CELESTIAL

CELESTIAL, trial NCT01908426 sponsored by Exelixis and reported in 2018, showed that cabozantinib extends survival in previously treated hepatocellular carcinoma, including after two prior lines of therapy. It randomised 707 patients who had received sorafenib to cabozantinib or placebo and met its primary overall survival endpoint, with a marked improvement in progression-free survival. OnCo links it to hepatocellular carcinoma and to the cabozantinib drug record. Since first-line treatment has moved to immunotherapy combinations, whether cabozantinib keeps its benefit as a second-line option after atezolizumab and bevacizumab or dual checkpoint blockade is the open question.