Clinical trial NCT02702388: A Trial of Lenvatinib (E7080) in Subjects With Iodine-131 Refractory Differentiated Thyroid Cancer to Evaluate Whether an Oral Starting Dose of 18 Milligram (mg) Daily Will Provide Comparable Efficacy to a 24 mg Starting Dose, But Have a Better Safety Profile
Official title: A Multicenter, Randomized, Double-Blind Phase 2 Trial of Lenvatinib (E7080) in Subjects With 131I-Refractory Differentiated Thyroid Cancer to Evaluate Whether an Oral Starting Dose of 18 mg Daily Will Provide Comparable Efficacy to a 24-mg Starting Dose, But Have a Better Safety Profile
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Thyroid Cancer
Keywords: Lenvatinib
E7080
Iodine-131 Refractory Differentiated Thyroid Cancer
Lenvima
Phase 2
RR-DTC
Lead sponsor: Eisai Inc.
Sponsor class: INDUSTRY
Collaborators: name: Merck Sharp & Dohme LLC
First posted: 2016-03-08
Enrollment: 241
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This is a multicenter, randomized, double-blind study being conducted as a postmarketing requirement to the US Food and Drug Administration (FDA) to evaluate whether there is a lower starting dosage of lenvatinib 24 mg once daily (QD) that provides comparable efficacy but has a better safety profile in participants with radioiodine-refractory differentiated thyroid cancer RR-DTC with radiographic evidence of disease progression within the prior 12 months.

Detailed description: This study consists of 2 phases, the Prerandomization Phase and the Randomization Phase. The Prerandomization Phase will last no longer than 28 days and will include a Screening Period to establish protocol eligibility and a Baseline Period to confirm eligibility and establish disease characteristics prior to randomization and treatment.

The Randomization Phase will consist of a Treatment Period and a Follow-up Period. It will begin at the time of randomization of the first participant and will consist of 28-day blinded study treatment cycles. The data cutoff for the primary analysis will occur at the end of the Randomization Phase, which is defined as when the last participant enrolled completes the Week 24 tumor assessments or discontinues study treatment if before Week 24.

Participants on treatment at the time of data cutoff for the primary analysis will remain on blinded investigational product until the primary analysis has been completed, after which they will transition to commercial lenvatinib outside the study. The last participant's last assessment (Off-treatment visit) will be the End of Study.

Participants will be randomly assigned to treatment with 1 of 2 blinded starting dosages of lenvatinib in a 1:1 ratio to receive lenvatinib 18 mg or 24 mg orally once daily (QD). Dose reductions will occur in succession based on the previous dose level (24, 20, 14, 10, and 8 mg QD, or 18, 14, 10, 8, and 4 mg QD, respectively). Once the dose has been reduced, it may not be increased at a later date.

Eligibility criteria: Inclusion Criteria:

1. Participants must have histologically or cytologically confirmed diagnosis of one of the following differentiated thyroid cancer (DTC) subtypes:

   1. Papillary thyroid cancer (PTC)

      * Follicular variant
      * Variants (including but not limited to tall cell, columnar cell, cribriform-morular, solid, oxyphil, Warthin's-like, trabecular, tumor with nodular fasciitis-like stroma, Hürthle cell variant of papillary carcinoma, poorly differentiated)
   2. Follicular thyroid cancer (FTC)

      * Hurthle cell
      * Clear cell
      * Insular
2. Measurable disease meeting the following criteria and confirmed by central radiographic review:

