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    Clinical Trial Results:
    A Multicenter, Randomized, Open-Label, Phase 3 Trial to Compare the Efficacy and Safety of Lenvatinib (E7080) Versus Sorafenib in First-Line Treatment of Subjects With Unresectable Hepatocellular Carcinoma

    Summary
    EudraCT number
    2012-002992-33
    Trial protocol
    IT   DE   GB   ES   PL   BE  
    Global end of trial date
    10 Mar 2021

    Results information
    Results version number
    v2(current)
    This version publication date
    24 Mar 2022
    First version publication date
    12 Sep 2018
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    E7080-G000-304
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01761266
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Eisai, Inc.
    Sponsor organisation address
    155 Tice Boulevard, Woodcliff Lake, New Jersey, United States, 07677
    Public contact
    Eisai Medical Information, Eisai Inc., +1 888-274-2378, esi_oncmedinfo@eisai.com
    Scientific contact
    Eisai Medical Information, Eisai, Inc., +1 888-274-2378, esi_oncmedinfo@eisai.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    10 Mar 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    10 Mar 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study was to compare overall survival (OS) in subjects treated with lenvatinib versus sorafenib as a first-line treatment in subjects with unresectable heptocellular carcinoma (HCC).
    Protection of trial subjects
    This study was conducted in accordance with standard operating procedures (SOPs) of the sponsor (or designee), which are designed to ensure adherence to Good Clinical Practice (GCP) guidelines as required by the following: - Principles of the World Medical Association Declaration of Helsinki (World Medical Association, 2008) - International Council on Harmonisation (ICH) E6 Guideline for GCP (CPMP/ICH/135/95) of the European Agency for the Evaluation of Medicinal Products, Committee for Proprietary Medicinal Products, International Council for Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use - Title 21 of the United States (US) Code of Federal Regulations (US 21 CFR) regarding clinical studies, including Part 50 and Part 56 concerning informed subject consent and Institutional Review Board (IRB) regulations and applicable sections of US 21 CFR Part 312 - European Good Clinical Practice Directive 2005/28/EC and Clinical Trial Directive 2001/20/EC for studies conducted within any European Union (EU) country. All suspected unexpected serious adverse reactions were reported, as required, to the Competent Authorities of all involved EU member states. - Article 14, Paragraph 3, and Article 80-2 of the Pharmaceutical Affairs Law (Law No. 145, 1960) for studies conducted in Japan, in addition to Japan’s GCP Subject Information and Informed Consent.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Mar 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    China: 213
    Country: Number of subjects enrolled
    Hong Kong: 21
    Country: Number of subjects enrolled
    Japan: 168
    Country: Number of subjects enrolled
    Korea, Republic of: 142
    Country: Number of subjects enrolled
    Malaysia: 11
    Country: Number of subjects enrolled
    Philippines: 7
    Country: Number of subjects enrolled
    Singapore: 16
    Country: Number of subjects enrolled
    Taiwan: 54
    Country: Number of subjects enrolled
    Thailand: 8
    Country: Number of subjects enrolled
    Belgium: 4
    Country: Number of subjects enrolled
    Canada: 1
    Country: Number of subjects enrolled
    France: 52
    Country: Number of subjects enrolled
    Germany: 20
    Country: Number of subjects enrolled
    Israel: 3
    Country: Number of subjects enrolled
    Italy: 28
    Country: Number of subjects enrolled
    Poland: 35
    Country: Number of subjects enrolled
    Russian Federation: 73
    Country: Number of subjects enrolled
    Spain: 15
    Country: Number of subjects enrolled
    United Kingdom: 20
    Country: Number of subjects enrolled
    United States: 63
    Worldwide total number of subjects
    954
    EEA total number of subjects
    154
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    553
    From 65 to 84 years
    397
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects took part in the study at 154 investigative sites in Australia, Belgium, Canada, China, France, Germany, Hong Kong, Israel, Italy, Japan, South Korea, Malaysia, Philippines, Poland, Russia, Singapore, Spain, Taiwan, Thailand, United Kingdom, and the United States from 1 March 2013 to 10 March 2021.

    Pre-assignment
    Screening details
    A total of 1,492 subjects were screened, 954 subjects were enrolled and randomized, out of which 951 subjects were treated in the study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Lenvatinib
    Arm description
    Subjects received lenvatinib capsules 12 milligram (mg) based on the subject's body weight greater than or equal to (>=) 60 kilogram (kg) or 8 mg based on the subject'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, subject request, or withdrawal of consent.
    Arm type
    Experimental

    Investigational medicinal product name
    Lenvatinib
    Investigational medicinal product code
    E7080
    Other name
    Lenvima
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Lenvatinib capsule 12 mg based on the subject's body weight >=60 kg or 8 mg based on the subject's body weight <60 kg at baseline, orally, QD in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Arm title
    Sorafenib
    Arm description
    Subjects received sorafenib 400 mg tablets, orally, twice daily (BID) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.
    Arm type
    Experimental

    Investigational medicinal product name
    Sorafenib
    Investigational medicinal product code
    Other name
    Nexavar
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Sorafenib 400 mg tablets, orally, BID in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Number of subjects in period 1
    Lenvatinib Sorafenib
    Started
    478
    476
    Treated
    476
    475
    Completed
    0
    0
    Not completed
    478
    476
         Consent withdrawn by subject
    14
    10
         Death
    415
    402
         Sponsor Decision
    41
    52
         Lost to follow-up
    8
    12

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Lenvatinib
    Reporting group description
    Subjects received lenvatinib capsules 12 milligram (mg) based on the subject's body weight greater than or equal to (>=) 60 kilogram (kg) or 8 mg based on the subject'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, subject request, or withdrawal of consent.

