)6 (8.5)4 (4.9)
LymphopeniaNANA2 (3.9)0 (0)7 (14.9)1 (2.1)2 (10)0 (0)NANA
Fatigue11 (13.9)1 (1.3)10 (19.6)1 (2.6)19 (40.4)1 (2.1)6 (29)1 (5)7 (9.9)3 (4.2)
AnorexiaNANA4 (7.8)0 (0)8 (17.0)2 (4.3)8 (38)0 (0)7 (9.9)1 (1.4)
Nausea11 (13.9)1 (1.3)7 (13.7)0 (0)4 (8.5)0 (0)NANA2 (2.8)1 (1.4)
Vomiting8 (10.1)1 (1.3)7 (13.7)0 (0)NANA3 (14)0 (0)4 (5.6)0 (0)
Diarrhoea5 (6.3)NA5 (9.8)0 (0)NANA6 (29)0 (0)5 (7.0)0 (0)
ConstipationNANA2 (3.9)0 (0)NANANANANANA
DyspepsiaNANA1 (2.6)0 (0)NANANANANANA
DysphagiaNANA1 (2.6)0 (0)NANANANANANA
AlopeciaNANA1 (2.6)0 (0)4 (8.5)0 (0)4 (19)0 (0)3 (4.2)0 (0)
AstheniaNANANANA1 (1.3)NA10 (48)2 (10)8 (11.3)1 (1.4)
Abdominal painNANANANANANANANA1 (1.4)1 (1.4)
Hepatic failureNA1 (1.3)NANANANANANANANA
ALT increasedNANANANA3 (6.4)0 (0)NANANANA
AST increasedNA1 (1.3)NANANANANANANANA
ALP increasedNA1 (1.3)NANANANANANANANA
HypokalemiaNANA1 (2.6)0 (0)NANANANANANA
DehydrationNA1 (1.3)NANANANANANANANA
HyperammonaemiaNA1 (1.3)NANANANANANANANA
HyponatraemiaNA1 (1.3)NANANANANANANANA
HyperbilirubinemiaNANANANANANA3 (14)1 (5)NANA
RashNANA6 (11.8)0 (0)3 (6.4)0 (0)NANANANA
PruritusNANA1 (2.6)0 (0)NANANANA2 (2.8)0 (0)
Hot flushNANA2 (3.9)0 (0)NANANANANANA
Hand-foot syndromeNANA1 (2.6)1 (2.6)NANANANANANA
Mucosal inflammationNANA2 (3.9)2 (3.9)NANANANANANA
Tongue discolorationNANA3 (5.9)0 (0)NANANANANANA
Peripheral oedemaNANANANANANA3 (14)0 (0)NANA
Weight lossNANA3 (5.9)0 (0)NANANANANANA
PyrexiaNANA1 (2.6)0 (0)NANANANA4 (5.6)0 (0)
SepsisNANANANANANANANA5 (7.0)5 (7.0)
Prolonged QTcNANANANA3 (6.4)0 (0)NANANANA
BradycardiaNANANANA2 (4.3)0 (0)NANA8 (11.3)1 (1.4)
Table 3 Current status of MET inhibitors for the treatment of advanced hepatocellular carcinoma
First-line therapy of advanced HCC
INC280: A phase II sing-arm trial (NCT01737827)
MSC2156119J vs sorafenib: A phase II RCT (NCT01988493)
Golvatinib plus sorafenib vs sorafenib alone: A phase II RCT (NCT01271504)
Foretinib: A phase II sing-arm trial (NCT00920192)
Second-line therapy of advanced HCC
Tivantinib vs placebo: A phase II RCT (NCT00988741)
Tivantinib vs placebo: A phase III RCT (NCT01755767)
Cabozantinib vs placebo: A phase II randomized discontinuation trial (NCT00940225)
Cabozantinib vs placebo: A phase III RCT (NCT01908426)
INC280 vs placebo: A phase II RCT (NCT01964235)
MSC2156119J: A phase II sing-arm trial (NCT02115373)