   1. At least 1 lesion of greater than or equal to (\>=)1.0 centimeter (cm) in the longest diameter for a non-lymph node or \>=1.5 cm in the short-axis diameter for a lymph node that is serially measurable according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) using computed tomography/magnetic resonance imaging (CT/MRI). If there is only 1 target lesion and it is a non-lymph node, it should have a longest diameter of \>=1.5 cm.
   2. Lesions that have had external beam radiotherapy (EBRT) or locoregional therapies such as radiofrequency (RF) ablation must show evidence of progressive disease based on RECIST 1.1 to be deemed a target lesion.
3. Participants must show evidence of disease progression within 12 months (an additional month will be allowed to accommodate actual dates of performance of screening scans, that is, within less than or equal to \<=13 months) prior to signing informed consent, according to RECIST 1.1 assessed and confirmed by central radiographic review of CT and/or MRI scans.
4. Participants must be Iodine-131 refractory/resistant as defined by at least one of the following:

   1. One or more measurable lesions that do not demonstrate iodine uptake on any radioiodine scan.
   2. One or more measurable lesions that have progressed according to RECIST 1.1 within 12 months (an additional month will be allowed to accommodate actual dates of performance of screening scans, ie, within ≤13 months) after Iodine-131 therapy, despite demonstration of radioiodine avidity at the time of that treatment by pre- or posttreatment scanning. These participants must not be eligible for possible curative surgery.
   3. Cumulative activity of Iodine-131 of greater than (\>) 600 millicurie (mCi) or 22 gigabecquerels (GBq), with the last dose administered at least 6 months prior to study entry.
5. Participants with known brain metastases who have completed whole brain radiotherapy, stereotactic radiosurgery or complete surgical resection, will be eligible if they have remained clinically stable, asymptomatic, and off steroids for one month.
6. Participants must be receiving thyroxine suppression therapy and thyroid stimulating hormone (TSH) should not be elevated (TSH should be \<=5.50 micro-international units per liter \[mcIU/ML\]). When tolerated by the participant, thyroxine dose should be changed to achieve TSH suppression (TSH \<0.50 mcIU/ML) and this dose may be changed concurrently upon starting study drug treatment.
7. All chemotherapy or radiation-related toxicities must have resolved to Grade \<2 severity per Common Terminology Criteria for Adverse Events (CTCAE v4.03), except alopecia and infertility.
8. Participants must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2.
9. Adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP ≤150/90 mmHg at Screening and no change in antihypertensive medications within 1 week prior to Cycle 1/Day 1.
10. Adequate renal function defined as calculated creatinine clearance \>=30 mL/min per the Cockcroft and Gault formula.
11. Adequate bone marrow function:

    1. Absolute neutrophil count (ANC) \>=1500/mm\^3 (\>=1.5\*10\^3/uL)
    2. Platelets \>=100,000/mm\^3 (\>=100\*10\^9/L)
    3. Hemoglobin \>=9.0 g/dL
12. Adequate blood coagulation function as evidenced by an International Normalized Ratio (INR) \<=1.5.
13. Adequate liver function:

    1. Bilirubin \<=1.5\*upper limit of normal (ULN) except for unconjugated hyperbilirubinemia or Gilbert's syndrome.
    2. Alkaline phosphatase, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) \<=3\*ULN (\<=5\*ULN if participant has liver metastases). If alkaline phosphatase is \>3\*ULN (in absence of liver metastases) or \>5\*ULN (in presence of liver metastases) AND the participant also is known to have bone metastases, the liver-specific alkaline phosphatase must be separated from the total and used to assess the liver function instead of total alkaline phosphatase.
14. Males or females age \>=18 years at the time of informed consent.
15. Females must not be lactating or pregnant at Screening or Baseline (as documented by a negative beta-human chorionic gonadotropin \[B-hCG\] test with a minimum sensitivity of 25 IU/L or equivalent units of B-hCG. A separate baseline assessment is required if a negative screening pregnancy test was obtained more than 72 hours before the first dose of study drug.
16. All females will be considered to be of childbearing potential unless they are postmenopausal (amenorrheic for at least 12 consecutive months, in the appropriate age group and without other known or suspected cause) or have been sterilized surgically (ie, bilateral tubal ligation, total hysterectomy or bilateral oophorectomy, all with surgery at least 1 month before dosing).
17. Females of childbearing potential should avoid becoming pregnant and use highly effective contraception while on treatment with lenvatinib and for at least 1 month after finishing treatment. Females of childbearing potential must not have had unprotected sexual intercourse within 30 days before study entry and must agree to use a highly effective method of contraception (example, total abstinence, an intrauterine device, a contraceptive implant, an oral contraceptive, or have a vasectomized partner with confirmed azoospermia) throughout the entire study period and for 30 days after study drug discontinuation. Females who are using hormonal contraceptives must have been on a stable dose of the same hormonal contraceptive product for at least 4 weeks before dosing and must continue to use the same contraceptive during the study and for 30 days after study drug discontinuation. Women using oral hormonal contraceptives should add a barrier method.
18. Participants must voluntarily agree to provide written informed consent.
19. Participants must be willing and able to comply with all aspects of the protocol.

