Rangshahi Kiran, Nanda Siddhartha, Gurunthalingam Meenalotchini Prakash, Katiyara Vikas, Thangaraju Pugazhenthan, Gaikwad Nitin R
Department of Pharmacology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Department of Radiotherapy, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Curr Drug Saf. 2025;20(2):224-228. doi: 10.2174/0115748863281030240304105117.
Hand-Foot Syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a common reaction to Tyrosine Kinase Inhibitors (TKIs), which can often lead to discontinuation of the drug. Lenvatinib is a recently approved drug for the treatment of endometrial carcinoma, which has been proven to provide a better overall survival rate and longer duration of progression-free survival among patients with advanced endometrial cancer. Herein, we have reported a case of carcinoma endometrium with metastasis who had to discontinue the use of lenvatinib due to the adverse drug reaction.
A 60-year-old female patient with carcinoma endometrium with metastasis, post radical hysterectomy with bilateral salpingo-oophorectomy with omentectomy, was started on tablet lenvatinib 8 mg once daily orally for 15 days. After 12 days of treatment, the patient noticed painful lesions with reddish-black discoloration over the left forearm and dorsal aspect of the left hand and fingers, and was diagnosed with lenvatinib-induced hand-foot syndrome. Lenvatinib was discontinued and tab. prednisolone 30mg was taken orally. The reaction subsided after five days.
Hand-foot syndrome is one of the commonest ADRs due to the use of lenvatinib. Lenvatinib is an oral formulation that patients can take at their homes. Hence, educating patients regarding the HFS is important so that they report it to the treating physicians on time. It is also essential to educate patients regarding the precautions to be taken to avoid hand-foot syndrome. This will help the physicians with the early discontinuation and appropriate treatment with corticosteroids, which will help in improving the quality of life of the patients already suffering from cancer.
手足综合征（HFS），也称为掌跖红细胞感觉异常，是酪氨酸激酶抑制剂（TKIs）常见的不良反应，常导致药物停用。乐伐替尼是一种最近获批用于治疗子宫内膜癌的药物，已被证明在晚期子宫内膜癌患者中能提供更好的总生存率和更长的无进展生存期。在此，我们报告了一例子宫内膜癌伴转移患者，因药物不良反应不得不停用乐伐替尼。
一名60岁的子宫内膜癌伴转移女性患者，接受了根治性子宫切除术、双侧输卵管卵巢切除术及大网膜切除术，开始口服乐伐替尼片，每日一次，每次8mg，共15天。治疗12天后，患者注意到左前臂、左手背及手指出现疼痛性病变，伴有红黑色色素沉着，被诊断为乐伐替尼所致的手足综合征。停用乐伐替尼，口服泼尼松龙片30mg。五天后反应消退。
手足综合征是使用乐伐替尼最常见的不良反应之一。乐伐替尼是一种口服制剂，患者可在家中服用。因此，对患者进行手足综合征相关教育很重要，以便他们及时向治疗医生报告。对患者进行预防手足综合征的注意事项教育也至关重要。这将有助于医生早期停药并适当使用皮质类固醇进行治疗，从而有助于提高已患癌症患者的生活质量。
