lenvatinib (Lenvima)

Indications

• treatment of differentiated thyroid cancer that has progressed despite radioactive iodine therapy

Contraindications

Caution

• control blood pressure prior to administration of lenvatinib
  • withhold lenvatinib for hypertension stage 3 or stage 4 (BP > 180/110 mm Hg)

Dosage

• 24 mg PO QD

Capsules: 10 mg, 4 mg

Dosage adjustment in renal failure

• 14 mg PO QD for patients with severe renal failure
  • 14 mg PO QD for patients with severe liver failure

Adverse effects

• most common
  • hypertension
  • fatigue
  • diarrhea
  • arthralgia, myalgia
• serious
  • heart failure
  • arterial thromboembolism & embolic stroke
  • hepatotoxicity

Clinical significance

• median progression-free survival: 18 months vs 4 months for placebo
• reduction in tumor size: 65% vs 2% for placebo

More general terms

• small inhibitory antineoplastic agent (ib drug)