Exclusion Criteria:

1. Anaplastic or medullary carcinoma of the thyroid.
2. Diagnosed with meningeal carcinomatosis.
3. Two or more prior vascular endothelial growth factor (VEGF)/vascular endothelial growth factor receptor (VEGFR)-targeted therapies or any ongoing treatment for RR-DTC other than TSH-suppressive thyroid hormone therapy.
4. Prior treatment with lenvatinib.
5. Participants who have received any anticancer treatment within 21 days or any investigational agent within 30 days (or 5 half-lives) prior to the first dose of study drug and should have recovered from any toxicity related to previous anticancer treatment. This does not apply to the use of TSH suppressive thyroid hormone therapy.
6. Major surgery (example, laparotomy, thoracotomy or joint replacement) within 3 weeks prior to randomization or elective surgery scheduled to be performed during the study.
7. Participants having \>1+ proteinuria on urine dipstick testing will undergo 24-hour urine collection for quantitative assessment of proteinuria. Participants with urine protein \>=1 g/24 h will be ineligible.
8. Gastrointestinal malabsorption or any other condition that in the opinion of the investigator might affect the absorption of study drug.
9. Significant cardiovascular impairment: history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction or cerebral vascular accident within 6 months of the first dose of study drug, or cardiac arrhythmia associated with hemodynamic instability.
10. Prolongation of corrected QT interval (QTc) to \>480 ms as demonstrated by a repeated electrocardiogram (ECG) or a clinically significant ECG abnormality, including a marked prolonged QT/QTc interval (example, a repeated demonstration of a QTc interval \>500 ms).
11. Active hemoptysis (bright red blood of at least 0.5 teaspoon) within 3 weeks prior to the first dose of study drug.
12. Active infection (any infection requiring treatment).
13. Active malignancy (except for DTC or definitively treated melanoma in-situ, basal or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix) within the past 24 months.
14. Bleeding or thrombotic disorders.
15. Known intolerance to study drug (or any of the excipients).
16. Any medical or other condition that in the opinion of the investigator(s) would preclude the participant's participation in a clinical study.
17. Females who are pregnant or breastfeeding.

