Lenvatinib

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

Indications

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

1. Differentiated thyroid cancer : For patients with local recurrence or metastatic progression refractory to radioactive iodine.

2. Renal cell carcinoma : Combined with everolimus for the treatment of advanced renal cell carcinoma that has previously received anti-angiogenic therapy.

3. Hepatocellular carcinoma : Used for first-line treatment of unresectable hepatocellular carcinoma. u200b

Usage and Dosage

Dosage form : 4mg and 10mg capsules, swallow them whole and do not break or chew them.

Recommended dosage of :

1. Thyroid cancer: 24 mg once daily.

2. Renal cell carcinoma: 18 mg combined with 5 mg everolimus once a day.

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

Adjustment principle :

If grade 3 adverse reactions occur, the medication must be suspended and the dose reduced after recovery (such as thyroid cancer to 20 mg).

Use with caution in patients with severe hepatic and renal insufficiency.

Side effects

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

2. Serious risks :

Hypertensive crisis : Blood pressure needs to be controlled before medication and monitored weekly during treatment.

Heart failure : Monitor cardiac function and discontinue medication immediately if symptoms occur.

Renal failure : Renal function needs to be monitored especially when combined with everolimus.

Hepatotoxicity : Check ALT/AST regularly, and discontinue medication if grade 3 or above.

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

Drug Precautions

1. Contraindications : Contraindicated for those allergic to lenvatinib; contraindicated during pregnancy (may cause fetal damage).

2. Monitoring requirements :

Monitor blood pressure, heart function, liver and kidney function and electrolytes regularly before and during treatment.

Thyroid cancer patients need to monitor TSH levels.

3. Drug interaction :

Avoid the combined use of strong CYP3A4 inducers (such as rifampicin) or inhibitors (such as ketoconazole).

Combined use with warfarin may increase the risk of bleeding.

Storage method

Avoid light and store at 20°C-25°C (short-term fluctuations of 15°C-30°C are allowed). Keep container tightly closed and protected from moisture.