Luo Lan, Liang Hao, Yuan Lin, Wu Ya-Kun
Department of Pharmacy, Suining Central Hospital, Suining, Sichuan, China.
Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan, China.
Front Oncol. 2025 Apr 22;15:1520770. doi: 10.3389/fonc.2025.1520770. eCollection 2025.
Although numerous anticancer drugs targeting vascular endothelial growth factor (VEGF) are commonly used in clinical practice, life-threatening drug-drug interactions (DDIs) involving these drugs are rarely reported.
A male patient had been taking aspirin for two years following a stroke. He was subsequently diagnosed with hepatocellular carcinoma (HCC) and initiated lenvatinib therapy. Shortly after, he developed lenvatinib-induced hypertension (191/102 mmHg) and was prescribed amlodipine for blood pressure control. At his first routine follow-up for HCC treatment, he was asymptomatic but was incidentally diagnosed with acute aortic dissection (AD). The patient declined endovascular treatment, and his AD lesions remained temporarily stable. Although lenvatinib is generally considered a safe and effective option for advanced HCC, this case raises concerns about a potential link between lenvatinib and aspirin in the development of AD due to their temporal association. This case highlights the need for increased clinical awareness regarding possible DDIs between these two drugs, particularly in patients with untreated acute AD.
The concurrent use of lenvatinib and aspirin may increase the risk of AD in patients with cancer. To prevent life-threatening complications, patients receiving both therapies should be closely monitored and strictly adhere to treatment guidelines. For patients who decline invasive AD treatment, continued lenvatinib therapy might be a cost-effective option to improve prognosis, though the continuation of aspirin therapy requires careful consideration.
尽管众多靶向血管内皮生长因子（VEGF）的抗癌药物在临床实践中常用，但涉及这些药物的危及生命的药物相互作用（DDIs）鲜有报道。
一名男性患者中风后服用阿司匹林两年。随后他被诊断为肝细胞癌（HCC）并开始接受乐伐替尼治疗。不久后，他出现了乐伐替尼诱导的高血压（191/102 mmHg），并被开了氨氯地平来控制血压。在他首次进行HCC治疗的常规随访时，他没有症状，但偶然被诊断出患有急性主动脉夹层（AD）。患者拒绝血管内治疗，其AD病变暂时保持稳定。尽管乐伐替尼通常被认为是晚期HCC的安全有效选择，但由于这两种药物在时间上的关联，该病例引发了对乐伐替尼与阿司匹林在AD发生过程中潜在联系的担忧。该病例强调了提高对这两种药物之间可能存在的药物相互作用的临床认识的必要性，特别是在未治疗的急性AD患者中。
乐伐替尼和阿司匹林同时使用可能会增加癌症患者发生AD的风险。为预防危及生命的并发症，接受这两种治疗的患者应密切监测并严格遵守治疗指南。对于拒绝侵入性AD治疗的患者，持续使用乐伐替尼治疗可能是改善预后的一种经济有效的选择，不过阿司匹林治疗的继续使用需要仔细考虑。