Primary outcomes:
measure: Objective Response Rate (ORR) as of Week 24 (ORR24wk)
timeFrame: From the date of randomization up to Week 24
measure: Percentage of Participants With Grade 3 or Higher Treatment-emergent Adverse Events (TEAEs) in the First 24 Weeks
timeFrame: Baseline up to Week 24
Secondary outcomes:
measure: Progression-free Survival (PFS)
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurs first up to approximately 2 years 6 months
measure: PFS After Next Line of Treatment (PFS2)
timeFrame: Time from randomization to PD on next-line treatment or death from any cause, whichever occurs first up to approximately 2 years 6 months
measure: Number of Participants With TEAE and Serious Adverse Events (SAEs)
timeFrame: From date of first administration of study drug up to 28 days after last dose of study drug up to approximately 3 years 3 months
measure: Time to Treatment Discontinuation Due to an Adverse Event (AE)
timeFrame: From date of first administration of study drug up to approximately 2 years 6 months
measure: Number of Dose Reductions
timeFrame: From date of first administration of study drug up to approximately 2 years 6 months
measure: Time to First Dose Reduction
timeFrame: From date of first administration of study drug up to approximately 2 years 6 months
measure: Model Predicted Apparent Total Clearance (CL/F) Following Oral Dosing of Lenvatinib
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Model Predicted Area Under the Plasma Drug Concentration-time Curve (AUC) for Lenvatinib
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Parameter Estimates From the Population Pharmacokinetic/Pharmacodynamic (PK/PD) Model Describing the Relationship Between Lenvatinib Exposure (AUC) and Thyroglobulin Levels
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Parameter Estimates From the Population Pharmacokinetic/Pharmacodynamic (PK/PD) Model Describing the Relationship Between Lenvatinib Exposure (AUC) and Thyroid-Stimulating Hormone (TSH) Levels
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Baseline Level Estimates From the Population PK/PD Model Describing the Relationship Between Lenvatinib Exposure (AUC) and Vascular Endothelial Growth Factor (VEGF), Soluble Tie-2, Angiopoietin-2 (Ang-2) and Fibroblast Growth Factor-23 (FGF23) Levels
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Mean Residence Time (MRT) Estimates From the Population PK/PD Model Describing the Relationship Between Lenvatinib Exposure (AUC) and VEGF, Soluble Tie-2, Ang-2 and FGF23 Levels
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Hill Coefficient Estimates From the Population PK/PD Model Describing the Relationship Between Lenvatinib Exposure (AUC) and VEGF, Soluble Tie-2, Ang-2 and FGF23 Levels
timeFrame: Cycle 1 Day 1: 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 8: predose, Cycle 1 Day 15: predose, 0.5-4 hours and 6-10 hours postdose; Cycle 1 Day 22: optionally at predose; Cycle 2 Day 1: predose and 2-12 hours postdose (Cycle length=28 days)
measure: Parameter Estimates From the PK/PD Model for Tumor Growth Inhibition and Serum Biomarkers Tie-2 and Ang-2
timeFrame: Baseline up to week 120
measure: Lenvatinib Mean AUC Resulting in 50% of the Emax (EC50) Estimate From the PK/PD Model for Tumor Growth Inhibition and Serum Biomarkers Tie-2 and Ang-2
timeFrame: Baseline up to week 120
measure: Scale Factor Estimate for Final Parametric Time to Event PK/PD Model for PFS
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurred first up to approximately 3 years 3 months
measure: Shape Factor Estimate for Final Parametric Time to Event PK/PD Model for PFS
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurred first up to approximately 3 years 3 months
measure: Lenvatinib AUC Exposure Effect Estimate for Final Parametric Time to Event PK/PD Model for PFS
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurred first up to approximately 3 years 3 months
measure: Predicted Percent Change in Tumor Size Estimate for Final Parametric Time to Event PK/PD Model for PFS
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurred first up to approximately 3 years 3 months
measure: Baseline Tumor Size Estimate for Final Parametric Time to Event PK/PD Model for PFS