    Reporting group title
    Sorafenib
    Reporting group description
    Subjects received sorafenib 400 mg tablets, orally, twice daily (BID) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Reporting group values
    Lenvatinib Sorafenib Total
    Number of subjects
    478 476 954
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    61.3 ( 11.69 ) 61.2 ( 12.01 ) -
    Sex: Female, Male
    Units: subjects
        Female
    73 75 148
        Male
    405 401 806
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    6 11 17
        Not Hispanic or Latino
    472 465 937
        Unknown or Not Reported
    0 0 0
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    1 0 1
        Asian
    334 326 660
        Native Hawaiian or Other Pacific Islander
    0 1 1
        Black or African American
    7 6 13
        White
    135 141 276
        Other
    1 2 3

    End points

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    End points reporting groups
    Reporting group title
    Lenvatinib
    Reporting group description
    Subjects received lenvatinib capsules 12 milligram (mg) based on the subject's body weight greater than or equal to (>=) 60 kilogram (kg) or 8 mg based on the subject'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, subject request, or withdrawal of consent.

    Reporting group title
    Sorafenib
    Reporting group description
    Subjects received sorafenib 400 mg tablets, orally, twice daily (BID) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Primary: Overall Survival (OS)

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    End point title
    Overall Survival (OS) [1]
    End point description
    OS was defined as the duration from the date of randomization until the date of death from any cause. Subjects who were lost to follow-up were censored at the last date the subject was known to be alive, and subjects who remained alive were censored at the time of data cutoff. The full analysis set (FAS) included all subjects who were randomized.
    End point type
    Primary
    End point timeframe
    From date of randomization until date of death from any cause (approximately up to 3.8 years)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was planned for this endpoint.
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    13.6 (12.1 to 14.9)
    12.3 (10.4 to 13.9)
    No statistical analyses for this end point

    Secondary: Progression Free Survival (PFS)

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    End point title
    Progression Free Survival (PFS)
    End point description
    PFS was defined as the time from the date of randomization to the date of first documentation of disease progression based on modified Response Evaluation Criteria in Solid Tumors (mRECIST), or date of death, whichever occurred first. Disease progression was defined as at least a 20 percent (%) increase in the sum of diameters of target lesions, taking as reference the baseline sum of diameters of target lesions. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    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)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    7.4 (6.9 to 8.8)
    3.7 (3.6 to 4.6)
    No statistical analyses for this end point

    Secondary: Time to Progression (TTP)

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    End point title
    Time to Progression (TTP)
    End point description
    TTP was defined as the time from the date of randomization to the date of first documentation of disease progression based on mRECIST. Disease progression was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the baseline sum of diameters of target lesions. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    The time from the date of randomization to the date of first documentation of disease progression (approximately up to 3.8 years)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    8.9 (7.4 to 9.2)
    3.7 (3.6 to 5.4)
    No statistical analyses for this end point

    Secondary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR)
    End point description
    ORR was defined as the percentage of subjects with a best overall response of complete response (CR) or partial response (PR) based on mRECIST. CR was defined as disappearance of any intratumoral arterial enhancement in all target lesions. PR was defined as at least a 30% decrease in the sum of diameters of viable (enhancement of arterial phase) target lesions taking as reference to the baseline sum of the diameters of target lesions. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    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)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: percentage of subjects
        number (confidence interval 95%)
    24.1 (20.2 to 27.9)
    9.2 (6.6 to 11.8)
    No statistical analyses for this end point

    Secondary: 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)

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    End point title
    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)
    End point description
    EORTC QLQ-C30 included 30 questions comprising 9 multi-item scales: 5 functional scales (physical, role, cognitive, emotional, and social) and 9 symptom scales (fatigue, pain, nausea/vomiting, dyspnoea, appetite loss, insomnia, constipation, diarrhea and financial difficulties) and a single global health and QOL status score. Most questions used a 4-point scale (1=Not at all to 4=Very much); 2 questions used a 7-point scale (1= Very poor to 7=Excellent). All domain scores were calculated as an average of item scores and transformed to 0 to 100 score range. A high score for a functional scale represents a high/healthy level of functioning, a high score for the global health status/quality of life (QoL) represents a high QoL, but a high score for a symptom scale/item represents a high level of symptomatology/problem. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    Baseline up to Off-Treatment Visit (approximately up to 3.8 years)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
        median (confidence interval 95%)
    1.7 (1.05 to 1.84)
    1.8 (1.05 to 1.84)
    No statistical analyses for this end point

