NCT01761266

Brief Summary

E7080-G000-304 is a multicenter, randomized, open-label, noninferiority Phase 3 study to compare the efficacy and safety of lenvatinib versus sorafenib as a first-line systemic treatment in participants with unresectable Hepatocellular Carcinoma (HCC).

Trial Health

98
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Strong global presence with extensive site network
Enrollment
954

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started Mar 2013

Longer than P75 for phase_3

Geographic Reach
21 countries

186 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 2, 2013

Completed
2 days until next milestone

First Posted

Study publicly available on registry

January 4, 2013

Completed
2 months until next milestone

Study Start

First participant enrolled

March 1, 2013

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 13, 2016

Completed
1.9 years until next milestone

Results Posted

Study results publicly available

September 25, 2018

Completed
2.5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 10, 2021

Completed
Last Updated

April 5, 2022

Status Verified

March 1, 2022

Enrollment Period

3.7 years

First QC Date

January 2, 2013

Results QC Date

August 27, 2018

Last Update Submit

March 8, 2022

Conditions

Keywords

Hepatocellular CarcinomaNeoplasmsCancer

Outcome Measures

Primary Outcomes (1)

  • Overall Survival (OS)

    OS was defined as the duration from the date of randomization until the date of death from any cause. Participants who were lost to follow-up were censored at the last date the participant was known to be alive, and participants who remained alive were censored at the time of data cutoff.

    From date of randomization until date of death from any cause (approximately up to 3.8 years)

Secondary Outcomes (7)

  • Progression Free Survival (PFS)

    From the date of randomization to the date of first documentation of disease progression, or date of death, whichever occurred first (approximately up to 3.8 years)

  • Time to Progression (TTP)

    The time from the date of randomization to the date of first documentation of disease progression (approximately up to 3.8 years)

  • Objective Response Rate (ORR)

    From the date of randomization to the date of first documentation of disease progression, or date of death, whichever occurred first (approximately up to 3.8 years)

  • Time to Clinically Meaningful Worsening of Health Related Quality of Life (HRQoL) Assessed Using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

    Baseline up to Off-Treatment Visit (approximately up to 3.8 years)

  • Time to Clinically Meaningful Worsening of HRQoL Assessed Using - EORTC QLQ- Hepatocellular Carcinoma Domain (HCC 18)

    Baseline up to Off-Treatment Visit (approximately up to 3.8 years)

  • +2 more secondary outcomes

Other Outcomes (3)

  • Disease Control Rate (DCR)

    From the date of randomization to the date of first documentation of disease progression, or date of death, whichever occurred first (approximately up to 3.8 years)

  • Clinical Benefit Rate (CBR)

    From the date of randomization to the date of first documentation of disease progression, or date of death, whichever occurred first (approximately up to 3.8 years)

  • Percent Change From Baseline in Serum Biomarker

    Cycle 1 Day 15, Cycle 2 Day 1, Cycle 3 Day 1, Cycle 4 Day 1, Cycle 5 Day 1, Cycle 6 Day 1, Cycle 7 Day 1, Cycle 8 Day 1, Cycle 9 Day 1 and at the Off-Treatment Visit (approximately up to 3.8 years)

Study Arms (2)

Lenvatinib

ACTIVE COMPARATOR

Participants received lenvatinib capsules 12 milligram (mg) based on the participant's body weight greater than or equal to (\>=) 60 kilogram (kg) or 8 mg based on the participant's body weight less than (\<) 60 kg at baseline, orally, once daily (QD) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, participant request, or withdrawal of consent.

Drug: Lenvatinib

Sorafenib

ACTIVE COMPARATOR

Participants received sorafenib 400 mg tablets, orally, twice daily (BID) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, participant request, or withdrawal of consent.

Drug: Sorafenib

Interventions

12 mg (or 8 mg) once daily (QD) oral dosing.

Also known as: E7080, Lenvima
Lenvatinib

400 mg twice daily (BID) oral dosing.

