A Study of E7080 Alone, and in Combination With Everolimus in Subjects With Unresectable Advanced or Metastatic Renal Cell Carcinoma Following One Prior Vascular Endothelial Growth Factor (VEGF)-Targeted Treatment

Sponsor
Eisai Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT01136733
Collaborator
(none)
173
37
3
90.2
4.7
0.1

Study Details

Study Description

Brief Summary

This is an open-label, multicenter, Phase 1b/2 study of lenvatinib alone and in combination with everolimus in subjects with unresectable advanced or metastatic renal cell carcinoma following one prior VEGF-targeted treatment.

Condition or Disease Intervention/Treatment Phase
Phase 1/Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
173 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
An Open-Label, Multicenter, Phase 1b/2 Study of E7080 Alone, and in Combination With Everolimus in Subjects With Unresectable Advanced or Metastatic Renal Cell Carcinoma Following One Prior VEGF-Targeted Treatment
Actual Study Start Date :
Aug 5, 2010
Actual Primary Completion Date :
Jun 13, 2014
Actual Study Completion Date :
Feb 8, 2018

Arms and Interventions

Arm Intervention/Treatment
Experimental: Lenvatinib

Drug: Lenvatinib
taken orally, once a day
Other Names:
  • E7080, Lenvima, Kisplyx
  • Experimental: Lenvatinib plus Everolimus

    Drug: Lenvatinib
    taken orally, once a day
    Other Names:
  • E7080, Lenvima, Kisplyx
  • Drug: Everolimus
    taken orally, once a day
    Other Names:
  • Afinitor
  • Active Comparator: Everolimus

    Drug: Everolimus
    taken orally, once a day
    Other Names:
  • Afinitor
  • Outcome Measures

    Primary Outcome Measures

    1. Phase 1b: Number of Participants With Dose-limiting Toxicity (DLT) [First dose of study drug (Cycle 1 Day 1) to end of first 4 weeks of therapy (Cycle 1)]

      A DLT was defined as either a treatment-related failure to administer greater than or equal to (>=) 75% of the planned dosage of lenvatinib/everolimus or a specific National Cancer Institute Common Toxicity Criteria (NCI CTC) >= Grade 3 (severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care daily living activities) hematologic or nonhematologic toxicities considered to be possibly related to lenvatinib and/or everolimus therapy assessed during the first treatment cycle of each dose level. Higher grade indicates more severe toxicity.

    2. Phase 1b: Maximum Tolerated Dose (MTD) and Recommended Phase 2 (RP2) Dose [First dose of study drug (Cycle 1 Day 1) to end of Cycle 2 (1 cycle = 28 days/4 weeks)]

      The highest dose level resulting in 0 or 1 DLT in 6 participants was to be considered the MTD of Phase 1b. Once the MTD was established, the participant cohort was expanded to a minimum of 10 participants. The MTD was confirmed by assessing DLTs during Cycle 1 and intolerable toxicities (i.e., not manageable with dose interruption and/or reduction) during Cycle 2 of therapy. Once the dose of lenvatinib/everolimus combination to be used in the succeeding Phase 2 part of the study was established, enrollment into Phase 2 was started. The RP2 dose was the same as the confirmed MTD and was used for the Phase 2 Treatment Arm A of this study.

    3. Phase 2: Progression-Free Survival (PFS) [Date of randomization into Phase 2 (Cycle 1 Day 1) to the date of first documentation of disease progression or death (whichever occurred first), assessed up to data cutoff date (13 Jun 2014), up to approximately 2 years and 3 months]

      PFS was defined as the time (in months) from the date of first dose of study drug to the first documentation of disease progression or death, whichever occurred first. Kaplan-Meier (K-M) estimates were used to estimate median PFS, presented with 2-sided 95% confidence intervals (CIs). Tumor assessments were performed every 8 weeks (or sooner if there was evidence of progressive disease using computed tomography (CT) or magnetic resonance imaging (MRI) and scan acquisition techniques (including use or nonuse of intravenous (IV) contrast). Tumor response was determined at the site by the investigator and radiologist using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 in the evaluation of the tumor assessment scans. The date of objective disease progression was defined as the earliest date of radiological disease progression. Participants removed from therapy due to clinical progression with no radiologic confirmation were censored at their last radiologic assessment date.

    Secondary Outcome Measures

    1. Phase 2: Overall Survival (OS) [Randomization (Cycle 1 Day 1) until date of death from any cause, assessed up to the data cutoff date (10 Dec 2014), up to approximately 2 years and 9 months]

      OS was defined as the time (in months) from the date of randomization until date of death from any cause. Median survival time was calculated using K-M estimate for each treatment arm and presented with 2-sided 95% CIs. Participants who were lost to follow-up or alive at the data cutoff date (10 Dec 2014) were censored at the date the participants were last known to be alive.

    2. Phase 2: Objective Response Rate (ORR) [Randomization (Cycle 1 Day 1) until first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months]

      The ORR was defined as the percentage of participants who had the best overall response (BOR) of complete response (CR) or partial response (PR) as determined by the investigator, using RECIST 1.1 in the evaluation of MRI or CT scans of targeted lesions. Tumor assessments were performed every 8 weeks (or sooner if there was evidence of progressive disease). The BOR was defined as the best response recorded from the start of the study treatment until discontinuation from the study. CR was defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to less than 10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR = CR + PR was calculated with exact 95% CIs using the method of Clopper and Pearson.

    3. Disease Control Rate (DCR) [Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months]

      The DCR was defined as the percentage of participants who had a BOR of CR or PR or SD (minimum duration from randomization to SD greater than or equal to 7 weeks). Assessments were performed every 8 weeks and were based on investigator review data using RECIST 1.1. The 95% CI was constructed using the method of Clopper and Pearson. DCR = CR + PR + SD greater than or equal to 7 weeks.

    4. Durable Stable Disease (SD) Rate [Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months]

      The durable SD rate was defined as the percentage of participants whose BOR was SD and the duration of SD was greater than or equal to 23 weeks. The durable SD was based on investigator review data using RECIST 1.1. The 95% CI was constructed using the method of Clopper and Pearson.

    5. Clinical Benefit Rate (CBR) [Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months]

      The CBR was defined as the percentage of participants who had BOR of CR, PR, or durable SD (duration of SD was greater than or equal to 23 weeks) and was based on investigator review data using RECIST 1.1. The BOR was defined as the best response recorded from the start of study treatment until discontinuation from the study. There was no requirement for confirmatory measurement of PR or CR to deem either one the BOR. The 95% CI was constructed using the method of Clopper and Pearson. CBR = CR + PR + SD greater than or equal to 23 weeks.

    6. Summary of Plasma Concentrations of Lenvatinib for Sparse Pharmacokinetic (PK) Sampling for Phase 1b and Phase 2 [Cycle 1 (Day 1), Cycle 2 (Day 1), Cycle 3 (Day 1)]

      Blood samples were collected during the Randomization Phase. Most participants had 6 samples taken over 3 cycles of treatment (sparse sampling - 2 samples taken per cycle, one at predose and one at 2 to 8 hours postdose). Plasma concentrations of lenvatinib were measured and concentration data were summarized. The summary statistics at time points with one or more below the limit of quantitation (BLQ) values were calculated by assigning zero for each BLQ value.

    7. Summary of Blood Concentrations of Everolimus for Sparse PK Sampling for Phase 1b and Phase 2 [Cycle 1 (Day 1), Cycle 2 (Day 1), Cycle 3 (Day 1)]

      Blood samples were collected during the Randomization Phase. Most participants had 6 samples taken over 3 cycles of treatment (sparse sampling - 2 samples taken per cycle, one at predose and one at 2 to 8 hours postdose). Whole blood concentrations of everolimus were measured and concentration data were summarized. The summary statistics at time points with one or more BLQ values were calculated by assigning zero for each BLQ value.