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

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    End point title
    Time to Clinically Meaningful Worsening of HRQoL Assessed Using - EORTC QLQ- Hepatocellular Carcinoma Domain (HCC 18)
    End point description
    The EORTC QLQ-HCC-18 was an 18-item questionnaire design used along with the 30-item EORTC QLQ-C30. EORTC QLQ-HCC 18 questionnaire included 8 symptom scales such as fatigue, jaundice, body image, nutrition, pain, fever, sex life and abdominal swelling. Each individual item ranges from 1 to 4, where 1 = “not at all” and 4 = “very much.” All domain scores were calculated as an average of item scores and transformed to 0 to 100 score range. A high score for a functional scale represented a high/healthy level of functioning, a high score for the global health status/quality of life (QoL) represented a high QoL, but a high score for a symptom scale/item represented a high level of symptomatology/problem. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    Baseline up to Off-Treatment Visit (approximately up to 3.8 years)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
    median (confidence interval 95%)
        Fatigue
    1.9 (1.81 to 1.97)
    1.8 (1.74 to 1.87)
        Jaundice
    4.6 (3.72 to 5.52)
    3.7 (2.86 to 4.73)
        Body Image
    2.8 (2.73 to 3.68)
    1.9 (1.84 to 2.73)
        Nutrition
    4.1 (3.68 to 5.52)
    2.8 (2.04 to 3.06)
        Pain
    2.7 (1.97 to 2.83)
    2.8 (2.73 to 3.72)
        Fever
    5.5 (4.57 to 6.51)
    3.7 (2.99 to 5.52)
        Sex Life
    7.4 (5.46 to 9.17)
    6.7 (4.60 to 13.78)
        Abdominal swelling
    7.4 (5.52 to 9.24)
    7.4 (5.46 to 10.13)
    No statistical analyses for this end point

    Secondary: Time to Clinically Meaningful Worsening of HRQoL Assessed Using EuroQol Five Dimension Health Questionnaire (EQ-5D-3L)

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    End point title
    Time to Clinically Meaningful Worsening of HRQoL Assessed Using EuroQol Five Dimension Health Questionnaire (EQ-5D-3L)
    End point description
    The EuroQol five dimension health questionnaire (EQ-5D-3L) assesses quality of life along 5 dimensions. Subjects rate 5 aspects of health (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) by choosing from 3 answering options (1=no problems; 2=some problems; 3=extreme problems). The summed score ranges from 3-15 with "3" corresponding to no problems; "15" corresponding to severe problems in 5 dimensions. EQ-5D-3L also included EQ visual analogue scale (VAS) that ranges between 100 (best imaginable health); 0 (worst imaginable health). Decrease from baseline in EQ-5D-3L signifies improvement. Total index EQ-5D-3L summary score weighted with range -0.594 (worst) to 1.0 (best). EQ-5D-3L also included EQ health utilities index (HUI) where 1.00 indicated perfect health while score of 0.00 indicated death. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date.The FAS included all subjects who were randomized.
    End point type
    Secondary
    End point timeframe
    Baseline up to Off-Treatment Visit (approximately up to 3.8 years)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: months
    median (confidence interval 95%)
        VAS
    2.8 (2.17 to 3.65)
    1.9 (1.84 to 2.33)
        HUI
    2.8 (1.97 to 3.52)
    1.9 (1.84 to 2.66)
    No statistical analyses for this end point

    Secondary: Area Under the Plasma Drug Concentration-time Curve (AUC) for Lenvatinib

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    End point title
    Area Under the Plasma Drug Concentration-time Curve (AUC) for Lenvatinib
    End point description
    AUC was assessed on Cycle 1 Day 1, Cycle 2 Day 1 and Cycle 1 Day 15. Summarized data for all time points was reported. As planned, data for this secondary endpoint was collected and analyzed up to the primary completion date. The pharmacokinetic (PK) analysis set included all subjects who had received at least 1 dose of lenvatinib and had at least 1 quantifiable lenvatinib concentration.
    End point type
    Secondary
    End point timeframe
    Cycle 1 Day 1, Cycle 2 Day 1: pre-dose, 0.5-4 and 6-10 hours post-dose; Cycle 1 Day 15: pre-dose, 2-12 hours post-dose (cycle length= 28 days)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    150
    318
    Units: nanogram*hour per milliliter (ng*h/mL)
        arithmetic mean (standard deviation)
    1969.6 ( 743.0 )
    2120.9 ( 685.6 )
    No statistical analyses for this end point

    Other pre-specified: Disease control rate (DCR)

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    End point title
    Disease control rate (DCR)
    End point description
    DCR was defined as the percentage of subjects with a best overall response of CR or PR, or stable disease (SD). Best overall response of SD must have been >=7 weeks after randomization. CR was defined as disappearance of any intratumoral arterial enhancement in all target lesions. PR was defined as at least a 30% decrease in the sum of diameters of viable (enhancement of arterial phase) target lesions taking as reference the baseline sum of the diameters of target lesions. SD was when a case does not qualify for either PR or PD and was new non-target lesions. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the baseline sum of diameters of target lesions. As planned, data for this pre-specified endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Other pre-specified
    End point timeframe
    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)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: percentage of subjects
        number (confidence interval 95%)
    75.5 (71.7 to 79.4)
    60.5 (56.1 to 64.9)
    No statistical analyses for this end point

    Other pre-specified: Clinical Benefit Rate (CBR)