Sorafenib

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may not qualify if:

  • Imaging findings for HCC corresponding to any of the following:
  • HCC with \>=50 percent liver occupation
  • Clear invasion into the bile duct
  • Portal vein invasion at the main portal branch (Vp4).
  • Participants who have received any systemic chemotherapy, including anti-vascular endothelial growth factor (VEGF) therapy, or any systemic investigational anticancer agents, including lenvatinib, for advanced/unresectable HCC. Note: Participants who have received local hepatic injection chemotherapy are eligible.
  • Participants who have received any anticancer therapy (including surgery, percutaneous ethanol injection, radio frequency ablation, transarterial \[chemo\] embolization, hepatic intra-arterial chemotherapy, biological, immunotherapy, hormonal, or radiotherapy) or any blood enhancing treatment (including blood transfusion, blood products, or agents that stimulate blood cell production, eg, granulocyte colony-stimulating factor \[G-CSF\]) within 28 days prior to randomization.
  • Participants who have not recovered from toxicities as a result of prior anticancer therapy, except alopecia and infertility. Recovery is defined as \< Grade 2 severity per Common Terminology Criteria for Adverse Events Version 4.0 (CTCAE v4.0).
  • Significant cardiovascular impairment: history of congestive heart failure \> New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction or stroke within 6 months of the first dose of study drug, or cardiac arrhythmia requiring medical treatment at Screening.
  • Prolongation of corrected QT interval (QTc) interval to \>480 millisecond (ms)
  • Gastrointestinal malabsorption or any other condition that might affect the absorption of lenvatinib in the opinion of the investigator.
  • Bleeding or thrombotic disorders or use of anticoagulants requiring therapeutic INR monitoring, eg, warfarin or similar agents. Treatment with low molecular weight heparin and factor X inhibitors which do not require INR monitoring is permitted. Antiplatelet agents are prohibited throughout the study.
  • Gastrointestinal bleeding event or active hemoptysis (bright red blood of at least 0.5 teaspoon) within 28 days prior to randomization.
  • Gastric or esophageal varices that require interventional treatment within 28 days prior to randomization. Prophylaxis with pharmacologic therapy (eg, nonselective beta-blocker) is permitted.
  • Active malignancy (except for HCC or definitively treated melanoma in-situ, basal or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix) within the past 36 months.
  • Participants whose only target lesion(s) is in bone will be excluded.
  • +11 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (186)