    8. Area Under the Plasma Concentration-Time Curve From 0 to 24 Hours (AUC(0-24)) for Lenvatinib When Administered Alone or in Combination With Everolimus [Phase 2: Cycle 1 Day 15 immediately predose, and 30 minutes, 1, 2, 3, 4, 8, 12 (optional), and 24 hours postdose (predose on Day 16)]

      Between 9 and 12 participants in each of the 3 treatment arms participated in an optional substudy where instead of the sparse sampling, 9 samples were to be taken over 1 single 24-hour period (i.e., intensive sampling) for full PK profiling. Blood samples were analyzed for study drug using standardized methods. PK parameters for lenvatinib were derived from lenvatinib concentration data using non-compartmental methods. Data were compared via descriptive statistics between single agent and combination therapy.

    9. Maximum Concentration (Cmax) of Lenvatinib in Plasma When Administered Alone or in Combination With Everolimus [Phase 2: Cycle 1 Day 15]

      Cmax for lenvatinib was defined as the maximum observed concentration of lenvatinib in plasma following administration of study treatment on Cycle 1 Day 15 and was obtained directly from the measured plasma concentration-time curves.

    10. Time to Cmax (Tmax) for Lenvatinib When Administered Alone or in Combination With Everolimus [Phase 2: Cycle 1 Day 15]

      Tmax for lenvatinib was the amount of time taken after administration of study treatment on Cycle 1 Day 15 to reach maximum concentration (Cmax) of lenvatinib in plasma.

    11. Area Under the Blood Concentration-Time Curve From 0 to 24 Hours for Everolimus When Administered Alone or in Combination With Lenvatinib [Phase 2: Cycle 1 Day 15 immediately predose, and 30 minutes, 1, 2, 3, 4, 8, 12 (optional), and 24 hours postdose (predose on Day 16)]

      Between 9 and 12 participants in each of the 3 treatment arms participated in an optional substudy where instead of the sparse sampling, 9 samples were to be taken over 1 single 24-hour period (i.e., intensive sampling) for full PK profiling. Blood samples were analyzed for study drug using standardized methods. PK parameters for everolimus were derived from everolimus concentration data using non-compartmental methods. Data were compared via descriptive statistics between single agent and combination therapy.

    12. Maximum Concentration of Everolimus (Cmax) in Blood When Administered Alone or in Combination With Lenvatinib [Phase 2: Cycle 1 Day 15]

      Cmax for everolimus was defined as the maximum observed concentration of everolimus in blood following administration of study treatment on Cycle 1 Day 15 and was obtained directly from the measured blood concentration-time curves.

    13. Time to Cmax (Tmax) for Everolimus When Administered Alone or in Combination With Lenvatinib [Phase 2: Cycle 1 Day 15]

      Tmax for everolimus was the amount of time taken after administration of study treatment on Cycle 1 Day 15 to reach the maximum concentration (Cmax) of everolimus in blood.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 99 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Select Inclusion Criteria:
    • Histologically confirmed diagnosis of renal cell carcinoma.

    • Phase 2: Histological or cytological confirmation of predominant clear cell renal cell carcinoma (RCC) (original tissue diagnosis of RCC is acceptable).

    • Documented evidence of unresectable advanced or metastatic RCC. Phase 2: Radiographic evidence of disease progression according to modified Response Evaluation Criteria in Solid Tumors (RECIST 1.1).

    • Phase 2: One prior vascular endothelial growth factor (VEGF)-targeted treatment (for example, but not limited to, sunitinib, sorafenib, pazopanib, bevacizumab, axitinib, vatalanib, AV951/tivozanib) for unresectable advanced or metastatic RCC.

    • Phase 2: Measurable disease meeting the following criteria: a.) at least 1 lesion of greater than or equal to 1.5 cm in the longest diameter for a non-lymph node or greater than or equal to 1.5 cm in the short axis diameter for a lymph node which is serially measurable according to Modified RECIST 1.1 using computerized tomography/magnetic resonance imaging (CT/MRI) or photography. Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1.

    • Adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP less than or equal to 150/90 mmHg at screening and no change in antihypertensive medications within 1 week prior to the Screening Visit.

    Select Exclusion Criteria:
    Phase 1b or Phase 2 specific per below:
    • Phase 1b only: Subjects with untreated or unstable metastasis to the central nervous system (CNS) are excluded. Subjects who have completed local therapy and have discontinued the use of steroids for this indication at least 4 weeks prior to commencing treatment and in whom stability has been proven by at least 2 CT or MRI scans obtained at least 4 weeks apart are eligible for Phase 1b only. Phase 2 only: Subjects with CNS (e.g., brain or leptomeningeal) metastasis are excluded.

    • Phase 2 only: More than one prior VEGF-targeted treatment for unresectable advanced or metastatic RCC.

    Phase 1b or Phase 2 specific per below:
    • Phase 1b only: Prior exposure to lenvatinib. Phase 2 only: Prior exposure to lenvatinib or mammalian target of rapamycin (mTOR) inhibitor.

    • Subjects should not have received any anticancer treatment within 21 days or any investigational agent within 30 days prior to the first dose of study drug and should have recovered from any toxicity related to previous anticancer treatment. Major surgery within 3 weeks prior to the first dose of study drug.

    • Subjects having greater than 1+ proteinuria on urinalysis will undergo 24-hour urine collection for quantitative assessment of proteinuria.

    • Subjects with urine protein greater than or equal to 1 g/24 hours will be ineligible. Uncontrolled diabetes as defined by fasting serum glucose at 1.5 x ULN.

    • Phase 2 only: Active malignancy (except for renal cell carcinoma, melanoma in-situ, basal or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix) within the past 24 months.

    • Known intolerance to any of the study drugs (or any of the excipients) and/or known hypersensitivity to rapamycins (e.g., sirolimus, everolimus, temsirolimus) or any of the excipients.

    • Phase 1b only: Subjects who discontinued prior tyrosine kinase inhibitor due to toxicity will be ineligible.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Tucson Arizona United States
    2 Orange California United States
    3 San Diego California United States
    4 Tampa Florida United States
    5 Joliet Illinois United States
    6 Louisville Kentucky United States
    7 Annapolis Maryland United States
    8 Bethesda Maryland United States
    9 Boston Massachusetts United States
    10 Tupelo Mississippi United States
    11 New York New York United States
    12 Tulsa Oklahoma United States
    13 Charleston South Carolina United States
    14 Dallas Texas United States
    15 Brno Czechia
    16 Olomouc Czechia
    17 Prague Czechia
    18 Gdansk Poland
    19 Lodz Poland
    20 Szczecin Poland
    21 Warsaw Poland
    22 Barcelona Spain
    23 Cordoba Spain
    24 Madrid Spain
    25 Pamplona Spain
    26 Bristol United Kingdom
    27 Cambridge United Kingdom
    28 Cardiff United Kingdom
    29 Glasgow United Kingdom
    30 Guildford United Kingdom
    31 Ipswich United Kingdom
    32 Leicester United Kingdom
    33 London United Kingdom
    34 Manchester United Kingdom
    35 Southampton United Kingdom
    36 Surrey United Kingdom
    37 Wirral United Kingdom

    Sponsors and Collaborators

    • Eisai Inc.