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    End point title
    Clinical Benefit Rate (CBR)
    End point description
    CBR was defined as percentage of subjects with best overall response of CR or PR or durable SD (duration of SD >=23 weeks after randomization). For subjects whose best overall response (BOR) was SD, duration of SD was defined as time from date of randomization to first documented PD or death, whichever occurred first. CR was defined as disappearance of any intratumoral arterial enhancement in all target lesions. PR was defined as at least a 30% decrease in the sum of diameters of viable (enhancement of arterial phase) target lesions taking as reference baseline sum of diameters of target lesions. SD was when a case does not qualify for either PR or PD. PD was defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the baseline sum of diameters of target lesions. As planned, data for this pre-specified endpoint was collected and analyzed up to the primary completion date. The FAS included all subjects who were randomized.
    End point type
    Other pre-specified
    End point timeframe
    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)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    478
    476
    Units: percentage of subjects
        number (confidence interval 95%)
    59.0 (54.6 to 63.4)
    38.4 (34.1 to 42.8)
    No statistical analyses for this end point

    Other pre-specified: Percent Change from Baseline in Serum Biomarker

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    End point title
    Percent Change from Baseline in Serum Biomarker
    End point description
    The serum biomarkers analysed were angiopoietin-2 (ANG2), fibroblast growth factor 19 (FGF19), fibroblast growth factor 21 (FGF21), fibroblast growth factor 23 (FGF23) and vascular endothelial growth factor (VEGF) as blood serum biomarkers, and protein induced by vitamin K absence or antagonist-II (PIVKA-II) as a blood tumor marker in serum. As planned, data for this pre-specified endpoint was collected and analyzed up to the primary completion date. The pharmacodynamics (PD) analysis set included all subjects who received at least 1 dose of study drug and had evaluable PD data. Here “n” was subjects who were evaluable for the outcome measure at given time points.
    End point type
    Other pre-specified
    End point timeframe
    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)
    End point values
    Lenvatinib Sorafenib
    Number of subjects analysed
    66
    48
    Units: percent change
    median (standard deviation)
        ANG 2: Cycle 1 Day 15
    -28.1 ( 15.94 )
    8.9 ( 23.96 )
        ANG 2: Cycle 2 Day 1
    -28.8 ( 16.53 )
    -0.9 ( 24.06 )
        ANG 2: Cycle 3 Day 1
    -32.2 ( 23.23 )
    0.5 ( 26.62 )
        ANG 2: Cycle 4 Day 1
    -35.6 ( 22.91 )
    -4.5 ( 20.05 )
        ANG 2: Cycle 5 Day 1
    -38.9 ( 19.83 )
    7.0 ( 23.25 )
        ANG 2: Cycle 6 Day 1
    -36.7 ( 23.59 )
    -3.6 ( 24.82 )
        ANG 2: Cycle 7 Day 1
    -41.4 ( 21.20 )
    1.0 ( 32.83 )
        ANG 2: Cycle 8 Day 1
    -40.2 ( 25.33 )
    -6.7 ( 31.26 )
        ANG 2: Cycle 9 Day 1
    -39.6 ( 14.04 )
    -1.1 ( 29.68 )
        ANG 2: Off-Treatment
    11.7 ( 99.13 )
    16.8 ( 27.88 )
        FGF19: Cycle 1 Day 15
    75.0 ( 155.01 )
    1.3 ( 83.65 )
        FGF19: Cycle 2 Day 1
    66.5 ( 134.26 )
    36.6 ( 119.65 )
        FGF19: Cycle 3 Day 1
    86.9 ( 123.85 )
    22.8 ( 70.58 )
        FGF19: Cycle 4 Day 1
    208.1 ( 602.11 )
    46.8 ( 214.14 )
        FGF19: Cycle 5 Day 1
    152.8 ( 228.37 )
    -1.0 ( 40.36 )
        FGF19: Cycle 6 Day 1
    119.8 ( 203.81 )
    26.9 ( 67.13 )
        FGF19: Cycle 7 Day 1
    64.4 ( 101.97 )
    -5.9 ( 57.39 )
        FGF19: Cycle 8 Day 1
    95.8 ( 135.31 )
    53.9 ( 113.79 )
        FGF19: Cycle 9 Day 1
    159.3 ( 202.00 )
    56.6 ( 109.46 )
        FGF19: Off-Treatment
    140.1 ( 270.73 )
    9.0 ( 64.17 )
        FGF 21: Cycle 1 Day 15
    22.0 ( 75.22 )
    4.0 ( 43.14 )
        FGF 21: Cycle 2 Day 1
    15.7 ( 77.44 )
    18.6 ( 57.18 )
        FGF 21: Cycle 3 Day 1
    38.3 ( 38.3 )
    49.4 ( 76.43 )
        FGF 21: Cycle 4 Day 1
    42.9 ( 145.43 )
    32.8 ( 70.63 )
        FGF 21: Cycle 5 Day 1
    41.0 ( 95.97 )
    31.1 ( 43.15 )
        FGF 21: Cycle 6 Day 1
    52.6 ( 168.22 )
    23.2 ( 40.90 )
        FGF 21: Cycle 7 Day 1
    63.4 ( 128.34 )
    23.7 ( 53.84 )
        FGF 21 : Cycle 8 Day1
    38.3 ( 115.53 )
    17.0 ( 68.51 )
        FGF 21: Cycle 9 Day1
    59.1 ( 108.39 )
    68.9 ( 103.55 )
        FGF 21: Off-Treatment
    141.4 ( 340.51 )
    104.9 ( 183.28 )
        FGF 23: Cycle 1 Day15
    23.9 ( 49.01 )
    -16.3 ( 36.14 )
        FGF 23: Cycle 2 Day 1
    20.9 ( 56.91 )
    -6.2 ( 48.18 )
        FGF 23: Cycle 3 Day 1
    25.5 ( 45.27 )
    17.3 ( 75.25 )
        FGF 23: Cycle 4 Day 1
    29.5 ( 48.38 )
    14.2 ( 49.29 )
        FGF 23: Cycle 5 Day 1
    29.6 ( 63.69 )
    1.0 ( 47.28 )
        FGF 23: Cycle 6 Day 1
    26.3 ( 54.57 )
    -10.6 ( 46.15 )
        FGF 23: Cycle 7 Day 1
    31.5 ( 57.44 )
    0.7 ( 46.95 )
        FGF 23: Cycle 8 Day 1
    38.1 ( 67.35 )
    2.8 ( 43.84 )
        FGF 23: Cycle 9 Day 1
    23.2 ( 62.58 )
    0.5 ( 38.74 )
        FGF 23: Off-Treatment
    17.8 ( 73.59 )
    14.2 ( 47.11 )
        PIVKA-II: Cycle 1 Day 15
    80.0 ( 171.41 )
    166.9 ( 256.04 )
        PIVKA-II: Cycle 2 Day 1
    169.7 ( 329.33 )
    243.8 ( 416.82 )
        PIVKA-II: Cycle 3 Day 1
    252.4 ( 611.40 )
    218.7 ( 281.45 )
        PIVKA-II: Cycle 4 Day 1
    371.7 ( 812.45 )
    196.2 ( 348.80 )
        PIVKA-II: Cycle 5 Day 1
    628.2 ( 1752.64 )
    369.5 ( 766.59 )
        PIVKA-II: Cycle 6 Day 1
    648.7 ( 2746.41 )
    415.7 ( 554.27 )
        PIVKA-II: Cycle 7 Day 1
    184.8 ( 352.75 )
    703.6 ( 1226.58 )
        PIVKA-II: Cycle 8 Day 1
    277.8 ( 481.53 )
    724.0 ( 1257.87 )
        PIVKA-II: Cycle 9 Day 1
    318.8 ( 577.21 )
    859.1 ( 1492.93 )
        PIVKA-II: Off-Treatment
    809.3 ( 1827.42 )
    272.5 ( 489.60 )
        VEGF: Cycle 1 Day 15
    157.5 ( 300.21 )
    97.4 ( 118.43 )
        VEGF: Cycle 2 Day 1
    128.9 ( 333.85 )
    94.0 ( 180.80 )
        VEGF: Cycle 3 Day 1
    97.7 ( 162.39 )
    66.0 ( 124.58 )
        VEGF: Cycle 4 Day 1
    113.4 ( 231.19 )
    76.1 ( 111.20 )
        VEGF: Cycle 5 Day 1
    132.4 ( 249.59 )
    116.2 ( 215.57 )
        VEGF: Cycle 6 Day 1
    113.1 ( 219.36 )
    130.9 ( 341.12 )
        VEGF: Cycle 7 Day 1
    133.1 ( 383.43 )
    96.9 ( 173.77 )
        VEGF: Cycle 8 Day 1
    148.7 ( 349.58 )
    181.1 ( 399.67 )
        VEGF: Cycle 9 Day 1
    129.6 ( 215.05 )
    135.6 ( 267.61 )
        VEGF: Off-Treatment
    127.1 ( 266.64 )
    147.8 ( 304.31 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All treatment-emergent adverse events were collected from first dose of study drug (Baseline) up to 30 days after last dose of study drug (approximately up to 8 years)
    Adverse event reporting additional description
    The safety analysis set included all subjects who received at least 1 dose of study drug. Total number of Deaths (all-causes) was reported for all subjects randomized that is Total number of subjects exposed for Lenvatinib were 478 and for Sorafenib were 476.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.1
    Reporting groups
    Reporting group title
    Sorafenib
    Reporting group description
    Subjects received sorafenib 400 mg tablets, orally, twice daily in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Reporting group title
    Lenvatinib
    Reporting group description
    Subjects received lenvatinib capsules 12 mg based on the subject's body weight >=60 kg or 8 mg based on the subject's body weight <60 kg at baseline, orally, once daily (QD) in continuous 28-day treatment cycles up to documented disease progression, development of unacceptable toxicity, subject request, or withdrawal of consent.

