Table 1.

General recommendations for lenvatinib dose modifications in hepatocellular carcinoma patients ⁴ , ⁵

			Persistent and intolerable grade 2 or 3 toxicities †		Grade 4
Body weight	Starting dose	Adverse reaction	Dose modification	Adjusted dose ‡
≥ 60 kg	12 mg od	1st occurrence §	Interrupt until resolved to Grade 0 or 1, or baseline ††	8 mg od	Discontinue ¶
		2nd occurrence		4 mg od
		3rd occurrence		4 mg qod
< 60 kg	8 mg od	1st occurrence §		4 mg od
		2nd occurrence		4 mg qod
		3rd occurrence		Discontinue

od, once daily; qod, every other day.

^† Medical management for nausea, vomiting, or diarrhea should be initiated prior to dose interruption or reduction.

^‡ Lenvatinib dose is to be reduced in succession based on the previous dose level (12, 8, 4, or 4 mg every other day).

^§ No dose adjustment required for first occurrence of hematological toxicity or proteinuria.

^¶ For hematologic toxicity, dosing can restart when resolved to grade 2 and, for proteinuria, dosing can resume when resolved to less than 2 g/24 h.

^†† Excluding laboratory abnormalities judged to be non–life‐threatening, which should be managed as grade 3.