Lenvatinib has been approved for marketing in China for the treatment of radiation-induced iodine refractory differentiated thyroid cancer.

Indications

Lenvatinib is a multi-target tyrosine kinase inhibitor suitable for the following situations:

Differentiated thyroid cancer: used for patients with locally recurrent or metastatic advanced stages that are difficult to treat with radioactive iodine.

Renal cell carcinoma: Combination therapy with everolimus for advanced renal cell carcinoma previously treated with anti angiogenic therapy.

Hepatocellular carcinoma: used for first-line treatment of unresectable hepatocellular carcinoma. ​

Usage and dosage

Dosage form: 4mg and 10mg capsules, swallowed whole and cannot be opened or chewed.

Recommended dosage:

Thyroid cancer: 24mg once daily.

Renal cell carcinoma: 18mg combined with 5mg everolimus once daily.

Hepatocellular carcinoma: 12mg once daily for those weighing ≥ 60kg, 8mg once daily for those weighing<60kg.

Adjustment principle:

If a grade 3 adverse reaction occurs, medication should be suspended and reduced after recovery (such as to 20mg for thyroid cancer).

Severe liver and kidney dysfunction requires careful use.

Side effects

Common adverse reactions: hypertension (73%), fatigue (67%), diarrhea (67%), decreased appetite (54%), weight loss (51%), nausea (50%).

Serious risk:

Hypertension crisis: Blood pressure should be controlled before medication and monitored weekly during treatment.

Heart failure: Monitor heart function and stop medication immediately if symptoms appear.

Renal failure: Especially when combined with everolimus, renal function needs to be monitored.

Hepatotoxicity: ALT/AST should be checked regularly, and medication should be discontinued if it is grade 3 or above.

Bleeding risk: The incidence of severe bleeding events is about 2%.

Medication precautions

Contraindications: Not recommended for individuals allergic to lenvatinib; Prohibited during pregnancy (may cause fetal damage).

Monitoring requirements:

Regularly monitor blood pressure, heart function, liver and kidney function, and electrolytes before and during treatment.

Thyroid cancer patients need to monitor TSH levels.

Drug interactions:

Avoid using potent CYP3A4 inducers (such as rifampicin) or inhibitors (such as ketoconazole) in combination.

Combined use with warfarin may increase the risk of bleeding.

Storage method

Store in the dark at 20 ° C-25 ° C (allowing short-term fluctuations of 15 ° C-30 ° C). Keep the container sealed and moisture-proof.

Lenvatinibinformation