    Investigators

    • Study Director: Eisai Medical Services, Eisai Limited

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Eisai Inc.
    ClinicalTrials.gov Identifier:
    NCT01136733
    Other Study ID Numbers:
    • E7080-G000-205
    First Posted:
    Jun 3, 2010
    Last Update Posted:
    Feb 27, 2019
    Last Verified:
    Jan 1, 2018

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail A total of 173 participants were enrolled into the study and treated.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18mg) and everolimus (5 mg) was once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Period Title: Phase 1b
    STARTED 7 11 2 0 0 0 0
    COMPLETED 6 6 0 0 0 0 0
    NOT COMPLETED 1 5 2 0 0 0 0
    Period Title: Phase 1b
    STARTED 0 0 0 0 51 52 50
    COMPLETED 0 0 0 0 0 0 0
    NOT COMPLETED 0 0 0 0 51 52 50

    Baseline Characteristics

    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus Total
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) was once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles. Total of all reporting groups
    Overall Participants 7 11 2 0 51 52 50 173
    Age, Customized (Years) [Geometric Mean (Standard Deviation) ]
    Phase 1b
    58.0
    (3.92)
    58.1
    (7.97)
    61.0
    (2.83)
    0
    (0)
    0
    (0)
    0
    (0)
    58.4
    (6.29)
    Phase 2
    0
    (0)
    0
    (0)
    0
    (0)
    61.7
    (8.2)
    63.3
    (8.6)
    58.9
    (9.2)
    61.3
    (8.8)
    Sex: Female, Male (Count of Participants)
    Female
    3
    42.9%
    2
    18.2%
    1
    50%
    16
    Infinity
    13
    25.5%
    12
    23.1%
    47
    94%
    Male
    4
    57.1%
    9
    81.8%
    1
    50%
    35
    Infinity
    39
    76.5%
    38
    73.1%
    126
    252%

    Outcome Measures

    1. Primary Outcome
    Title Phase 1b: Number of Participants With Dose-limiting Toxicity (DLT)
    Description A DLT was defined as either a treatment-related failure to administer greater than or equal to (>=) 75% of the planned dosage of lenvatinib/everolimus or a specific National Cancer Institute Common Toxicity Criteria (NCI CTC) >= Grade 3 (severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care daily living activities) hematologic or nonhematologic toxicities considered to be possibly related to lenvatinib and/or everolimus therapy assessed during the first treatment cycle of each dose level. Higher grade indicates more severe toxicity.
    Time Frame First dose of study drug (Cycle 1 Day 1) to end of first 4 weeks of therapy (Cycle 1)

    Outcome Measure Data

    Analysis Population Description
    Safety analysis set included all participants who received at least one dose of study treatment.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 7 11 2 0 0 0 0
    Grade 3 abdominal pain
    1
    14.3%
    0
    0%
    0
    0%
    Grade 2 fatigue with Grade 1 GI reflux & anorexia
    0
    0%
    1
    9.1%
    0
    0%
    Grade 3 nausea
    0
    0%
    0
    0%
    1
    50%
    Grade 2 stomatitis
    0
    0%
    0
    0%
    1
    50%
    2. Primary Outcome
    Title Phase 1b: Maximum Tolerated Dose (MTD) and Recommended Phase 2 (RP2) Dose
    Description The highest dose level resulting in 0 or 1 DLT in 6 participants was to be considered the MTD of Phase 1b. Once the MTD was established, the participant cohort was expanded to a minimum of 10 participants. The MTD was confirmed by assessing DLTs during Cycle 1 and intolerable toxicities (i.e., not manageable with dose interruption and/or reduction) during Cycle 2 of therapy. Once the dose of lenvatinib/everolimus combination to be used in the succeeding Phase 2 part of the study was established, enrollment into Phase 2 was started. The RP2 dose was the same as the confirmed MTD and was used for the Phase 2 Treatment Arm A of this study.
    Time Frame First dose of study drug (Cycle 1 Day 1) to end of Cycle 2 (1 cycle = 28 days/4 weeks)

