Graduate School of Life Sciences, Kumamoto University Hospital Cancer Center, Kumamoto, 860-8556, Japan.
Department of Breast and Endocrine Surgery, Kumamoto University, Kumamoto, Japan.
Med Oncol. 2018 Jan 31;35(3):19. doi: 10.1007/s12032-018-1088-5.
Lenvatinib, a multi-tyrosine kinase inhibitor, has been proven to be an effective treatment option for patients with iodine-131-refractory thyroid cancer. Many adverse effects of lenvatinib have been reported; thus, dose reduction is common. However, a few studies have analyzed the causes of lenvatinib dose reduction in daily clinical practice. Here, we investigate the factors involved in early lenvatinib dose reduction to analyze lenvatinib dose modification. We analyzed 20 thyroid cancer patients who began receiving lenvatinib at the Kumamoto University Hospital Cancer Center from July 2015 to November 2016. Patients were classified into the following groups based on the time until first withdrawal or dose reduction in lenvatinib: group A (early, ≤ 10 days) and group B (other, > 10 days). Patients' clinical features and reasons for withdrawal or dose reduction were analyzed. The age range of patients was 54-91 years, and the median observation period was 293 days. There were no significant differences in the administered line of lenvatinib; the presence/absence of primary residual tumors; or the history of hypertension, proteinuria, and diarrhea between the two groups (A, n = 7; B, n = 13). The cause for initial withdrawal or dose reduction was grade 3 hypertension in all group A patients, which was significantly higher than that in group B (p = 0.0001). Our results suggest that early blood pressure control may be effective as a method to maintain the lenvatinib dose intensity.
仑伐替尼是一种多靶点酪氨酸激酶抑制剂，已被证明是碘-131 治疗抵抗性甲状腺癌患者的有效治疗选择。仑伐替尼有许多不良反应已被报道；因此，剂量减少是常见的。然而，一些研究分析了在日常临床实践中仑伐替尼剂量减少的原因。在这里，我们研究了参与早期仑伐替尼剂量减少的因素，以分析仑伐替尼剂量调整。我们分析了 2015 年 7 月至 2016 年 11 月期间在熊本大学医院癌症中心开始接受仑伐替尼治疗的 20 例甲状腺癌患者。根据仑伐替尼首次停药或剂量减少的时间，患者分为以下两组：A 组（早期，≤10 天）和 B 组（其他，>10 天）。分析了患者的临床特征和停药或减少剂量的原因。患者年龄范围为 54-91 岁，中位观察期为 293 天。两组患者仑伐替尼给药线数、原发肿瘤残留情况、高血压、蛋白尿和腹泻病史均无显著差异（A 组 n=7，B 组 n=13）。A 组所有患者初始停药或剂量减少的原因均为 3 级高血压，明显高于 B 组（p=0.0001）。我们的结果表明，早期血压控制可能是维持仑伐替尼剂量强度的有效方法。
