Lenvatinib (lenvatinib) common side effects and risk reminders that patients should be aware of

Lenvatinib (also known as Lenvatinib, English name: Lenvatinib) is a multi-target tyrosine kinase inhibitor (TKI), which is widely used to treat many types of cancer, including differentiated thyroid cancer ( pan>DTC), hepatocellular carcinoma (HCC), renal cell carcinoma (RCC) and endometrial cancer, etc. It inhibits vascular endothelial growth factor receptor (VEGFR), fibroblast growth factor receptor (FGFR), platelet-derived growth factor receptor ( Various kinases such as pan>PDGFR), RET and KIT block tumor angiogenesis and tumor cell proliferation to achieve anti-cancer effects.

Although lenvatinib has shown significant clinical efficacy, as a targeted drug, its side effects cannot be ignored, and some patients may experience a series of systemic or organ-specific adverse reactions during use. Understanding these side effects and how to deal with them is of great significance to improving patients' medication compliance and quality of life.

1. Overview of common side effects

1.Hypertension

Hypertension is one of the most common side effects of lenvatinib. About40%-70% of patients experience elevated blood pressure in the early stages of treatment. This is mainly related to its inhibition of VEGFR, which affects the stability and relaxation function of vascular endothelium. Some patients experience blood pressure fluctuations within 1-2 weeks after taking the medication. If not properly controlled, it may lead to complications such as cerebral hemorrhage and heart failure. It is recommended that patients regularly monitor their blood pressure before and after medication, and adjust the dosage of antihypertensive drugs in a timely manner under the guidance of a doctor.

2.Proteinuria and renal impairment

Because lenvatinib can affect glomerular capillary permeability, some patients may experience proteinuria or even decreased renal function. Mild proteinuria is common and reversible, but if severe proteinuria develops, medication may need to be suspended or reduced. Patients should regularly check urine routine and renal function during medication, and intervene promptly if abnormalities are found.

3.Diarrhea and gastrointestinal reactions

Digestive system symptoms such as diarrhea, loss of appetite, nausea, and vomiting are relatively common and may affect patients' nutrient absorption and quality of life. Mild symptoms can be alleviated through dietary adjustments and symptomatic treatment, while severe diarrhea requires suspension of medication and replenishing fluids and electrolytes. It is recommended that patients maintain a light diet, pay attention to fluid intake, and regularly review electrolyte levels during medication.

4.Fatigue and weight loss

Fatigue and decreased physical strength are problems encountered by many patients receiving targeted therapy. Lenvatinib is no exception. Some patients will experience significant loss of energy and rapid weight loss during treatment, especially in elderly patients. Although such symptoms are not fatal, they have a great impact on the quality of life. You should pay attention to reasonable arrangements for work and rest, ensure adequate nutrition, and adjust the treatment rhythm according to the actual situation.

5.Abnormal thyroid function

Long-term use of lenvatinib may lead to hypothyroidism or hyperthyroidism, especially in patients with thyroid cancer. It is recommended to regularly monitor thyroid function indicators (such as TSH, FT3, FT4). Once abnormalities are found, timely supplementation of thyroid hormones or other interventions are required.

6.Bleeding and Thrombosis

Because lenvatinib affects angiogenesis, some patients may experience nose bleeding, gum bleeding, and even gastrointestinal bleeding. A few serious cases may develop arterial thrombotic events, such as myocardial infarction or cerebral infarction. Therefore, patients with a history of cardiovascular and cerebrovascular diseases should use it with caution and have their coagulation function evaluated regularly.

7.Hand-foot syndrome (skin toxicity)

Similar to otherTKI drugs, lenvatinib may cause redness, swelling, peeling, and pain in the hands and feet, especially in long-term users. Although these side effects are not fatal, they can significantly affect daily life. Pay attention to reducing friction, wearing loose shoes and socks, and using moisturizer to relieve symptoms.

2. Risk warnings that patients should be aware of during medication

1.Regular review is crucial

Although Lenvatinib is an oral medication, close monitoring is required during treatment. It is recommended that patients undergo blood pressure, liver and kidney function, electrolyte, thyroid function and other tests every 2-4 weeks to ensure that the drug is metabolized smoothly and safely in the body.

2.Strictly follow the doctor’s instructions and do not stop taking the medicine or change the dose at will

Some patients may stop taking the drug or change the dose on their own after experiencing side effects, which is a very dangerous behavior. Any adjustments should be made under the guidance of a professional doctor to avoid affecting the efficacy or causing adverse rebound.

3. Caution is required when combined with other drugs.

Lenvatinib is metabolized by liver enzymeCYP3A4, and there is a risk of interaction with certain drugs (such as anti-epileptic drugs, antibiotics, antihypertensive drugs, etc.). Patients should tell their doctors truthfully about all the medications they are taking so that a safe combination can be formulated.

4.Contraindicated during pregnancy and lactation

Animal studies have shown that lenvatinib may cause teratogenic risks to the fetus, so the drug is contraindicated in pregnant women and should be avoided in breastfeeding women. If there is a need for fertility during treatment, effective contraceptive measures should be taken, and a washout period should be followed after stopping the drug before planning pregnancy.

5.Mental health also needs attention

Faced with the long-term stress of cancer treatment and side effects, some patients may develop emotional problems such as anxiety and depression. Families are advised to be supportive and seek psychological counseling or psychiatric support if necessary.

Lenvatinib, as a multi-target targeted drug, has shown good efficacy in the treatment of a variety of solid tumors, providing new hope for patients with advanced cancer. However, the efficacy is accompanied by a series of side effects, especially high blood pressure, kidney damage, bleeding, etc., which require special attention. Patients should establish a correct concept of medication during use, actively cooperate with doctors in treatment, conduct regular reviews, and closely observe physical changes to achieve early detection and early intervention to maximize treatment effects and quality of life. Only by striking a balance between efficacy and safety can the therapeutic value of lenvatinib be truly maximized.

Reference materials:https://www.drugs.com/