Eisai Company, Ltd. and Merck & Company (NYSE:MRK), known as MSD outside the United States and Canada, today announced that the multiple receptor tyrosine kinase inhibitor LENVIMA^® (lenvatinib mesylate) has been approved in Japan for unresectable hepatocellular carcinoma (HCC). This is the first approval worldwide for LENVIMA for the indication of unresectable HCC and the first new systemic therapy to be approved in Japan for the front line treatment of HCC in approximately 10 years. Additionally, this is the first regulatory approval for LENVIMA under the global strategic collaboration agreement executed in March 2018 between Eisai and Merck for the co-development and co-commercialization of LENVIMA.

This approval was based on a phase 3 clinical study (Study 304/REFLECT study) conducted by Eisai investigating LENVIMA as a first-line treatment in patients with unresectable HCC. In this study, LENVIMA demonstrated statistically significant non-inferiority of overall survival (OS) (13.6 months) compared to sorafenib (12.3 months) (hazard ratio [HR] 0.92, 95% confidence interval [CI]=0.79-1.06). Additionally, LENVIMA showed highly statistically significant and clinically meaningful improvements as compared to sorafenib in the secondary endpoints of progression-free survival (PFS) (HR 0.66, 95% CI=0.57-0.77, p<0.00001), time to progression (TTP) (HR 0.63, 95% CI=0.53-0.73, p<0.00001), and objective response rate (ORR) (LENVIMA 24% versus sorafenib 9%, p<0.00001). Furthermore, LENVIMA helped to delay deterioration in several quality of life (QOL) and symptom domains (pre-specified secondary endpoint), including in areas such as pain and diarrhea, compared to sorafenib (nominal p-value<0.05).

In this study, the five most common adverse events observed in the LENVIMA arm were hypertension (42%), diarrhea (39%), decreased appetite (34%), weight loss (31%) and fatigue (30%), which is consistent with the known safety profile of LENVIMA.

Liver cancer is the second leading cause of cancer-related deaths, with approximately 750,000 deaths per year estimated globally. Additionally, approximately 780,000 cases are newly diagnosed each year, about 80 percent of which occur in Asia, including Japan and China. HCC accounts as the primary reason for 85 percent to 90 percent of liver cancer cases. It is estimated that there are approximately 42,000 HCC patients in Japan, with approximately 26,000 deaths every year. To date, treatment options for unresectable HCC have been limited, and the prognosis is very poor, emphasizing that this is an area of high unmet medical need.

"With the approval of this additional indication of unresectable HCC for LENVIMA, we are proud to be able to deliver the first new front-line systemic therapy treatment option for HCC in Japan in approximately 10 years, and expect this will contribute to HCC treatment," said Dr. Takashi Owa, Eisai Oncology Business Group Chief Medicine Creation Officer. "Eisai will continue with its efforts in oncology research and development in order to deliver hopes for a potential cure for cancer to patients and their families."

"Today’s approval is an important first for LENVIMA and a significant first regulatory event under our collaboration with Eisai," said Dr. Roy Baynes, Senior Vice President and Head of Global Clinical Development, Chief Medical Officer, Merck Research Laboratories. "We congratulate Eisai on the approval of this new indication and look forward to working together to bring this important treatment option to patients."

Having received approval of this indication, Eisai will receive a development milestone payment from Merck. There are no changes to Eisai’s consolidated financial results forecasts for the fiscal year ending March 31, 2018 based on the receipt of this milestone payment.

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