    Outcome Measure Data

    Analysis Population Description
    Safety analysis set included all participants who received at least one dose of study treatment.
    Arm/Group Title Phase 1b: Dose Escalation and MTD Expansion Cohorts
    Arm/Group Description Oral everolimus (18 mg) and lenvatinib (5 mg) were taken once daily in the morning (consistently with or without food) with water. Any dietary habits around the time of study medication intake had to be kept as consistent as possible throughout the study.
    Measure Participants 11
    Number [mg/day]
    18.0
    3. Primary Outcome
    Title Phase 2: Progression-Free Survival (PFS)
    Description PFS was defined as the time (in months) from the date of first dose of study drug to the first documentation of disease progression or death, whichever occurred first. Kaplan-Meier (K-M) estimates were used to estimate median PFS, presented with 2-sided 95% confidence intervals (CIs). Tumor assessments were performed every 8 weeks (or sooner if there was evidence of progressive disease using computed tomography (CT) or magnetic resonance imaging (MRI) and scan acquisition techniques (including use or nonuse of intravenous (IV) contrast). Tumor response was determined at the site by the investigator and radiologist using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 in the evaluation of the tumor assessment scans. The date of objective disease progression was defined as the earliest date of radiological disease progression. Participants removed from therapy due to clinical progression with no radiologic confirmation were censored at their last radiologic assessment date.
    Time Frame Date of randomization into Phase 2 (Cycle 1 Day 1) to the date of first documentation of disease progression or death (whichever occurred first), assessed up to data cutoff date (13 Jun 2014), up to approximately 2 years and 3 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Median (95% Confidence Interval) [Months]
    14.6
    7.4
    5.5
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm C): 10 mg Everolimus
    Comments Null hypothesis of no difference in PFS was analyzed using the stratified log-rank test with hemoglobin (less than or equal to 13 g/dL vs greater than 13 g/dL for males; and less than or equal to 11.5 g/dL vs greater than 11.5 g/dL for females) and corrected serum calcium (greater than or equal to 10 mg/dL vs less than 10 mg/dL) as stratification factors. Each null hypothesis was tested at a nominal alpha=0.05.
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value =0.0005
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.40
    Confidence Interval (2-Sided) 95%
    0.24 to 0.68
    Parameter Dispersion Type:
    Value:
    Estimation Comments Hazard ratio between treatment groups and corresponding 95% CI was estimated using the stratified Cox regression model (stratified by hemoglobin and corrected serum calcium) with treatment as a factor.
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm B): 24 mg Lenvatinib, Phase 2 (Arm C): 10 mg Everolimus
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value 0.0479
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.61
    Confidence Interval (2-Sided) 95%
    0.38 to 0.98
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm B): 24 mg Lenvatinib
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value 0.1209
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.66
    Confidence Interval (2-Sided) 95%
    0.39 to 1.10
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    4. Secondary Outcome
    Title Phase 2: Overall Survival (OS)
    Description OS was defined as the time (in months) from the date of randomization until date of death from any cause. Median survival time was calculated using K-M estimate for each treatment arm and presented with 2-sided 95% CIs. Participants who were lost to follow-up or alive at the data cutoff date (10 Dec 2014) were censored at the date the participants were last known to be alive.
    Time Frame Randomization (Cycle 1 Day 1) until date of death from any cause, assessed up to the data cutoff date (10 Dec 2014), up to approximately 2 years and 9 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set which included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Median (95% Confidence Interval) [Months]
    25.5
    19.1
    15.4
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm C): 10 mg Everolimus
    Comments Planned analyses were performed to test null hypothesis of treatment difference in OS at a nominal significance level of 0.05 (2-sided) using the stratified log-rank test using stratification factors.
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value =0.0242
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.514
    Confidence Interval (2-Sided) 95%
    0.299 to 0.884
    Parameter Dispersion Type:
    Value:
    Estimation Comments Hazard ratio between treatment groups and corresponding 95% CI was estimated using the stratified Cox regression model (stratified by hemoglobin and corrected serum calcium) with treatment as a factor.
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm B): 24 mg Lenvatinib, Phase 2 (Arm C): 10 mg Everolimus
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value =0.1181
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.684
    Confidence Interval (2-Sided) 95%
    0.411 to 1.138
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm B): 24 mg Lenvatinib
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value =0.3157
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Hazard Ratio (HR)
    Estimated Value 0.751
    Confidence Interval (2-Sided) 95%
    0.433 to 1.301
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    5. Secondary Outcome
    Title Phase 2: Objective Response Rate (ORR)
    Description The ORR was defined as the percentage of participants who had the best overall response (BOR) of complete response (CR) or partial response (PR) as determined by the investigator, using RECIST 1.1 in the evaluation of MRI or CT scans of targeted lesions. Tumor assessments were performed every 8 weeks (or sooner if there was evidence of progressive disease). The BOR was defined as the best response recorded from the start of the study treatment until discontinuation from the study. CR was defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to less than 10 mm. PR was defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR = CR + PR was calculated with exact 95% CIs using the method of Clopper and Pearson.
    Time Frame Randomization (Cycle 1 Day 1) until first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set which included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Number (95% Confidence Interval) [Percentage of participants]
    43.1
    615.7%
    26.9
    244.5%
    6.0
    300%
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm C): 10 mg Everolimus
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments Analysis performed after database lock. P-value was based on the 2-sided Fisher's exact P-value.
    Method Fisher Exact
    Comments
    Method of Estimation Estimation Parameter Rate ratio
    Estimated Value 7.2
    Confidence Interval (2-Sided) 95%
    2.3 to 22.5
    Parameter Dispersion Type:
    Value:
    Estimation Comments Rate ratio was based on the normal approximation.
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm B): 24 mg Lenvatinib, Phase 2 (Arm C): 10 mg Everolimus
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value 0.0067
    Comments Analysis performed after database lock. P-value was based on the 2-sided Fisher's exact P-value.
    Method Fisher Exact
    Comments
    Method of Estimation Estimation Parameter Rate ratio
    Estimated Value 4.5
    Confidence Interval (2-Sided) 95%
    1.4 to 14.7
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus, Phase 2 (Arm B): 24 mg Lenvatinib
    Comments
    Type of Statistical Test Superiority or Other
    Comments
    Statistical Test of Hypothesis p-Value =0.1007
    Comments Analysis performed after database lock. P-value was based on the 2-sided Fisher's exact P-value.
    Method Fisher Exact
    Comments
    Method of Estimation Estimation Parameter Rate ratio
    Estimated Value 1.6
    Confidence Interval (2-Sided) 95%
    0.9 to 2.8
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    6. Secondary Outcome
    Title Disease Control Rate (DCR)
    Description The DCR was defined as the percentage of participants who had a BOR of CR or PR or SD (minimum duration from randomization to SD greater than or equal to 7 weeks). Assessments were performed every 8 weeks and were based on investigator review data using RECIST 1.1. The 95% CI was constructed using the method of Clopper and Pearson. DCR = CR + PR + SD greater than or equal to 7 weeks.
    Time Frame Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set which included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day withwater, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Number (95% Confidence Interval) [Percentage of participants]
    84.3
    1204.3%
    78.8
    716.4%
    68.0
    3400%
    7. Secondary Outcome
    Title Durable Stable Disease (SD) Rate
    Description The durable SD rate was defined as the percentage of participants whose BOR was SD and the duration of SD was greater than or equal to 23 weeks. The durable SD was based on investigator review data using RECIST 1.1. The 95% CI was constructed using the method of Clopper and Pearson.
    Time Frame Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set which included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Number (95% Confidence Interval) [Percentage of participants]
    25.5
    364.3%
    38.5
    350%
    36.0
    1800%
    8. Secondary Outcome
    Title Clinical Benefit Rate (CBR)
    Description The CBR was defined as the percentage of participants who had BOR of CR, PR, or durable SD (duration of SD was greater than or equal to 23 weeks) and was based on investigator review data using RECIST 1.1. The BOR was defined as the best response recorded from the start of study treatment until discontinuation from the study. There was no requirement for confirmatory measurement of PR or CR to deem either one the BOR. The 95% CI was constructed using the method of Clopper and Pearson. CBR = CR + PR + SD greater than or equal to 23 weeks.
    Time Frame Baseline (Randomization) to first evidence of disease progression, assessed up to the data cutoff date (13 Jun 2014), or up to approximately 2 years and 3 months

    Outcome Measure Data

    Analysis Population Description
    Full analysis set which included all randomized participants.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4 week) cycles.
    Measure Participants 0 0 0 0 51 52 50
    Number (95% Confidence Interval) [Percentage of participants]
    68.6
    980%
    65.4
    594.5%
    42.0
    2100%
    9. Secondary Outcome
    Title Summary of Plasma Concentrations of Lenvatinib for Sparse Pharmacokinetic (PK) Sampling for Phase 1b and Phase 2
    Description Blood samples were collected during the Randomization Phase. Most participants had 6 samples taken over 3 cycles of treatment (sparse sampling - 2 samples taken per cycle, one at predose and one at 2 to 8 hours postdose). Plasma concentrations of lenvatinib were measured and concentration data were summarized. The summary statistics at time points with one or more below the limit of quantitation (BLQ) values were calculated by assigning zero for each BLQ value.
    Time Frame Cycle 1 (Day 1), Cycle 2 (Day 1), Cycle 3 (Day 1)

    Outcome Measure Data

    Analysis Population Description
    Pharmacokinetic analysis set included all participants who have received at least one dose of study drug (lenvatinib or everolimus) and have evaluable concentration data.
    Arm/Group Title Cycle 1, Day 1 (0 Hours) Cycle 1, Day 1 (2-8 Hours) Cycle 2, Day 1 (0 Hours) Cycle 2, Day 1 (2-8 Hours) Cycle 3, Day 1 (0 Hours) Cycle 3, Day 1 (2-8 Hours)
    Arm/Group Description Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration.
    Measure Participants 57 55 45 41 42 40
    Geometric Mean (Standard Deviation) [ng/mL]
    5.6
    (29.8)
    197
    (140)
    66.9
    (52.7)
    237
    (154)
    37.0
    (35.5)
    180
    (118)
    10. Secondary Outcome
    Title Summary of Blood Concentrations of Everolimus for Sparse PK Sampling for Phase 1b and Phase 2
    Description Blood samples were collected during the Randomization Phase. Most participants had 6 samples taken over 3 cycles of treatment (sparse sampling - 2 samples taken per cycle, one at predose and one at 2 to 8 hours postdose). Whole blood concentrations of everolimus were measured and concentration data were summarized. The summary statistics at time points with one or more BLQ values were calculated by assigning zero for each BLQ value.
    Time Frame Cycle 1 (Day 1), Cycle 2 (Day 1), Cycle 3 (Day 1)