    Serious adverse events
    Sorafenib Lenvatinib
    Total subjects affected by serious adverse events
         subjects affected / exposed
    149 / 475 (31.37%)
    209 / 476 (43.91%)
         number of deaths (all causes)
    402
    415
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant neoplasm progression
         subjects affected / exposed
    14 / 475 (2.95%)
    11 / 476 (2.31%)
         occurrences causally related to treatment / all
    0 / 14
    0 / 12
         deaths causally related to treatment / all
    0 / 14
    0 / 11
    Cancer pain
         subjects affected / exposed
    0 / 475 (0.00%)
    4 / 476 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    3 / 475 (0.63%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    2 / 4
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Liver carcinoma ruptured
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Metastases to central nervous system
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Metastases to spine
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infected neoplasm
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intracranial tumour haemorrhage
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Meningioma
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastases to bone
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal cell carcinoma
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour necrosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour rupture
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung neoplasm malignant
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant ascites
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant pleural effusion
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Plasma cell myeloma
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mantle cell lymphoma
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastases to adrenals
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Aortic dissection
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Deep vein thrombosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombophlebitis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shock
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombophlebitis superficial
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    5 / 475 (1.05%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    4 / 6
    4 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthenia
         subjects affected / exposed
    1 / 475 (0.21%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    0 / 1
    4 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    3 / 475 (0.63%)
    5 / 476 (1.05%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 5
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Oedema peripheral
         subjects affected / exposed
    1 / 475 (0.21%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    2 / 475 (0.42%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Death
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Generalised oedema
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral swelling
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Organ failure
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Sudden death
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    1 / 2
    0 / 1
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    2 / 475 (0.42%)
    5 / 476 (1.05%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pulmonary embolism
         subjects affected / exposed
    2 / 475 (0.42%)
    4 / 476 (0.84%)
         occurrences causally related to treatment / all
    1 / 2
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pneumonia aspiration
         subjects affected / exposed
    0 / 475 (0.00%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Respiratory failure
         subjects affected / exposed
    3 / 475 (0.63%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    1 / 3
    3 / 4
         deaths causally related to treatment / all
    1 / 3
    2 / 3
    Hepatopulmonary syndrome
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Hiccups
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Necrotising bronchiolitis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiogenic pulmonary oedema
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary infarction
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pneumothorax
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Major depression
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suicide attempt
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    1 / 475 (0.21%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    1 / 1
    3 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood pressure decreased
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium test positive
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    5 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intentional overdose
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foreign body
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax traumatic
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal fracture
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Traumatic haematoma
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac disorders
    Myocardial infarction
         subjects affected / exposed
    1 / 475 (0.21%)
    4 / 476 (0.84%)
         occurrences causally related to treatment / all
    0 / 1
    4 / 5
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Atrial fibrillation
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiopulmonary failure
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Acute myocardial infarction
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Heart valve stenosis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Nervous system disorders
    Hepatic encephalopathy
         subjects affected / exposed
    3 / 475 (0.63%)
    21 / 476 (4.41%)
         occurrences causally related to treatment / all
    1 / 4
    13 / 35
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 475 (0.00%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 0
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    3 / 3
    Coma hepatic
         subjects affected / exposed
    1 / 475 (0.21%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Cerebral infarction
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    1 / 1
    2 / 4
         deaths causally related to treatment / all
    0 / 0
    1 / 2
    Headache
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diplegia
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disturbance in attention
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Facial paralysis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paralysis recurrent laryngeal nerve
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Posterior reversible encephalopathy syndrome
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Basal ganglia haemorrhage
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Encephalopathy
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombotic cerebral infarction
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    6 / 475 (1.26%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    7 / 12
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone marrow failure
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    5 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disseminated intravascular coagulation
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Anaemia vitamin B12 deficiency
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Hypoacusis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vertigo
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Cataract
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ascites
         subjects affected / exposed
    12 / 475 (2.53%)
