Weight-based dosing of lenvatinib for advanced hepatocellular carcinoma

Sadahisa Ogasawara, Yoshihiko Ooka, Naoya Kato


Lenvatinib is an oral molecular target agent that blocks vascular endothelial growth factor receptors 1–3, fibroblast growth factor receptors 1–4, platelet-derived growth factor receptor α, RET, and KIT. It is noninferior, but not statistically superior, to sorafenib with regard to overall survival, according to the findings of a phase 3 trial of lenvatinib versus sorafenib as first-line therapy for advanced hepatocellular carcinoma (HCC) (the REFLECT trial) (1). Nowadays, lenvatinib has been approved all over the world and has become the second front-line tyrosine kinase inhibitor in patients with advanced HCC. The recommendations for starting lenvatinib therapy for advanced HCC are different from those for other molecular target agents in patient with advanced HCC in that dose is based on body weight (≥60 kg: 12 mg once daily; <60 kg: 8 mg once daily). The aim of this article is to discuss the weight-based dosing of lenvatinib for advanced HCC.