    Outcome Measure Data

    Analysis Population Description
    Pharmacokinetic analysis set included all participants who received at least one dose of study drug (lenvatinib or everolimus) and had evaluable concentration data.
    Arm/Group Title Cycle 1, Day 1 (0 Hours) Cycle 1, Day 1 (2-8 Hours) Cycle 2, Day 1 (0 Hours) Cycle 2, Day 1 (2-8 Hours) Cycle 3, Day 1 (0 Hours) Cycle 3, Day 1 (2-8 Hours)
    Arm/Group Description Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected immediately prior to study drug administration. Lenvatinib (18 mg) and everolimus (5 mg) were administered as described previously. Blood samples were collected 2 to 8 hours after study drug administration.
    Measure Participants 37 35 29 28 27 25
    Geometric Mean (Standard Deviation) [ng/mL]
    0.0
    (0.00)
    19.4
    (9.16)
    10.0
    (7.28)
    24.3
    (14.2)
    6.8
    (6.06)
    26.4
    (14.8)
    11. Secondary Outcome
    Title Area Under the Plasma Concentration-Time Curve From 0 to 24 Hours (AUC(0-24)) for Lenvatinib When Administered Alone or in Combination With Everolimus
    Description Between 9 and 12 participants in each of the 3 treatment arms participated in an optional substudy where instead of the sparse sampling, 9 samples were to be taken over 1 single 24-hour period (i.e., intensive sampling) for full PK profiling. Blood samples were analyzed for study drug using standardized methods. PK parameters for lenvatinib were derived from lenvatinib concentration data using non-compartmental methods. Data were compared via descriptive statistics between single agent and combination therapy.
    Time Frame Phase 2: Cycle 1 Day 15 immediately predose, and 30 minutes, 1, 2, 3, 4, 8, 12 (optional), and 24 hours postdose (predose on Day 16)

    Outcome Measure Data

    Analysis Population Description
    Pharmacokinetic sub analysis set consisted of all participants who agreed to participate in the intensive PK sampling portion of Phase 2 of the study, had received at least 1 dose of study drug (lenvatinib or everolimus), and had evaluable concentration data.
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 24 mg Lenvatinib
    Arm/Group Description Oral lenvatinib (18mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 8 9
    Mean (Standard Deviation) [ng·hr/mL]
    3185
    (1030)
    5252
    (2717)
    12. Secondary Outcome
    Title Maximum Concentration (Cmax) of Lenvatinib in Plasma When Administered Alone or in Combination With Everolimus
    Description Cmax for lenvatinib was defined as the maximum observed concentration of lenvatinib in plasma following administration of study treatment on Cycle 1 Day 15 and was obtained directly from the measured plasma concentration-time curves.
    Time Frame Phase 2: Cycle 1 Day 15

    Outcome Measure Data

    Analysis Population Description
    PK sub analysis set
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 24 mg Lenvatinib
    Arm/Group Description Oral lenvatinib (18mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 8 9
    Mean (Standard Deviation) [ng/mL]
    327
    (179)
    403
    (165)
    13. Secondary Outcome
    Title Time to Cmax (Tmax) for Lenvatinib When Administered Alone or in Combination With Everolimus
    Description Tmax for lenvatinib was the amount of time taken after administration of study treatment on Cycle 1 Day 15 to reach maximum concentration (Cmax) of lenvatinib in plasma.
    Time Frame Phase 2: Cycle 1 Day 15

    Outcome Measure Data

    Analysis Population Description
    PK sub analysis set
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 24 mg Lenvatinib
    Arm/Group Description Oral lenvatinib (18mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 8 9
    Median (Full Range) [Hours]
    2.0
    4.0
    14. Secondary Outcome
    Title Area Under the Blood Concentration-Time Curve From 0 to 24 Hours for Everolimus When Administered Alone or in Combination With Lenvatinib
    Description Between 9 and 12 participants in each of the 3 treatment arms participated in an optional substudy where instead of the sparse sampling, 9 samples were to be taken over 1 single 24-hour period (i.e., intensive sampling) for full PK profiling. Blood samples were analyzed for study drug using standardized methods. PK parameters for everolimus were derived from everolimus concentration data using non-compartmental methods. Data were compared via descriptive statistics between single agent and combination therapy.
    Time Frame Phase 2: Cycle 1 Day 15 immediately predose, and 30 minutes, 1, 2, 3, 4, 8, 12 (optional), and 24 hours postdose (predose on Day 16)

    Outcome Measure Data

    Analysis Population Description
    PK sub analysis set. n=8 for AUC(0-24)
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 4 8
    Mean (Standard Deviation) [ng·hr/mL]
    378
    (88.1)
    463
    (263)
    15. Secondary Outcome
    Title Maximum Concentration of Everolimus (Cmax) in Blood When Administered Alone or in Combination With Lenvatinib
    Description Cmax for everolimus was defined as the maximum observed concentration of everolimus in blood following administration of study treatment on Cycle 1 Day 15 and was obtained directly from the measured blood concentration-time curves.
    Time Frame Phase 2: Cycle 1 Day 15

    Outcome Measure Data

    Analysis Population Description
    PK sub analysis set
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 4 11
    Mean (Standard Deviation) [ng/mL]
    38
    (14.5)
    54
    (24.9)
    16. Secondary Outcome
    Title Time to Cmax (Tmax) for Everolimus When Administered Alone or in Combination With Lenvatinib
    Description Tmax for everolimus was the amount of time taken after administration of study treatment on Cycle 1 Day 15 to reach the maximum concentration (Cmax) of everolimus in blood.
    Time Frame Phase 2: Cycle 1 Day 15

    Outcome Measure Data

    Analysis Population Description
    PK sub analysis set
    Arm/Group Title Phase 2: 18 mg Lenvatinib + 5 mg Everolimus Phase 2: 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4-week) cycles.
    Measure Participants 4 11
    Median (Full Range) [Hours]
    1.0
    1.0