    12 / 476 (2.52%)
         occurrences causally related to treatment / all
    5 / 15
    8 / 15
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 475 (0.42%)
    8 / 476 (1.68%)
         occurrences causally related to treatment / all
    2 / 2
    7 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    5 / 475 (1.05%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    0 / 7
    3 / 8
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Abdominal pain
         subjects affected / exposed
    11 / 475 (2.32%)
    6 / 476 (1.26%)
         occurrences causally related to treatment / all
    1 / 11
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 475 (0.00%)
    6 / 476 (1.26%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 475 (0.42%)
    6 / 476 (1.26%)
         occurrences causally related to treatment / all
    2 / 5
    4 / 7
         deaths causally related to treatment / all
    0 / 2
    1 / 2
    Duodenal ulcer haemorrhage
         subjects affected / exposed
    1 / 475 (0.21%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    0 / 475 (0.00%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal ulcer
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal distension
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspepsia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    3 / 475 (0.63%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    3 / 4
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal haemorrhage
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Pancreatitis acute
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Varices oesophageal
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Food poisoning
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric perforation
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematochezia
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritoneal haemorrhage
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatic failure
         subjects affected / exposed
    8 / 475 (1.68%)
    14 / 476 (2.94%)
         occurrences causally related to treatment / all
    3 / 11
    8 / 22
         deaths causally related to treatment / all
    0 / 2
    3 / 10
    Jaundice cholestatic
         subjects affected / exposed
    4 / 475 (0.84%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    0 / 4
    2 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Portal vein thrombosis
         subjects affected / exposed
    0 / 475 (0.00%)
    4 / 476 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Cholangitis
         subjects affected / exposed
    2 / 475 (0.42%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Hepatic cirrhosis
         subjects affected / exposed
    0 / 475 (0.00%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Bile duct obstruction
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Bile duct stone
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute hepatic failure
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Biliary dilatation
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    2 / 475 (0.42%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic hepatic failure
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Haemobilia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic function abnormal
         subjects affected / exposed
    5 / 475 (1.05%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    5 / 6
    1 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Hepatorenal syndrome
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic pain
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydrocholecystis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver injury
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice
         subjects affected / exposed
    4 / 475 (0.84%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Intertrigo
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Drug eruption
         subjects affected / exposed
    2 / 475 (0.42%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seborrhoeic dermatitis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erythema multiforme
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psoriasis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    3 / 475 (0.63%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    0 / 475 (0.00%)
    4 / 476 (0.84%)
         occurrences causally related to treatment / all
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    2 / 475 (0.42%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal impairment
         subjects affected / exposed
    2 / 475 (0.42%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 3
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    IgA nephropathy
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal tubular necrosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    5 / 475 (1.05%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    5 / 475 (1.05%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Flank pain
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lumbar spinal stenosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neck pain
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal column stenosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    5 / 475 (1.05%)
    5 / 476 (1.05%)
         occurrences causally related to treatment / all
    1 / 7
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    3 / 475 (0.63%)
    7 / 476 (1.47%)
         occurrences causally related to treatment / all
    0 / 4
    2 / 11
         deaths causally related to treatment / all
    0 / 1
    1 / 5
    Cellulitis
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver abscess
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 475 (0.21%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis bacterial
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Urinary tract infection
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendiceal abscess
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Biliary tract infection
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dengue fever
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Gastrointestinal viral infection
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Groin abscess
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infectious pleural effusion
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Perihepatic abscess
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Periodontitis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural infection
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postoperative abscess
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Salmonellosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary tuberculosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Scrotal infection
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Tuberculosis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection enterococcal
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute sinusitis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspergillus infection
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic foot infection
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ophthalmic herpes simplex
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Perineal abscess
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia escherichia
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    2 / 475 (0.42%)
    11 / 476 (2.31%)
         occurrences causally related to treatment / all
    1 / 2
    8 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 475 (0.42%)
    3 / 476 (0.63%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    2 / 476 (0.42%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cachexia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Diabetes mellitus
