Department of Respiratory Medicine, Gunma University Graduate School of Medicine.
Oncology Center, Gunma University Hospital.
Anticancer Drugs. 2023 Apr 1;34(4):605-608. doi: 10.1097/CAD.0000000000001474. Epub 2022 Dec 5.
Lenvatinib is a multitargeted kinase inhibitor and maintaining its dose intensity has been shown to be beneficial in patients with thyroid and hepatocellular carcinomas. However, most patients require lenvatinib interruption and dose reduction due to the high incidence of adverse events (AEs). Lenvatinib was recently approved in Japan for patients with unresectable thymic carcinoma; however, real-world evidence of its clinical benefit is limited. Here, we report the case of chemotherapy-refractory thymic carcinoma in a patient who was administered a starting dose of lenvatinib using a 5-day on/2-day off (weekend-off) protocol, followed by alternate-day administration after fatigue onset derived from overt or subclinical hypothyroidism. Consequently, the patient exhibited a durable response to lenvatinib, with a 17-month progression-free survival without any severe or intolerable AEs. The present case suggests that maintaining lenvatinib dose intensity using such alternative administration regimens contributes to favorable clinical outcomes in thymic carcinoma.
乐伐替尼是一种多靶点激酶抑制剂，维持其剂量强度已被证明对甲状腺癌和肝细胞癌患者有益。然而，由于不良反应（AE）发生率高，大多数患者需要中断乐伐替尼治疗并减少剂量。乐伐替尼最近在日本被批准用于不可切除的胸腺癌患者；然而，其临床获益的真实世界证据有限。在此，我们报告了一例化疗耐药性胸腺癌患者的病例，该患者采用 5 天用药/2 天停药（周末停药）方案起始剂量给药乐伐替尼，随后在明显或亚临床甲状腺功能减退引起的疲劳出现后改为隔日给药。结果，患者对乐伐替尼表现出持久的应答，无进展生存期为 17 个月，且无严重或无法耐受的 AE。本病例提示，使用这种替代给药方案维持乐伐替尼的剂量强度有助于改善胸腺癌的临床结局。