    Adverse Events

    Time Frame Treatment-emergent adverse events (AEs) were collected and defined as those AEs that occurred after the first dose of study medication and up to 30 days after the last dose of study medication. AEs were collected for approximately 4 years.
    Adverse Event Reporting Description Safety analysis set included all participants who received at least one dose of study drug/s and had at least one postbaseline safety evaluation. AE severity was assessed using Common Terminology for Adverse Events (CTCAE). Serious AEs were followed until the event resolved or the event or sequelae stabilized.
    Arm/Group Title Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Arm/Group Description Oral lenvatinib (12 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in a fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no dose-limiting toxicity (DLT) occurred, then enrollment proceeded to Cohort 2. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 1. If 1 or none of the 6 participants had a DLT, then enrollment proceeded to Cohort 2. If 2 or more participants had a DLT during Cycle 1, the dose escalation committee (DEC) decided if they were lenvatinib-related and if enrollment could proceed, lenvatinib was reduced to 6 mg daily (everolimus dose was not reduced). If it could not be determined that the DLTs were lenvatinib-related, enrollment stopped. Oral lenvatinib (18 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment would proceed to Cohort 3. If 1 participant had a DLT, 3 more participants were enrolled in Cohort 2. If 1 or none of the 6 participants exhibited a DLT, enrollment proceeded to Cohort 3. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. Oral lenvatinib (24 mg) and everolimus (5 mg) were taken once daily in continuous 28-day cycles. Dose Escalation Cohort-Cycle 1: both study drugs were taken at the same time of day in the fasting state with water. Cycles 2, 3, etc. and Expansion Cohort: both study drugs were taken at the same time of day with water, either after a meal or in a fasting state. Dose escalation began with 3 participants in Cohort 1. If no DLT occurred, then enrollment proceeded to Cohort 4. If 1 participant had a DLT, 3 more participants were enrolled Cohort 3. If 1 or none of the 6 participants exhibited a DLT, then enrollment proceeded to Cohort 4. If 2 or more participants had a DLT during Cycle 1, dose escalation ceased and additional participants were enrolled to the next lower dose to achieve a total of 6 participants in that cohort. The DLT was achieved and no participants were enrolled into this cohort. Oral lenvatinib (18mg) and everolimus (5 mg) were taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Treatment cycles began with the first dose of study drug in Cycle 1 and continued in 28-day (4-week) consecutive cycles until completion of the off-treatment assessments (within 30 days after the last study treatment administration). Study drugs were administered at the clinic for the first dose and on the pharmacokinetic (PK) sampling days. Oral lenvatinib (24 mg) was taken once daily in the morning (consistently with or without food) with water, in continuous 28-day (4-week) cycles. Oral everolimus (10 mg) was taken once daily in the morning (consistently either with or without food) with water, in continuous 28-day (4 week) cycles.
    All Cause Mortality
    Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 6/7 (85.7%) 9/11 (81.8%) 0/2 (0%) 0/0 (NaN) 43/51 (84.3%) 40/52 (76.9%) 45/50 (90%)
    Serious Adverse Events
    Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 6/7 (85.7%) 8/11 (72.7%) 0/2 (0%) 0/0 (NaN) 30/51 (58.8%) 28/52 (53.8%) 21/50 (42%)
    Blood and lymphatic system disorders
    Anaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 1/52 (1.9%) 4/50 (8%)
    Sideroblastic Anaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Thrombocytopenia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 0/52 (0%) 0/50 (0%)
    Cardiac disorders
    Cardiomyopathy 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Myocardial Infarction 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Acute Myocardial Infarction 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 3/52 (5.8%) 1/50 (2%)
    Cardiac Failure 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Cardiac Failure Congestive 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Tachycardia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Ear and labyrinth disorders
    Vertigo Positional 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Endocrine disorders
    Inappropriate Antidiuretic Hormone Secretion 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Gastrointestinal disorders
    Abdominal Pain 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Gastritis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Vomiting 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 0/50 (0%)
    Diarrhoea 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 0/52 (0%) 0/50 (0%)
    Dysphagia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Gastric Haemorrhage 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Ileus 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Haemorrhoids 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    General disorders
    Fatigue 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    General Physical Health Deterioration 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 0/50 (0%)
    Non-Cardiac Chest Pain 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Asthenia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 1/50 (2%)
    Chest Discomfort 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 1/50 (2%)
    Pyrexia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 1/50 (2%)
    Hepatobiliary disorders
    Cholangitis 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Cholecystitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 0/50 (0%)
    Cholecystitis Acute 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Immune system disorders
    Drug Hypersensitivity 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Infections and infestations
    Cellulitis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Lung Infection 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Appendicitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Appendicitis Perforated 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Bronchopneumonia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Diabetic Foot Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Escherichia Sepsis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 1/50 (2%)
    Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Infectious Pleural Effusion 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Lower Respiratory Tract Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 2/50 (4%)
    Osteomyelitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 1/50 (2%)
    Parotitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Pneumonia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 1/50 (2%)
    Rectal Abscess 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Sepsis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 1/50 (2%)
    Upper Respiratory Tract Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Injury, poisoning and procedural complications
    Joint Dislocation 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Spinal Compression Fracture 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Toxicity to Various Agents 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Investigations
    Ejection Fraction Decreased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    White Blood Cell Count Decreased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Blood Bilirubin Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Blood Creatinine Phosphokinase Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Body Temperature Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Electrocardiogram Repolarisation Abnormality 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Fibrin D Dimer Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Transaminases Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Lipase Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Metabolism and nutrition disorders
    Dehydration 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 0/52 (0%) 0/50 (0%)
    Hypercholesterolaemia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Hyponatraemia 2/7 (28.6%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Decreased Appetite 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Failure to Thrive 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Glucose Tolerance Impaired 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Hyperkalaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 0/50 (0%)
    Hypomagnesaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Malnutrition 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Hypokalaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Back Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Flank Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Haemarthrosis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Musculoskeletal Chest Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 0/50 (0%)
    Psoriatic Arthropathy 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Pathological Fracture 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Spinal Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastatic Pain 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Malignant Pleural Effusion 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Nervous system disorders
    Cerebral Haemorrhage 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Convulsion 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 1/50 (2%)
    Haemorrhage Intracranial 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Headache 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 3/52 (5.8%) 1/50 (2%)
    Ischaemic Stroke 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Paresis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Posterior Reversible Encephalopathy Syndrome 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Somnolence 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Spinal Cord Compression 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Trigeminal Neuralgia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Carotid Artery Occlusion 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Psychiatric disorders
    Anxiety 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Confusional State 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 0/50 (0%)
    Renal and urinary disorders