Facility # 1

Los Angeles, California, United States

Location

Facility # 1

Sacramento, California, United States

Location

Facility # 1

San Francisco, California, United States

Location

Facility # 1

Washington D.C., District of Columbia, United States

Location

Facility # 1

Tampa, Florida, United States

Location

Facility # 1

Duluth, Georgia, United States

Location

Facility # 1

Lawrenceville, Georgia, United States

Location

Facility # 1

Baltimore, Maryland, United States

Location

Facility # 1

Detroit, Michigan, United States

Location

Facility # 1

Kansas City, Missouri, United States

Location

Facility # 1

St Louis, Missouri, United States

Location

Facility # 1

East Orange, New Jersey, United States

Location

Facility # 1

Brooklyn, New York, United States

Location

Facility # 1

Lake Success, New York, United States

Location

Facility # 1

New York, New York, United States

Location

Facility # 1

Charlotte, North Carolina, United States

Location

Facility # 1

Durham, North Carolina, United States

Location

Facility # 1

Portland, Oregon, United States

Location

Facility # 1

Austin, Texas, United States

Location

Facility # 1

Lubbock, Texas, United States

Location

Facility # 1

Seattle, Washington, United States

Location

Facility # 1

Camperdown, New South Wales, Australia

Location

Facility # 1

Wentworthville, New South Wales, Australia

Location

Facility # 1

Woolloongabba, Queensland, Australia

Location

Facility # 1

Fitzroy, Victoria, Australia

Location

Facility # 1

Melbourne, Victoria, Australia

Location

Facility # 2

Melbourne, Victoria, Australia

Location

Facility # 1

Nedlands, Western Australia, Australia

Location

Facility # 1

Brussels, Belgium

Location

Facility # 1

Edegem, Belgium

Location

Facility # 1

Liège, Belgium

Location

Facility # 1

Ottawa, Ontario, Canada

Location

Facility # 1

Hefei, Anhui, China

Location

Facility # 1

Beijing, Beijing Municipality, China

Location

Facility # 2

Beijing, Beijing Municipality, China

Location

Facility # 3

Beijing, Beijing Municipality, China

Location

Facility # 1

Chongqing, Chongqing Municipality, China

Location

Facility # 1

Fuzhou, Fujian, China

Location

Facility # 2

Fuzhou, Fujian, China

Location

Facility # 1

Guangzhou, Guangdong, China

Location

Facility # 1

Harbin, Heilongjiang, China

Location

Facility # 1

Changsha, Hunan, China

Location

Facility # 1

Nanjing, Jiangsu, China

Location

Facility # 1

Suzhou, Jiangsu, China

Location

Facility # 1

Changchun, Jilin, China

Location

Facility # 1

Dalian, Liaoning, China

Location

Facility # 1

Jinan, Shandong, China

Location

Facility # 1

Shanghai, Shanghai Municipality, China

Location

Facility # 3

Shanghai, Shanghai Municipality, China

Location

Facility # 1

Xi’an, Shanxi, China

Location

Facility # 2

Xi’an, Shanxi, China

Location

Facility # 1

Hangzhou, Zhejiang, China

Location

Facility # 1

Tianjin, Zhejiang, China

Location

Facility # 1

Nice, Alpes Maritimes, France

Location

Facility # 1

Pessac, Gironde, France

Location

Facility # 1

Toulouse, Haute Garonne, France

Location

Facility # 1

Montpellier, Herault, France

Location

Facility # 1

Rennes, Ille Et Vilaine, France

Location

Facility # 1

Vandœuvre-lès-Nancy, Meurthe Et Moselle, France

Location

Facility # 1

Amiens, Somme, France

Location

Facility # 1

Créteil, Val De Marne, France

Location

Facility # 1

Bordeaux, France

Location

Facility # 1

Lille, France

Location

Facility # 1

Lyon, France

Location

Facility # 1

Nord, 59037, France

Location

Facility # 1

Paris, 75013, France

Location

Facility # 1

Paris, 75020, France

Location

Facility # 1

Rhone, France

Location

Facility # 1

Heidelberg, Baden-Wurttemberg, Germany

Location

Facility # 1

Tübingen, Baden-Wurttemberg, Germany

Location

Facility # 1

Marburg, Hesse, Germany

Location

Facility # 1

Hanover, Lower Saxony, Germany

Location

Facility # 1

Cologne, North Rhine-Westphalia, Germany

Location

Facility # 1

Essen, North Rhine-Westphalia, Germany

Location

Facility # 1

Mainz, Rhineland-Palatinate, Germany

Location

Facility # 1

Hong Kong, Hong Kong

Location

Facility # 2

Hong Kong, Hong Kong

Location

Facility # 3

Hong Kong, Hong Kong

Location

Facility # 1

Kowloon, Hong Kong

Location

Facility # 1

Petah Tikva, Israel

Location

Facility # 1

Torrette, Ancona, Italy

Location

Facility # 1

Bari, Italy

Location

Facility # 1

Benevento, Italy

Location

Facility # 1

Bologna, Italy

Location

Facility # 1

Napoli, Italy

Location

Facility # 2

Napoli, Italy

Location

Facility # 1

Palermo, Italy

Location

Facility # 1

Roma, Italy

Location

Facility # 1

Nagoya, Aichi-ken, Japan

Location

Facility # 1

Kashiwa, Chiba, Japan

Location

Facility # 1

Matsuyama, Ehime, Japan

Location

Facility # 1

Kurume, Fukuoka, Japan

Location

Facility # 1

Sapporo, Hokkaido, Japan

Location

Facility # 2

Sapporo, Hokkaido, Japan

Location

Facility # 1

Nishinomiya, Hyōgo, Japan

Location

Facility # 1

Kanazawa, Ishikawa-ken, Japan

Location

Facility # 1

