What are the side effects of Lenvatinib? How effective is the treatment?
Lenvatinib is a multi-target tyrosine kinase inhibitor mainly used to treat malignant tumors such as thyroid cancer, hepatocellular carcinoma, and renal cell carcinoma. Its clinical efficacy is significant, but attention should be paid to the management of related side effects.
1. Side effects and management
1.1 Common adverse reactions
(1) Hypertension: incidence rate>70%, regular monitoring and timely use of antihypertensive drugs are necessary.
(2) Proteinuria: About 30% of patients experience it, and medication should be suspended in severe cases.
(3) Digestive symptoms: diarrhea, nausea and vomiting, and decreased appetite are common.
1.2 Serious side effects
(1) Cardiovascular events: including heart failure, QT interval prolongation, and arterial thrombosis.
(2) Hepatorenal toxicity: May cause liver failure or kidney function damage.
(3) Bleeding risk: In severe cases, gastrointestinal bleeding or cerebral hemorrhage may occur.
1.3 Special Monitoring Requirements
(1) Before treatment, it is necessary to evaluate cardiac function, blood pressure, and urinary protein levels.
(2) Monitor blood pressure every 2 weeks during medication and check urine protein every month.
(3) If a grade 3 adverse reaction occurs, medication should be temporarily suspended, and if a grade 4 adverse reaction occurs, medication should be permanently discontinued.
2 Clinical efficacy evaluation
2.1 Therapeutic effect of thyroid cancer
(1) The Phase III study showed a median progression free survival of 18.3 months, which was significantly prolonged compared to placebo.
(2) The objective remission rate was 64.8%, the complete remission rate was 1.5%, and the median duration of remission was 30 months.
2.2 Efficacy of Liver Cancer Treatment
(1) The REFELECT trial confirmed a median overall survival of 13.6 months and non inferiority to sorafenib.
(2) The objective remission rate was 24.1%, and the median progression free survival was 7.3 months, significantly better than the control group.
2.3 Therapeutic effect on renal cancer
(1) The median progression free survival in the combination therapy group was 14.6 months, which was nearly twice as long as that in the monotherapy group.
(2) The objective remission rate is 37%, with a median overall survival of 25.5 months, significantly improving patient prognosis.
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