timeFrame: Time from the date of randomization to the date of first documentation of PD, or date of death, whichever occurred first up to approximately 3 years 3 months
measure: Input Rate Indirect Effect Model Estimate From Base/Final PK/PD Blood Pressure Model
timeFrame: From date of first administration of study drug up to 6 months
measure: Drug Effect on Systolic and Diastolic Input Rate Estimates From Base/Final PK/PD Blood Pressure Model
timeFrame: From date of first administration of study drug up to 6 months
measure: Number of Participants With Weight Decrease Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Hypertension Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Proteinuria Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Fatigue Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Diarrhea Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Nausea Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Number of Participants With Vomiting Stratified by AUC Quartile (Q) Group
timeFrame: Up to 3 years 3 months
measure: Change From Baseline in the Health-Related Quality of Life (HRQoL) Assessed by European Quality of Life (EuroQol) Five-Dimensional, 3-Level (EQ-5D-3L) Index Score and Visual Analogue Scale (VAS)
timeFrame: Baseline, Week 8, 16, and 24
measure: Change From Baseline in the HRQoL Assessed by Functional Assessment of Cancer Therapy-General (FACT-G) Total Score
timeFrame: Baseline, Week 8, 16 and 24
Other outcomes:
Locations:
city: La Jolla
country: United States
facility: Facility#1
state: California
city: San Diego
country: United States
facility: Facility #1
state: California
city: Torrance
country: United States
facility: Facility #1
state: California
city: Washington
country: United States
facility: Facility #1
state: District of Columbia
city: Boston
country: United States
facility: Facility #1
state: Massachusetts
city: Boston
country: United States
facility: Facility #2
state: Massachusetts
city: Ann Arbor
country: United States
facility: Facility #1
state: Michigan
city: Detroit
country: United States
facility: Facility #1
state: Michigan
city: Morristown
country: United States
facility: Facility#2
state: New Jersey
city: Summit
country: United States
facility: Facility#1
state: New Jersey
city: Bronx
country: United States
facility: Facility #1
state: New York
city: Columbus
country: United States
facility: Facility #1
state: Ohio
city: Portland
country: United States
facility: Facility #1
state: Oregon
city: Philadelphia
country: United States
facility: Facility #2
state: Pennsylvania
city: Philadelphia
country: United States
facility: Facility #1
state: Pennsylvania
city: Seattle
country: United States
facility: Facility #1
state: Washington
city: Darlinghurst
country: Australia
facility: Facility #1
state: New South Wales
city: Saint Leonards
country: Australia
facility: Facility #1
state: New South Wales
city: Brisbane
country: Australia
facility: Royal Brisbane and Women's Hospital
state: Queensland
city: Chermside
country: Australia
facility: Facility#2
state: Queensland
city: Herston
country: Australia
facility: Facility #1
state: Queensland
city: Melbourne
country: Australia
facility: Facility #1
state: Victoria
city: Nedlands
country: Australia
facility: Facility #1
state: Western Australia
city: Melbourne
country: Australia
facility: Facility #1
city: Saint Leonards
country: Australia
facility: Facility #1
city: Edegem
country: Belgium
facility: Facility #1
state: Antwerpen
city: Bruxelles
country: Belgium
facility: Facility #1
state: Brussels
city: Namur
country: Belgium
facility: Facility #2
city: Namur
country: Belgium
facility: Facility #1
city: Calgary
country: Canada
facility: Facility #1
state: Alberta
city: Toronto
country: Canada
facility: Facility #1
state: Ontario
city: Quebec
country: Canada
facility: Facility #1
city: Odense
country: Denmark
facility: Facility #1
state: Syddanmark
city: Strasbourg
country: France
facility: Facility #1
state: Bas-Rhin
city: Caen
country: France
facility: Facility #1
state: Calvados
city: Dijon
country: France
facility: Facility #1
state: Cote-d'Or
city: Bordeaux
country: France
facility: Facility #1
state: Gironde
city: Angers
country: France
facility: Facility #1
state: Maine-et-Loire
city: Villejuif
country: France
