Review ArticlesA metanalysis on cabozantinib and bone metastases true story or commercial gimmick?Bersanelli, Melissaa,,b; Buti, Sebastianob; Ghidini, Antonioc; Tiseo, Marcelloa,,b; Petrelli, FaustodAuthor Information aMedicine and Surgery Department, University of Parma, Parma, Italy; bMedical Oncology Unit, University Hospital of Parma, Parma, Italy; cOncology Unit, Casa di cura Igea, Milan, Italy dMedical Oncology Unit, ASST Bergamo Ovest, Treviglio (BG), Italy Received 7 August 2019 Revised form accepted 29 November 2019 Correspondence to Fausto Petrelli, Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio (BG) Italy, Tel: +390363424420; fax +390363424380; e-mail: firstname.lastname@example.org Anti-Cancer Drugs: March 2020 - Volume 31 - Issue 3 - p 211-215 doi: 10.1097/CAD.0000000000000883 Buy Metrics Abstract Is it true that cabozantinib should be the preferred option treating patients with bone metastases? Are there any reliable comparisons between this drug and other standard options in this subgroup? To address the issue, we performed a systematic review and metanalysis of randomized trials with cabozantinib, to assess its effectiveness, in terms of overall survival, according to the presence of bone metastases. We included (a) randomized controlled trials; (b) any solid tumors and therapeutic line; and (c) overall survival data available according to the site of disease. Cabozantinib improved overall survival both for the group with bone metastases, with risk of death decreased by 53% (hazard ratio, 0.47; 95% confidence interval, 0.26–0.87; P=0.02) and for the group without bone metastases, decreasing the risk of death by 44% (hazard ratio, 0.56; 95% confidence interval, 0.40–0.79; P=0.001) over the standard of care. The difference was not significantly different between the two groups. Despite cabozantinib can be undoubtedly listed as a good therapeutic option for cancer patients with bone metastases, it seems that its preclinical profile against bone remodeling does not translate into an actual clinical relevance, preventing from considering the presence of bone metastases as principal criterion for the choice of this drug. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.