Abstract
Differentiated thyroid cancer (DTC) refractory to radioactive iodine has a very poor prognosis, and treatment options are limited. Recently, however, small-molecular tyrosine kinase inhibitors (TKI) have shown clinical benefits in advanced thyroid cancer.
The efficacy and safety of lenvatinib (lenvima®) were evaluated in locally recurrent and metastatic radioactive iodine (RAI)-refractory differentiated thyroid cancer in the SELECT trial, and the drug was approved in 2015 in Japan. The most common side effects of lenvatinib were hypertension, fatigue, diarrhea, and appetite loss. Reported serious side effects included thromboembolic events, liver damage, fistula formation, and others. Some side effects of TKI are new, and not previously experienced with chemotherapy. Given that these side effects have not been seen with traditional cytotoxic anticancer drugs, a clear understanding of their expression and measures against them are important. Optimal management includes measures to deal with side effects as well as dose modification or interruption.
Cooperation with co-workers, including nurses, pharmacists and dentists, should include education about side effects and management of lenvatinib administration.
Here, we report the history of lenvatinib until approval, and describe its main adverse effects and their management.
