Lenvatinib Treatment for Kidney Cancer

Lenvatinib treatment for kidney cancer has become a significant therapeutic approach, especially for advanced renal cell carcinoma (RCC). Approved by the U.S. Food and Drug Administration (FDA) in 2016, lenvatinib is used in combination with everolimus for patients with advanced RCC who have previously undergone anti-angiogenic therapy. This approval represents a notable advancement in the array of treatments available for advanced stages of RCC.

Lenvatinib is a multi-targeted tyrosine kinase inhibitor (TKI) that acts on various tyrosine kinase receptors, including VEGFR1, VEGFR2, VEGFR3, FGFR1-4, PDGFRα, RET, and KIT. Its mechanism of action involves interrupting pathways that promote tumor growth and angiogenesis, which is the formation of new blood vessels supplying the tumor. When used for kidney cancer, lenvatinib is typically combined with everolimus, an mTOR inhibitor, to enhance its anti-cancer effects.

For advanced RCC, lenvatinib, in combination with everolimus, is prescribed to patients who have previously received anti-angiogenic therapy. This combination therapy is particularly beneficial for patients whose disease has progressed despite initial treatments. Lenvatinib is administered orally in capsule form, allowing for convenient at-home treatment. The dosage of lenvatinib may be adjusted based on the patient’s response and side effects.

The efficacy of lenvatinib in treating kidney cancer is supported by a phase 2 clinical trial. This trial demonstrated a significant improvement in progression-free survival in patients treated with lenvatinib and everolimus, compared to those receiving everolimus alone. The combination therapy has shown to improve overall response rates and delay disease progression in patients with advanced RCC.

Common side effects of lenvatinib include hypertension, fatigue, diarrhea, decreased appetite, weight loss, nausea, stomatitis, and proteinuria. Management of these side effects involves dose adjustments, supportive care, and specific medications, such as those for hypertension. Lenvatinib can also cause severe side effects like cardiac dysfunction, hemorrhagic events, and thrombotic events, necessitating careful monitoring and management.

Patients receiving lenvatinib require regular monitoring, including blood pressure checks, kidney function tests, and assessments for side effects. Periodic imaging tests are also conducted to evaluate treatment response and monitor for disease progression.

The introduction of lenvatinib treatment for kidney cancer, particularly in combination with everolimus, provides a new option for patients with advanced RCC, especially those who have not responded to initial therapy. Its broad spectrum of action against various pathways involved in tumor growth and angiogenesis makes lenvatinib a valuable addition to the treatments available for advanced kidney cancer.

Reference

Motzer RJ, Hutson TE, Glen H, et al. Lenvatinib, everolimus, and the combination in patients with metastatic renal cell carcinoma: a randomised, phase 2, open-label, multicentre trial. Lancet Oncol. 2015;16(15):1473-1482.

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