Lenvatinib is a multiple kinase inhibitor (VEGFR-1, 2, 3；FGFR-1, 2, 3, 4；PDGFRα；RET and KIT) that exhibits antitumor activity by blocking the cell growth signaling pathway. It is approved for the treatment of thyroid cancer and renal cell carcinoma. In a phase III trial (REFLECT/Study 304), patients with unresectable hepatocellular carcinoma treated with lenvatinib as first-line treatment was compared to those treated with sorafenib. The results reveal that lenvatinib increases progression-free survival and overall survival compared to sorafenib. In the subpopulation analysis of this trial, for patients in the Greater China Region, the objective response rate of using lenvatinib was higher (21.5%) than using sorafenib (8.3%). The progression-free survival was 5.6 months longer in the lenvatinib group than in the sorafenib group (9.2 months versus 3.6 months; hazard ratio 0.55). The overall survival was 4.8 months longer in the lenvatinib group than in the sorafenib group (15.0 months versus 10.2 months; hazard ratio 0.73). The side effect profile is manageable. These results reveal that lenvatinib provides significant clinical benefit in patients from the Greater China Region.