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 475 (0.21%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoproteinaemia
         subjects affected / exposed
    1 / 475 (0.21%)
    0 / 476 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypomagnesaemia
         subjects affected / exposed
    0 / 475 (0.00%)
    1 / 476 (0.21%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Sorafenib Lenvatinib
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    469 / 475 (98.74%)
    469 / 476 (98.53%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    147 / 475 (30.95%)
    200 / 476 (42.02%)
         occurrences all number
    269
    419
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    48 / 475 (10.11%)
    53 / 476 (11.13%)
         occurrences all number
    84
    122
    Fatigue
         subjects affected / exposed
    120 / 475 (25.26%)
    141 / 476 (29.62%)
         occurrences all number
    170
    226
    Oedema peripheral
         subjects affected / exposed
    33 / 475 (6.95%)
    67 / 476 (14.08%)
         occurrences all number
    45
    107
    Pyrexia
         subjects affected / exposed
    61 / 475 (12.84%)
    63 / 476 (13.24%)
         occurrences all number
    74
    79
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    37 / 475 (7.79%)
    45 / 476 (9.45%)
         occurrences all number
    46
    54
    Dysphonia
         subjects affected / exposed
    57 / 475 (12.00%)
    113 / 476 (23.74%)
         occurrences all number
    69
    134
    Epistaxis
         subjects affected / exposed
    15 / 475 (3.16%)
    35 / 476 (7.35%)
         occurrences all number
    17
    35
    Dyspnoea
         subjects affected / exposed
    17 / 475 (3.58%)
    31 / 476 (6.51%)
         occurrences all number
    19
    39
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    28 / 475 (5.89%)
    33 / 476 (6.93%)
         occurrences all number
    34
    38
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    51 / 475 (10.74%)
    53 / 476 (11.13%)
         occurrences all number
    108
    86
    Aspartate aminotransferase increased
         subjects affected / exposed
    80 / 475 (16.84%)
    64 / 476 (13.45%)
         occurrences all number
    173
    128
    Blood alkaline phosphatase increased
         subjects affected / exposed
    29 / 475 (6.11%)
    32 / 476 (6.72%)
         occurrences all number
    40
    59
    Blood bilirubin increased
         subjects affected / exposed
    63 / 475 (13.26%)
    67 / 476 (14.08%)
         occurrences all number
    128
    141
    Electrocardiogram QT prolonged
         subjects affected / exposed
    24 / 475 (5.05%)
    33 / 476 (6.93%)
         occurrences all number
    62
    59
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    27 / 475 (5.68%)
    37 / 476 (7.77%)
         occurrences all number
    41
    60
    Neutrophil count decreased
         subjects affected / exposed
    13 / 475 (2.74%)
    41 / 476 (8.61%)
         occurrences all number
    21
    101
    Platelet count decreased
         subjects affected / exposed
    59 / 475 (12.42%)
    87 / 476 (18.28%)
         occurrences all number
    127
    260
    Weight decreased
         subjects affected / exposed
    108 / 475 (22.74%)
    149 / 476 (31.30%)
         occurrences all number
    182
    290
    White blood cell count decreased
         subjects affected / exposed
    25 / 475 (5.26%)
    47 / 476 (9.87%)
         occurrences all number
    55
    115
    Nervous system disorders
    Headache
         subjects affected / exposed
    39 / 475 (8.21%)
    45 / 476 (9.45%)
         occurrences all number
    48
    57
    Dizziness
         subjects affected / exposed
    16 / 475 (3.37%)
    29 / 476 (6.09%)
         occurrences all number
    22
    33
    Hepatic encephalopathy
         subjects affected / exposed
    6 / 475 (1.26%)
    24 / 476 (5.04%)
         occurrences all number
    6
    37
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    43 / 475 (9.05%)
    35 / 476 (7.35%)
         occurrences all number
    104
    55
    Thrombocytopenia
         subjects affected / exposed
    28 / 475 (5.89%)
    33 / 476 (6.93%)
         occurrences all number
    90
    81
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    24 / 475 (5.05%)
    39 / 476 (8.19%)
         occurrences all number
    27
    57
    Abdominal pain
         subjects affected / exposed
    83 / 475 (17.47%)
    82 / 476 (17.23%)
         occurrences all number
    111
    136
    Abdominal pain upper
         subjects affected / exposed
    41 / 475 (8.63%)
    58 / 476 (12.18%)
         occurrences all number
    59
    82
    Ascites
         subjects affected / exposed
    39 / 475 (8.21%)
    63 / 476 (13.24%)
         occurrences all number
    54
    82
    Constipation
         subjects affected / exposed
    52 / 475 (10.95%)
    76 / 476 (15.97%)
         occurrences all number
    62
    95
    Diarrhoea
         subjects affected / exposed
    223 / 475 (46.95%)
    186 / 476 (39.08%)
         occurrences all number
    448
    406
    Dyspepsia
         subjects affected / exposed
    18 / 475 (3.79%)
    31 / 476 (6.51%)
         occurrences all number
    20
    40
    Nausea
         subjects affected / exposed
    71 / 475 (14.95%)
    90 / 476 (18.91%)
         occurrences all number
    94
    131
    Stomatitis
         subjects affected / exposed
    56 / 475 (11.79%)
    45 / 476 (9.45%)
         occurrences all number
    76
    67
    Vomiting
         subjects affected / exposed
    37 / 475 (7.79%)
    75 / 476 (15.76%)
         occurrences all number
    65
    110
    Dry mouth
         subjects affected / exposed
    8 / 475 (1.68%)
    32 / 476 (6.72%)
         occurrences all number
    8
    38
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    120 / 475 (25.26%)
    15 / 476 (3.15%)
         occurrences all number
    140
    16
    Palmar-plantar erythrodysaesthesia syndrome
         subjects affected / exposed
    246 / 475 (51.79%)
    128 / 476 (26.89%)
         occurrences all number
    614
    236
    Pruritus
         subjects affected / exposed
    35 / 475 (7.37%)
    34 / 476 (7.14%)
         occurrences all number
    46
    41
    Rash
         subjects affected / exposed
    77 / 475 (16.21%)
    46 / 476 (9.66%)
         occurrences all number
    105
    59
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    55 / 475 (11.58%)
    117 / 476 (24.58%)
         occurrences all number
    125
    363
    Haematuria
         subjects affected / exposed
    9 / 475 (1.89%)
    25 / 476 (5.25%)
         occurrences all number
    11
    34
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    8 / 475 (1.68%)
    81 / 476 (17.02%)
         occurrences all number
    9
    104
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    20 / 475 (4.21%)
    42 / 476 (8.82%)
         occurrences all number
    31
    52
    Back pain
         subjects affected / exposed
    28 / 475 (5.89%)
    48 / 476 (10.08%)
         occurrences all number
    30
    55
    Musculoskeletal pain
         subjects affected / exposed
    25 / 475 (5.26%)
    47 / 476 (9.87%)
         occurrences all number
    30
    56
    Pain in extremity
         subjects affected / exposed
    18 / 475 (3.79%)
    38 / 476 (7.98%)
         occurrences all number
    32
    59
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    25 / 475 (5.26%)
    23 / 476 (4.83%)
         occurrences all number
    33
    26
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    126 / 475 (26.53%)
    162 / 476 (34.03%)
         occurrences all number
    165
    269
    Hypoalbuminaemia
         subjects affected / exposed
    38 / 475 (8.00%)
    43 / 476 (9.03%)
         occurrences all number
    56
    88
    Hypokalaemia
         subjects affected / exposed
    26 / 475 (5.47%)
    9 / 476 (1.89%)
         occurrences all number
    52
    14