    Proteinuria 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Renal Failure Acute 1/7 (14.3%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 4/52 (7.7%) 0/50 (0%)
    Haematuria 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Renal Impairment 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 0/50 (0%)
    Reproductive system and breast disorders
    Benign Prostatic Hyperplasia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 2/50 (4%)
    Pleural Effusion 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Acute Respiratory Failure 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 1/50 (2%)
    Haemoptysis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Pneumonitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 3/50 (6%)
    Pulmonary Embolism 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 1/50 (2%)
    Vascular disorders
    Deep Vein Thrombosis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Hot Flush 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Subclavian Vein Thrombosis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Venous Thrombosis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Other (Not Including Serious) Adverse Events
    Phase 1b (Cohort 1): 12 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 2): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 3): 24 mg Lenvatinib Plus 5 mg Everolimus Phase 1b (Cohort 4): 24 mg Lenvatinib Plus 10 mg Everolimus Phase 2 (Arm A): 18 mg Lenvatinib Plus 5 mg Everolimus Phase 2 (Arm B): 24 mg Lenvatinib Phase 2 (Arm C): 10 mg Everolimus
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 7/7 (100%) 11/11 (100%) 2/2 (100%) 0/0 (NaN) 51/51 (100%) 51/52 (98.1%) 50/50 (100%)
    Blood and lymphatic system disorders
    Anaemia 2/7 (28.6%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 7/51 (13.7%) 3/52 (5.8%) 11/50 (22%)
    Haemorrhagic Disorder 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Lymphadenopathy 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Neutropenia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Thrombocytopenia 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 1/52 (1.9%) 4/50 (8%)
    Cardiac disorders
    Angina Pectoris 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Aortic Valve Incompetence 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Coronary Artery Disease 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Coronary Artery Occlusion 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Mitral Valve Incompetence 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Palpitations 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 2/50 (4%)
    Tachycardia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Ventricular Hypokinesia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Left ventricular dysfunction 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Ear and labyrinth disorders
    Ear Pain 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Vertigo 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 3/52 (5.8%) 0/50 (0%)
    Endocrine disorders
    Hypothyroidism 1/7 (14.3%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 12/51 (23.5%) 19/52 (36.5%) 1/50 (2%)
    Inappropriate Antidiuretic Hormone Secretion 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Eye disorders
    Diplopia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Eye Swelling 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Ocular Hyperaemia 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Vision Blurred 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Gastrointestinal disorders
    Abdominal Pain 1/7 (14.3%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 12/51 (23.5%) 11/52 (21.2%) 1/50 (2%)
    Abdominal Pain Upper 2/7 (28.6%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 8/51 (15.7%) 7/52 (13.5%) 3/50 (6%)
    Anal Pruritus 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Anorectal Discomfort 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Aphthous Stomatitis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 0/50 (0%)
    Constipation 3/7 (42.9%) 4/11 (36.4%) 1/2 (50%) 0/0 (NaN) 6/51 (11.8%) 19/52 (36.5%) 9/50 (18%)
    Diarrhoea 3/7 (42.9%) 7/11 (63.6%) 1/2 (50%) 0/0 (NaN) 43/51 (84.3%) 37/52 (71.2%) 17/50 (34%)
    Dry Mouth 1/7 (14.3%) 0/11 (0%) 1/2 (50%) 0/0 (NaN) 2/51 (3.9%) 6/52 (11.5%) 3/50 (6%)
    Dyspepsia 0/7 (0%) 4/11 (36.4%) 0/2 (0%) 0/0 (NaN) 6/51 (11.8%) 6/52 (11.5%) 6/50 (12%)
    Flatulence 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 3/52 (5.8%) 0/50 (0%)
    Gastric Haemorrhage 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Gastritis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 0/52 (0%) 0/50 (0%)
    Gastrooesophageal Reflux Disease 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 2/52 (3.8%) 0/50 (0%)
    Gingival Bleeding 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Glossitis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Glossodynia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Haemorrhoidal Haemorrhage 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Haemorrhoids 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 0/50 (0%)
    Lip Discolouration 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Nausea 6/7 (85.7%) 6/11 (54.5%) 1/2 (50%) 0/0 (NaN) 22/51 (43.1%) 32/52 (61.5%) 8/50 (16%)
    Oral Mucosal Blistering 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Oral Pain 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 6/51 (11.8%) 5/52 (9.6%) 1/50 (2%)
    Paraesthesia Oral 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Stomatitis 4/7 (57.1%) 7/11 (63.6%) 2/2 (100%) 0/0 (NaN) 15/51 (29.4%) 13/52 (25%) 21/50 (42%)
    Vomiting 5/7 (71.4%) 5/11 (45.5%) 1/2 (50%) 0/0 (NaN) 24/51 (47.1%) 20/52 (38.5%) 6/50 (12%)
    Abdominal Pain Lower 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 0/50 (0%)
    Anal Fissure 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 0/50 (0%)
    Cheilitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 1/50 (2%)
    Toothache 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 3/52 (5.8%) 1/50 (2%)
    Mouth Ulceration 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 0/52 (0%) 5/50 (10%)
    Abdominal Discomfort 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 0/50 (0%)
    Abdominal Distension 0/7 (0%) 1/11 (9.1%) 1/2 (50%) 0/0 (NaN) 4/51 (7.8%) 2/52 (3.8%) 0/50 (0%)
    General disorders
    Asthenia 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 13/51 (25.5%) 8/52 (15.4%) 3/50 (6%)
    Chills 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 3/52 (5.8%) 1/50 (2%)
    Fatigue 4/7 (57.1%) 11/11 (100%) 2/2 (100%) 0/0 (NaN) 26/51 (51%) 21/52 (40.4%) 16/50 (32%)
    Gait Disturbance 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 1/50 (2%)
    Localised Oedema 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Non-Cardiac Chest Pain 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 1/50 (2%)
    Oedema Peripheral 1/7 (14.3%) 6/11 (54.5%) 0/2 (0%) 0/0 (NaN) 15/51 (29.4%) 9/52 (17.3%) 9/50 (18%)
    Pyrexia 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 9/51 (17.6%) 5/52 (9.6%) 5/50 (10%)
    Influenza Like Illness 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 2/52 (3.8%) 0/50 (0%)
    Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 2/52 (3.8%) 1/50 (2%)
    Malaise 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 3/52 (5.8%) 1/50 (2%)
    Peripheral Swelling 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 1/52 (1.9%) 2/50 (4%)
    Hepatobiliary disorders
    Dilatation Intrahepatic Duct Acquired 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Infections and infestations
    Bronchitis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 4/52 (7.7%) 1/50 (2%)
    Cellulitis 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Infectious Pleural Effusion 0/7 (0%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Influenza 2/7 (28.6%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Lymph Gland Infection 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Nasopharyngitis 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 7/51 (13.7%) 4/52 (7.7%) 7/50 (14%)
    Oral Herpes 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 3/50 (6%)
    Osteomyelitis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Paronychia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Pneumonia 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 1/50 (2%)
    Sinusitis 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 0/50 (0%)
    Skin Infection 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Upper Respiratory Tract Infection 2/7 (28.6%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 7/52 (13.5%) 7/50 (14%)
    Urinary Tract Infection 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 4/52 (7.7%) 3/50 (6%)
    Lower Respiratory Tract Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 4/52 (7.7%) 4/50 (8%)
    Respiratory Tract Infection 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 4/52 (7.7%) 1/50 (2%)
    Gingivitis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 0/52 (0%) 0/50 (0%)
    Injury, poisoning and procedural complications
    Arthropod Bite 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Contusion 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Fall 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 1/50 (2%)
    Periorbital Contusion 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Toxicity to Various Agents 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Investigations
    Alanine Aminotransferase Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 3/52 (5.8%) 3/50 (6%)
    Amylase Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 0/50 (0%)
    Aspartate Aminotransferase Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 2/52 (3.8%) 3/50 (6%)
    Blood Alkaline Phosphatase Increased 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 2/50 (4%)
    Blood Bilirubin Increased 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Blood Cholesterol Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 2/52 (3.8%) 3/50 (6%)
    Blood Creatine Phosphokinase Increased 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 0/52 (0%) 1/50 (2%)
    Blood Glucose Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 1/50 (2%)
    Blood Phosphorus Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 0/50 (0%)
    Blood Potassium Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Blood Triglycerides Increased 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 1/50 (2%)
    Cardiac Murmur 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Computerised Tomogram Thorax Abnormal 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Ejection Fraction Decreased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 4/52 (7.7%) 0/50 (0%)