Kawasaki, Kanagawa, Japan

Location

Facility # 1

Yokohama, Kanagawa, Japan

Location

Facility # 1

Tsu, Mie-ken, Japan

Location

Facility # 1

Ōmura, Nagasaki, Japan

Location

Facility # 1

Ōsaka-sayama, Osaka, Japan

Location

Facility # 1

Bunkyo-Ku, Tokyo, Japan

Location

Facility # 1

Chuo-ku, Tokyo, Japan

Location

Facility # 1

Koto-ku, Tokyo, Japan

Location

Facility # 1

Minato-ku, Tokyo, Japan

Location

Facility # 1

Musashino, Tokyo, Japan

Location

Facility # 1

Shimonoseki, Yamaguchi, Japan

Location

Facility # 1

Fukuoka, Japan

Location

Facility # 1

Hiroshima, Japan

Location

Facility # 1

Okayama, Japan

Location

Facility # 2

Osaka, Japan

Location

Facility # 1

Saga, Japan

Location

Facility # 2

Saga, Japan

Location

Facility # 1

Kuantan, Pahang, Malaysia

Location

Facility # 1

George Town, Pulau Pinang, Malaysia

Location

Facility # 1

Miri, Sarawak, Malaysia

Location

Facility # 1

Batu Caves, Selangor, Malaysia

Location

Facility # 1

Kuala Lumpur, Malaysia

Location

Facility # 1

Cebu City, Philippines

Location

Facility # 2

Cebu City, Philippines

Location

Facility # 1

Davao City, Philippines

Location

Facility # 1

Quezon City, Philippines

Location

Facility # 2

Quezon City, Philippines

Location

Facility # 1

Gdansk, Poland

Location

Facility # 1

Warsaw, Poland

Location

Facility # 1

Wroclaw, Poland

Location

Facility # 1

Arkhangelsk, Russia

Location

Facility # 1

Moscow, Russia

Location

Facility # 2

Moscow, Russia

Location

Facility # 3

Saint Petersburg, Russia

Location

Facility # 4

Saint Petersburg, Russia

Location

Facility # 1

Ufa, Russia

Location

Facility # 1

Singapore, Singapore

Location

Facility # 2

Singapore, Singapore

Location

Facility # 3

Singapore, Singapore

Location

Facility # 4

Singapore, Singapore

Location

Facility # 1

Goyang-si, Gyeonggi-do, South Korea

Location

Facility # 1

Seongnam-si, Gyeonggi-do, South Korea

Location

Facility # 2

Seongnam-si, Gyeonggi-do, South Korea

Location

Facility # 1

Suwon, Gyeonggi-do, South Korea

Location

Facility # 1

Daegu, Gyeongsangbuk-do, South Korea

Location

Facility # 1

Hwasun, Jeollanam-do, South Korea

Location

Facility # 1

Busan, South Korea

Location

Facility # 2

Busan, South Korea

Location

Facility # 3

Busan, South Korea

Location

Facility # 1

Incheon, South Korea

Location

Facility # 1

Seoul, South Korea

Location

Facility # 2

Seoul, South Korea

Location

Facility # 3

Seoul, South Korea

Location

Facility # 4

Seoul, South Korea

Location

Facility # 5

Seoul, South Korea

Location

Facility # 6

Seoul, South Korea

Location

Facility # 7

Seoul, South Korea

Location

Facility # 8

Seoul, South Korea

Location

Facility # 1

L'Hospitalet de Llobregat, Barcelona, Spain

Location

Facility # 1

Santander, Cantabria, Spain

Location

Facility # 1

Badajoz, Spain

Location

Facility # 1

Girona, Spain

Location

Facility # 1

Madrid, Spain

Location

Facility # 2

Madrid, Spain

Location

Facility # 3

Madrid, Spain

Location

Facility # 4

Madrid, Spain

Location

Facility # 1

Kaohsiung City, Taiwan

Location

Facility # 2

Kaohsiung City, Taiwan

Location

Facility # 1

Taichung, Taiwan

Location

Facility # 2

Taichung, Taiwan

Location

Facility # 1

Tainan, Taiwan

Location

Facility # 2

Tainan, Taiwan

Location

Facility # 1

Taipei, Taiwan

Location

Facility # 2

Taipei, Taiwan

Location

Facility # 3

Taipei, Taiwan

Location

Facility # 4

Taipei, Taiwan

Location

Facility # 5

Taipei, Taiwan

Location

Facility # 1

Taoyuan, Taiwan

Location

Facility # 1

Bangkoknoi, Bangkok, Thailand

Location

Facility # 1

Pathum Wan, Bangkok, Thailand

Location

Facility # 1

Ratchathewi, Bangkok, Thailand

Location

Facility # 1

Muang, Changwat Chiang Rai, Thailand

Location

Facility # 1

Muang, Chiang Mai, Thailand

Location

Facility # 2

London, Greater London, W12 OHS, United Kingdom

Location

Facility # 1

London, Greater London, United Kingdom

Location

Facility # 3

London, Greater London, United Kingdom

Location

Facility # 1

Manchester, Greater Manchester, United Kingdom

Location

Facility # 1

Liverpool, Merseyside, United Kingdom

Location

Facility # 1

Glasgow, Strathclyde, United Kingdom

Location

Facility # 1

Birmingham, West Midlands, United Kingdom

Location

Related Publications (9)

  • Piscaglia F, Ikeda K, Cheng AL, Kudo M, Ikeda M, Breder V, Ryoo BY, Mody K, Ren M, Ramji Z, Sung MW. Association between treatment-emergent hypertension and survival with lenvatinib treatment for patients with hepatocellular carcinoma in the REFLECT study. Cancer. 2024 Apr 15;130(8):1281-1291. doi: 10.1002/cncr.35185. Epub 2024 Jan 23.

  • Kudo M, Finn RS, Qin S, Han KH, Ikeda K, Cheng AL, Vogel A, Tovoli F, Ueshima K, Aikata H, Lopez CL, Pracht M, Meng Z, Daniele B, Park JW, Palmer D, Tamai T, Saito K, Dutcus CE, Lencioni R. Overall survival and objective response in advanced unresectable hepatocellular carcinoma: A subanalysis of the REFLECT study. J Hepatol. 2023 Jan;78(1):133-141. doi: 10.1016/j.jhep.2022.09.006. Epub 2022 Sep 20.