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Jan 2014
    Protocol Amendment 1: Revisions included changes to the inclusion/exclusion criteria and clarification of study conduct/procedures based on feedback from the investigators, addition of safety monitoring procedures as a result of the EU Voluntary Harmonisation Procedure (VHP) for protocol review, and updating of the instruments used to collect HRQoL.
    09 Apr 2014
    Protocol Amendment 2: As required by the Japanese regulatory authority (Pharmaceuticals and Medical Devices Agency), clarified that although progression of HCC was not to be reported as a TEAE, if the progression led to an untoward medical occurrence, this untoward medical occurrence was to be reported as a TEAE. Revision of Exclusion Criteria #10 to clarify that subjects who required active interventional treatment of gastric or esophageal varices within 28 days prior to randomization were to be excluded. As required by the French Health authority, clarified toxicity management for sorafenib-treated subjects with QTc prolongation (>=501 msec) and advised caution when using medicines that are known to prolong the QTc interval when used concomitantly with sorafenib.
    16 Jan 2015
    Protocol Amendment 3: As requested during the EU VHP review, information on the occurrence, diagnosis, and management of PRES in lenvatinib-treated subjects was added. As requested by the French Health Authority, since the occurrence of PRES was added to the lenvatinib Investigator’s Brochure as an “expected” adverse event, any further reports of PRES were no longer subject to expedited reporting to regulatory authorities.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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