Clinical Drug Experience Knowledgebase

Criteria

Inclusion Criteria:

Histologically confirmed advanced HCC with cirrhosis resulting from hepatitis B, hepatitis C, alcohol-related liver disease or any other aetiology OR Histologically confirmed advanced HCC resulting from NASH with or without cirrhosis
Patient is considered unsuitable for liver tumour resection and/or is refractory to radiotherapy and other loco-regional therapies
At least one measurable lesion with target lesion size ≥ 1.0 cm as measured by MRI or CT
Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
Child-Pugh class A or B (up to B7)
Eligible to undergo pre and post treatment mandated biopsies

Acceptable laboratory parameters, as demonstrated by:

Platelets ≥ 70 x 10^9/L
Serum albumin > 26 g/L
ALT and AST ≤ 5 x ULN
Bilirubin ≤ 50 µmol /L
WBC ≥ 2.0 x 10^9/L, Absolute neutrophil count ≥ 1.5 x 109/L
Haemoglobin ≥ 9.0 g/dL
Prothrombin time (PT) <20 seconds

Acceptable renal function as demonstrated by:

Serum creatinine ≤ 1.5 x ULN
Calculated creatinine clearance ≥ 60 mL/min

Exclusion Criteria:

Patients who have been treated with TACE or chemotherapy within the last 28 days
Prior investigational drugs within the last 30 days
Grade > 1 prior treatment-related toxicities (excluding alopecia) at the time of screening
Patients with clinically significant cancer ascites
Any episode of bleeding from oesophageal varices or other uncontrolled bleeding within the last 3 months prior to study treatment initiation
Patients with history of haemorrhage or gastrointestinal perforation
Patients administered with serum albumin within the last 7 days prior to the first study drug administration
Known infection with human immunodeficiency virus (HIV)
Patients with central nervous system (CNS), bone or peritoneal metastasis
Patients presenting with marked baseline prolongation of QT/QTc interval defined as repeated demonstration of a QTc interval ≥450 ms (males) and ≥460 ms (females) using Fridericia's correction formula
Signs and symptoms of heart failure characterised as greater than the New York Heart Association (NYHA) Class I or other clinically significant cardiac abnormalities (including history of myocardial infarction) including stable abnormalities.
Major surgery within the last 30 days prior to study treatment initiation
Patients with history of organ transplantation or cardiac surgery
Patients with sepsis, ineffective biliary drainage with or without cholangitis, obstructive jaundice or encephalopathy at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier
Evidence of spontaneous bacterial peritonitis or renal failure or allergic reactions to the agent or excipient at screening visit or within the last two weeks prior to study treatment initiation, whichever earlier
Known hypersensitivity to the active sorafenib or to any of the excipients
Occurrence of a grade 3 or higher sorafenib or lenvatinib related toxicity during any sorafenib / lenvatinib treatment received prior to study enrolment, according to toxicity criteria (NCI CTCAE v 5.0)
Pregnant or lactating women