Lenvatinib (brand name Lenvima) is a targeted therapy used to treat various types of cancer. It is a tyrosine kinase inhibitor (TKI) that works by blocking certain proteins (receptors) involved in the growth and spread of cancer cells. Specifically, lenvatinib blocks a series of enzymes involved in tumor growth, angiogenesis (the formation of new blood vessels that supply tumors), and the spread of cancer and Lenvatinib Price Malaysia.

Approved uses of Lenvatinib:
Thyroid cancer (differentiated thyroid cancer):

Lenvatinib is used primarily to treat advanced, progressive, or metastatic differentiated thyroid cancer (DTC), particularly in patients who have refractory disease (meaning the cancer is resistant to radioactive iodine therapy).

It is approved for use in patients with radioactive iodine-refractory differentiated thyroid cancer (RAI-refractory DTC) who require systemic therapy. In these cases, lenvatinib helps to slow tumour growth and improve symptoms.

Response rate: Lenvatinib has shown effectiveness in this context, with response rates in clinical trials typically being in the range of 60-70%, meaning that a significant proportion of patients experience tumour shrinkage or stabilisation.

Renal cell carcinoma (RCC):

Lenvatinib is also approved for the treatment of advanced renal cell carcinoma (a type of kidney cancer) in combination with everolimus, another targeted therapy.

This combination has been shown to improve progression-free survival (PFS) in patients with advanced RCC who have received prior treatment with immunotherapy or targeted therapy.

PFS improvement: In clinical studies, this combination has demonstrated significant benefits in delaying disease progression and prolonging survival compared with monotherapy.

Hepatocellular carcinoma (HCC):

Lenvatinib is approved for the treatment of advanced hepatocellular carcinoma (HCC), the most common form of liver cancer.

It is used in patients who are not candidates for surgery or whose disease cannot be cured, often as a first-line treatment.

PFS and OS benefits: Lenvatinib has shown improved progression-free survival (PFS) compared to other standard treatments such as sorafenib, with patients experiencing a delay in tumor growth and a survival benefit in some cases.

Endometrial cancer (under clinical investigation, off-label):
The use of lenvatinib for endometrial carcinoma (uterine cancer) is under research, particularly in combination with other treatments such as pembrolizumab (a PD-1 inhibitor).

Early studies have shown promising results, and lenvatinib may become a treatment option for advanced or recurrent endometrial cancer.

Mechanism of action:
Lenvatinib works by inhibiting several receptor tyrosine kinases involved in signaling pathways that promote cancer cell growth, angiogenesis, and metastasis. These include:

VEGFR (vascular endothelial growth factor receptor)
FGFR (fibroblast growth factor receptor)
PDGFR (platelet-derived growth factor receptor)
KIT (stem cell factor receptor)
RET (rearranged during transfection oncogene)
By blocking these receptors, lenvatinib helps prevent tumor cells from receiving the signals they need to grow and divide, and it prevents the formation of blood vessels that provide nutrients to the tumor.

Dosage:
Thyroid cancer: The usual starting dose is 24 mg once daily.
Renal cell carcinoma: The usual dose is 18 mg once daily in combination with everolimus.

Hepatocellular carcinoma: The starting dose for patients with generally normal liver function is usually 8 mg once daily, with adjustments made for liver function status or side effects.

Side effects:
Like other targeted therapies, lenvatinib can have side effects. Common ones include:

Hypertension (high blood pressure): Often requires management or treatment with antihypertensive medications.
Fatigue: Many patients experience fatigue or weakness.
Diarrhea: Gastrointestinal symptoms such as diarrhea can be common.
Loss of appetite and weight loss.
Liver problems: Lenvatinib can cause liver enzyme abnormalities, so regular liver function tests are necessary during treatment.
Proteinuria (protein in the urine), which may lead to kidney problems.
Hand-foot syndrome: A condition that causes redness, swelling, and pain on the palms of the hands and the soles of the feet.

Conclusion:
Lenvatinib is an effective treatment for many types of cancer, particularly advanced thyroid cancer, renal cell carcinoma, and hepatocellular carcinoma. It works by stopping the growth and spread of cancer cells through multiple mechanisms that target different growth factors involved in cancer progression. Its use in combination with other treatments, such as everolimus for RCC or pembrolizumab for endometrial cancer, is also being explored. Although this drug is generally well-tolerated, be cautious about its side effects, particularly high blood pressure and liver function problems.

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