lenvatinib

Lenvatinib is an oral multi-target tyrosine kinase inhibitor used in cancer therapy. It blocks several receptors involved in tumor growth and angiogenesis, including vascular endothelial growth factor receptors 1–3 (VEGFR-1, VEGFR-2, VEGFR-3), fibroblast growth factor receptors 1–4 (FGFR-1 to FGFR-4), as well as RET, KIT, and PDGFR-α. By inhibiting these pathways, lenvatinib can slow tumor vascularization and proliferation in susceptible cancers.

Common approved indications include differentiated thyroid carcinoma and unresectable hepatocellular carcinoma. The drug is taken by mouth and dosing is adjusted for tolerability and body weight in some indications. For differentiated thyroid carcinoma, a higher daily dose is typically used than for hepatocellular carcinoma, with adjustments possible based on side effects. Lenvatinib is prescribed under the supervision of a clinician, and dosing may change over the course of treatment in response to intolerance or adverse events.

Adverse effects are common and can range from mild to severe. Frequently reported events include hypertension, fatigue, diarrhea, decreased appetite and weight loss, nausea, stomatitis, thyroid dysfunction, proteinuria, and hand‑foot syndrome. Other possible effects include rash, hair color change, liver function alterations, and rare but serious events such as arterial thromboembolism, hemorrhage, wound healing impairment, or severe liver injury. Lenvatinib can be teratogenic and is generally not recommended during pregnancy; effective contraception is advised.

Pharmacologically, lenvatinib is metabolized in the liver and excreted through the feces and urine. Monitoring during treatment typically includes regular blood pressure checks, thyroid function tests, liver and kidney function labs, and assessment for proteinuria, with dose modifications made for intolerable or serious toxicity.