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Published on: April 15, 2016
Tivantinib (ARQ197) in hepatocellular carcinoma
Camillo Porta1, Palma Giglione, Alessandra Ferrari
1Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Pavia, Italy.
Abstract:
Here we review the development of tivantinib, a selective oral inhibitor of c-MET. The initially identified dose and schedule for clinical use was 360 mg twice daily. Biological considerations and early results suggested its activity against hepatocellular carcinoma after progression on sorafenib. The results of randomized Phase II study in this setting have already been reported; while in the overall population, the risk of progression was reduced by 36% (HR: 0.64; 90% CI: 0.43-0.94; p = 0.04), in the pre-defined MET-high population median overall survival (7.2 vs 3.8 months; p = 0.01), median time to progression (2.7 vs 1.4 months; p = 0.03) as well as disease control rate (50 vs 20%), were increased by tivantinib. During study conduction, tivantinib dose was amended to 240 mg twice daily, due to a high incidence of neutropenia, without losing clinical efficacy. Presently, a global Phase III trial is being conducted.
Insights
Tivantinib, a c-MET inhibitor, shows promise in treating advanced liver cancer. It improved survival and slowed progression in patients with MET-high hepatocellular carcinoma after sorafenib treatment.
Area of Science:
- Oncology
- Pharmacology
Background:
- Hepatocellular carcinoma (HCC) remains a significant health challenge.
- Sorafenib is a standard treatment, but resistance and progression are common.
- Targeting the c-MET pathway is a potential therapeutic strategy for HCC.
Purpose of the Study:
- To review the development of tivantinib, a selective oral c-MET inhibitor.
- To evaluate the efficacy and safety of tivantinib in patients with advanced HCC who progressed on sorafenib.
Main Methods:
- Review of tivantinib's development and clinical trial data.
- Analysis of a randomized Phase II study in HCC patients post-sorafenib.
- Assessment of overall and MET-high patient populations.
Main Results:
- Tivantinib (360 mg BID) reduced progression risk by 36% in the overall HCC population.
- In MET-high HCC patients, tivantinib significantly improved overall survival, time to progression, and disease control rate.
- Dose reduction to 240 mg BID mitigated neutropenia without compromising efficacy.
Conclusions:
- Tivantinib demonstrates clinical activity in advanced HCC, particularly in MET-high patients.
- The drug's safety profile, including neutropenia, can be managed with dose adjustments.
- Ongoing Phase III trials will further validate tivantinib's role in HCC treatment.
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