    Electrocardiogram QT Prolonged 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 0/50 (0%)
    Haemoglobin Decreased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 5/50 (10%)
    Lipase Increased 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 5/52 (9.6%) 3/50 (6%)
    Liver Function Test Abnormal 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Murphy's Sign Positive 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Platelet Count Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Protein Urine Present 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Transaminases Increased 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Weight Decreased 2/7 (28.6%) 5/11 (45.5%) 0/2 (0%) 0/0 (NaN) 16/51 (31.4%) 26/52 (50%) 4/50 (8%)
    White Blood Cell Count Decreased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    White Blood Cell Count Increased 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Blood Thyroid Stimulating Hormone Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 7/51 (13.7%) 2/52 (3.8%) 1/50 (2%)
    Blood Creatinine Increased 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 2/52 (3.8%) 4/50 (8%)
    Metabolism and nutrition disorders
    Decreased Appetite 3/7 (42.9%) 6/11 (54.5%) 1/2 (50%) 0/0 (NaN) 27/51 (52.9%) 30/52 (57.7%) 10/50 (20%)
    Dehydration 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 1/50 (2%)
    Failure to Thrive 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hypercalcaemia 2/7 (28.6%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hypercholesterolaemia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 18/51 (35.3%) 6/52 (11.5%) 8/50 (16%)
    Hyperglycaemia 2/7 (28.6%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 8/51 (15.7%) 3/52 (5.8%) 12/50 (24%)
    Hyperkalaemia 1/7 (14.3%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 3/52 (5.8%) 1/50 (2%)
    Hyperlipidaemia 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Hypernatraemia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hypertriglyceridaemia 1/7 (14.3%) 7/11 (63.6%) 0/2 (0%) 0/0 (NaN) 18/51 (35.3%) 7/52 (13.5%) 12/50 (24%)
    Hypophagia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hypophosphataemia 3/7 (42.9%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 1/50 (2%)
    Hypovolaemia 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Malnutrition 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Metabolic Acidosis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hypomagnesaemia 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 4/52 (7.7%) 0/50 (0%)
    Hypocalcaemia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 3/52 (5.8%) 2/50 (4%)
    Hypokalaemia 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 7/51 (13.7%) 0/52 (0%) 1/50 (2%)
    Hyponatraemia 1/7 (14.3%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 4/7 (57.1%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 14/51 (27.5%) 13/52 (25%) 7/50 (14%)
    Back Pain 3/7 (42.9%) 4/11 (36.4%) 0/2 (0%) 0/0 (NaN) 11/51 (21.6%) 11/52 (21.2%) 7/50 (14%)
    Flank Pain 0/7 (0%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 2/52 (3.8%) 2/50 (4%)
    Intervertebral Disc Protrusion 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Muscle Spasms 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 2/50 (4%)
    Muscular Weakness 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 3/52 (5.8%) 0/50 (0%)
    Musculoskeletal Chest Pain 1/7 (14.3%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 8/51 (15.7%) 7/52 (13.5%) 2/50 (4%)
    Musculoskeletal Pain 3/7 (42.9%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 8/52 (15.4%) 1/50 (2%)
    Myalgia 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 7/52 (13.5%) 1/50 (2%)
    Neck Pain 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 1/50 (2%)
    Pain in Extremity 2/7 (28.6%) 4/11 (36.4%) 0/2 (0%) 0/0 (NaN) 6/51 (11.8%) 6/52 (11.5%) 3/50 (6%)
    Spinal Osteoarthritis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Bone Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 4/52 (7.7%) 2/50 (4%)
    Groin Pain 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 1/52 (1.9%) 0/50 (0%)
    Pain In Jaw 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 0/50 (0%)
    Nervous system disorders
    Disturbance In Attention 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Dizziness 1/7 (14.3%) 5/11 (45.5%) 1/2 (50%) 0/0 (NaN) 2/51 (3.9%) 4/52 (7.7%) 2/50 (4%)
    Dysgeusia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 4/52 (7.7%) 1/50 (2%)
    Headache 4/7 (57.1%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 10/51 (19.6%) 13/52 (25%) 4/50 (8%)
    Hyperaesthesia 0/7 (0%) 0/11 (0%) 1/2 (50%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Hypoaesthesia 1/7 (14.3%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 1/50 (2%)
    Paraesthesia 1/7 (14.3%) 1/11 (9.1%) 1/2 (50%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 1/50 (2%)
    Peripheral Sensory Neuropathy 2/7 (28.6%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 4/52 (7.7%) 0/50 (0%)
    Sensory Disturbance 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Sinus Headache 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Tremor 0/7 (0%) 2/11 (18.2%) 1/2 (50%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Lethargy 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 7/52 (13.5%) 2/50 (4%)
    Psychiatric disorders
    Anxiety 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 3/52 (5.8%) 1/50 (2%)
    Confusional State 2/7 (28.6%) 0/11 (0%) 1/2 (50%) 0/0 (NaN) 1/51 (2%) 1/52 (1.9%) 0/50 (0%)
    Depression 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 2/50 (4%)
    Insomnia 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 10/51 (19.6%) 8/52 (15.4%) 1/50 (2%)
    Renal and urinary disorders
    Haematuria 0/7 (0%) 1/11 (9.1%) 1/2 (50%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 0/50 (0%)
    Nocturia 0/7 (0%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 3/50 (6%)
    Proteinuria 5/7 (71.4%) 6/11 (54.5%) 0/2 (0%) 0/0 (NaN) 13/51 (25.5%) 16/52 (30.8%) 7/50 (14%)
    Renal Failure Acute 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Renal Failure Chronic 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Renal Mass 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Pollakiuria 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 4/50 (8%)
    Reproductive system and breast disorders
    Vaginal Haemorrhage 0/7 (0%) 0/11 (0%) 1/2 (50%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Respiratory, thoracic and mediastinal disorders
    Cough 6/7 (85.7%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 20/51 (39.2%) 9/52 (17.3%) 16/50 (32%)
    Dysphonia 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 10/51 (19.6%) 19/52 (36.5%) 2/50 (4%)
    Dyspnoea 1/7 (14.3%) 7/11 (63.6%) 1/2 (50%) 0/0 (NaN) 11/51 (21.6%) 11/52 (21.2%) 11/50 (22%)
    Dyspnoea Exertional 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 1/52 (1.9%) 5/50 (10%)
    Epistaxis 2/7 (28.6%) 5/11 (45.5%) 1/2 (50%) 0/0 (NaN) 9/51 (17.6%) 4/52 (7.7%) 12/50 (24%)
    Haemoptysis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 3/52 (5.8%) 2/50 (4%)
    Lung Infiltration 0/7 (0%) 1/11 (9.1%) 1/2 (50%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Nasal Congestion 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 1/52 (1.9%) 1/50 (2%)
    Oropharyngeal Pain 1/7 (14.3%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 2/52 (3.8%) 2/50 (4%)
    Pleural Effusion 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 3/50 (6%)
    Pneumonitis 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 4/50 (8%)
    Productive Cough 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 2/50 (4%)
    Rhinorrhoea 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 2/50 (4%)
    Sinus Congestion 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Sputum Discoloured 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Upper-Airway Cough Syndrome 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Wheezing 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 2/50 (4%)
    Paranasal sinus discomfort 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 0/52 (0%) 0/50 (0%)
    Skin and subcutaneous tissue disorders
    Dermatitis Acneiform 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 1/50 (2%)
    Dry Skin 3/7 (42.9%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 5/51 (9.8%) 3/52 (5.8%) 3/50 (6%)
    Ecchymosis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Erythema 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 2/50 (4%)
    Erythema Multiforme 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Hyperhidrosis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 1/50 (2%)
    Hyperkeratosis 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 0/52 (0%) 1/50 (2%)
    Night Sweats 1/7 (14.3%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 2/52 (3.8%) 2/50 (4%)
    Palmar-Plantar Erythrodysaesthesia Syndrome 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 4/51 (7.8%) 8/52 (15.4%) 2/50 (4%)
    Petechiae 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Pruritus 2/7 (28.6%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 7/51 (13.7%) 3/52 (5.8%) 7/50 (14%)
    Rash 3/7 (42.9%) 5/11 (45.5%) 1/2 (50%) 0/0 (NaN) 9/51 (17.6%) 8/52 (15.4%) 11/50 (22%)
    Rash Erythematous 0/7 (0%) 2/11 (18.2%) 0/2 (0%) 0/0 (NaN) 2/51 (3.9%) 3/52 (5.8%) 4/50 (8%)
    Rash Macular 1/7 (14.3%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 5/50 (10%)
    Skin Mass 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 1/52 (1.9%) 0/50 (0%)
    Skin Ulcer 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 2/52 (3.8%) 1/50 (2%)
    Onychoclasis 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 3/50 (6%)
    Acne 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 3/50 (6%)
    Vascular disorders
    Aortic Dilatation 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 0/52 (0%) 0/50 (0%)
    Deep Vein Thrombosis 0/7 (0%) 1/11 (9.1%) 0/2 (0%) 0/0 (NaN) 0/51 (0%) 3/52 (5.8%) 0/50 (0%)
    Hypertension 5/7 (71.4%) 4/11 (36.4%) 0/2 (0%) 0/0 (NaN) 21/51 (41.2%) 26/52 (50%) 5/50 (10%)
    Hypotension 1/7 (14.3%) 3/11 (27.3%) 0/2 (0%) 0/0 (NaN) 3/51 (5.9%) 1/52 (1.9%) 0/50 (0%)
    Hot Flush 0/7 (0%) 0/11 (0%) 0/2 (0%) 0/0 (NaN) 1/51 (2%) 3/52 (5.8%) 0/50 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Eisai Medical Services
    Organization Eisai Medical Inc.
    Phone 1-888-422-4743
    Email
    Responsible Party:
    Eisai Inc.
    ClinicalTrials.gov Identifier:
    NCT01136733
    Other Study ID Numbers:
    • E7080-G000-205
    First Posted:
    Jun 3, 2010
    Last Update Posted:
    Feb 27, 2019
    Last Verified:
    Jan 1, 2018