  • Huynh J, Cho MT, Kim EJ, Ren M, Ramji Z, Vogel A. Lenvatinib in patients with unresectable hepatocellular carcinoma who progressed to Child-Pugh B liver function. Ther Adv Med Oncol. 2022 Aug 24;14:17588359221116608. doi: 10.1177/17588359221116608. eCollection 2022.

  • Vogel A, Qin S, Kudo M, Su Y, Hudgens S, Yamashita T, Yoon JH, Fartoux L, Simon K, Lopez C, Sung M, Mody K, Ohtsuka T, Tamai T, Bennett L, Meier G, Breder V. Lenvatinib versus sorafenib for first-line treatment of unresectable hepatocellular carcinoma: patient-reported outcomes from a randomised, open-label, non-inferiority, phase 3 trial. Lancet Gastroenterol Hepatol. 2021 Aug;6(8):649-658. doi: 10.1016/S2468-1253(21)00110-2. Epub 2021 Jun 2.

  • Okusaka T, Ikeda K, Kudo M, Finn R, Qin S, Han KH, Cheng AL, Piscaglia F, Kobayashi M, Sung M, Chen M, Wyrwicz L, Yoon JH, Ren Z, Mody K, Dutcus C, Tamai T, Ren M, Hayato S, Kumada H. Safety and efficacy of lenvatinib by starting dose based on body weight in patients with unresectable hepatocellular carcinoma in REFLECT. J Gastroenterol. 2021 Jun;56(6):570-580. doi: 10.1007/s00535-021-01785-0. Epub 2021 May 4.

  • Briggs A, Daniele B, Dick K, Evans TRJ, Galle PR, Hubner RA, Lopez C, Siebert U, Tremblay G. Covariate-adjusted analysis of the Phase 3 REFLECT study of lenvatinib versus sorafenib in the treatment of unresectable hepatocellular carcinoma. Br J Cancer. 2020 Jun;122(12):1754-1759. doi: 10.1038/s41416-020-0817-7. Epub 2020 Apr 8.

  • Yamashita T, Kudo M, Ikeda K, Izumi N, Tateishi R, Ikeda M, Aikata H, Kawaguchi Y, Wada Y, Numata K, Inaba Y, Kuromatsu R, Kobayashi M, Okusaka T, Tamai T, Kitamura C, Saito K, Haruna K, Okita K, Kumada H. REFLECT-a phase 3 trial comparing efficacy and safety of lenvatinib to sorafenib for the treatment of unresectable hepatocellular carcinoma: an analysis of Japanese subset. J Gastroenterol. 2020 Jan;55(1):113-122. doi: 10.1007/s00535-019-01642-1. Epub 2019 Nov 12.

  • Evans TRJ, Kudo M, Finn RS, Han KH, Cheng AL, Ikeda M, Kraljevic S, Ren M, Dutcus CE, Piscaglia F, Sung MW. Urine protein:creatinine ratio vs 24-hour urine protein for proteinuria management: analysis from the phase 3 REFLECT study of lenvatinib vs sorafenib in hepatocellular carcinoma. Br J Cancer. 2019 Jul;121(3):218-221. doi: 10.1038/s41416-019-0506-6. Epub 2019 Jun 28.

  • Kudo M, Finn RS, Qin S, Han KH, Ikeda K, Piscaglia F, Baron A, Park JW, Han G, Jassem J, Blanc JF, Vogel A, Komov D, Evans TRJ, Lopez C, Dutcus C, Guo M, Saito K, Kraljevic S, Tamai T, Ren M, Cheng AL. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018 Mar 24;391(10126):1163-1173. doi: 10.1016/S0140-6736(18)30207-1.

MeSH Terms

Conditions

Carcinoma, HepatocellularNeoplasms

Interventions

lenvatinibSorafenib

Condition Hierarchy (Ancestors)

AdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeLiver NeoplasmsDigestive System NeoplasmsNeoplasms by SiteDigestive System DiseasesLiver Diseases

Intervention Hierarchy (Ancestors)

Phenylurea CompoundsUreaAmidesOrganic ChemicalsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsNiacinamideNicotinic AcidsAcids, HeterocyclicHeterocyclic CompoundsPyridinesHeterocyclic Compounds, 1-Ring

Results Point of Contact

Title
Eisai Medical Information
Organization
Eisai Inc.

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

January 2, 2013

First Posted

January 4, 2013

Study Start

March 1, 2013

Primary Completion

November 13, 2016

Study Completion

March 10, 2021

Last Updated

April 5, 2022

Results First Posted

September 25, 2018

Record last verified: 2022-03

Locations