facility: Facility #2
state: Val-de-Marne
city: Villejuif
country: France
facility: Facility #1
state: Val-de-Marne
city: Angers
country: France
facility: Facility #2
city: Bordeaux
country: France
facility: Facility #1
city: Caen
country: France
facility: Facility #1
city: Dijon
country: France
facility: Facility #1
city: Lyon
country: France
facility: Facility #2
city: Paris
country: France
facility: Facility #1
city: Tubingen
country: Germany
facility: Facility #1
state: Baden-Wurttemberg
city: Wurzburg
country: Germany
facility: Facility #1
state: Bayern
city: Hannover
country: Germany
facility: Facility #1
state: Niedersachsen
city: Essen
country: Germany
facility: Facility #1
state: Nordrhein-Westfalen
city: Essen
country: Germany
facility: Facility #2
state: Nordrhein-Westfalen
city: Essen
country: Germany
facility: Facility #1
city: Leipzig
country: Germany
facility: Facility #1
city: Petach Tikva
country: Israel
facility: Facility #1
city: Roma
country: Italy
facility: Facility #6
state: Lazio
city: Roma
country: Italy
facility: Facility #1
state: Lazio
city: Roma
country: Italy
facility: Facility #2
state: Lazio
city: Roma
country: Italy
facility: Facility #3
state: Lazio
city: Milano
country: Italy
facility: Facility #2
state: Lombardia
city: Milano
country: Italy
facility: Facility #3
state: Lombardia
city: Milano
country: Italy
facility: Facility #4
state: Lombardia
city: Milano
country: Italy
facility: Facility #5
state: Lombardia
city: Livorno
country: Italy
facility: Facility #1
state: Toscana
city: Pisa
country: Italy
facility: Facility #1
state: Toscana
city: Milano
country: Italy
facility: Facility #6
city: Milano
country: Italy
facility: Facility #7
city: Pisa
country: Italy
facility: Facility #2
city: Roma
country: Italy
facility: Facility #4
city: Rozzano
country: Italy
facility: Facility #2
city: Torino
country: Italy
facility: Facility #1
city: Viagrande
country: Italy
facility: Facility #1
city: Busan
country: Korea, Republic of
facility: Facility#1
city: Goyang-si
country: Korea, Republic of
facility: Facility #1
city: Seoul
country: Korea, Republic of
facility: Facility #3
city: Seoul
country: Korea, Republic of
facility: Facility #4
city: Seoul
country: Korea, Republic of
facility: Facility #1
city: Seoul
country: Korea, Republic of
facility: Facility #2
city: Kielce
country: Poland
facility: Facility #2
city: Cluj-Napoca
country: Romania
facility: Facility #1
state: Cluj
city: Bucharest
country: Romania
facility: Facility #1
city: Saint Petersburg
country: Russian Federation
facility: Facility #4
state: Leningradskaya O
city: Moscow
country: Russian Federation
facility: Facility #3
city: Moscow
country: Russian Federation
facility: Facility #4
city: Moscow
country: Russian Federation
facility: Facility #1
city: Moscow
country: Russian Federation
facility: Facility #2
city: Obninsk
country: Russian Federation
facility: Facility #1
city: Saint Petersburg
country: Russian Federation
facility: Facility #3
city: Saint Petersburg
country: Russian Federation
facility: Facility #1
city: Saint Petersburg
country: Russian Federation
facility: Facility #2
city: Barcelona
country: Spain
facility: Facility #1
state: Cataluna
city: Madrid
country: Spain
facility: Facility #2
state: Madrid, Communidad Delaware
city: Badalona
country: Spain
facility: Facility #1
city: Barcelona
country: Spain
facility: Facility #2
city: Madrid
country: Spain
facility: Facility #1
city: Madrid
country: Spain
facility: Facility #2
city: Madrid
country: Spain
facility: Facility #3
city: Malaga
country: Spain
facility: Facility #1
city: Goteborg
country: Sweden
facility: Facility #1
city: Lund
country: Sweden
facility: Facility #1
city: London
country: United Kingdom
facility: Facility #1
state: City Of London
city: Glasgow
country: United Kingdom
facility: Facility #1
state: Glasgow City
Study officials:
References:
citation: Brose MS, Panaseykin Y, Konda B, de la Fouchardiere C, Hughes BGM, Gianoukakis AG, Joo Park Y, Romanov I, Krzyzanowska MK, Leboulleux S, Binder TA, Dutcus C, Xie R, Taylor MH. A Randomized Study of Lenvatinib 18 mg vs 24 mg in Patients With Radioiodine-Refractory Differentiated Thyroid Cancer. J Clin Endocrinol Metab. 2022 Feb 17;107(3):776-787. doi: 10.1210/clinem/dgab731.