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Care During Chemotherapy and Beyond

Lenvatinib

(len VA ti nib)

Trade name: Lenvima™

Lenvatinib is the generic for the trade name drug Lenvima™. In some cases, health care professionals may use the trade name Lenvima™ when referring to the generic drug name lenvatinib.

Drug type: Lenvatinib is a targeted therapy. It is an oral receptor tyrosine kinase inhibitor - (For more detail, see "How this drug works," below.)

What Lenvatinib Is Used For:

  • For the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer.
  • In combination with the drug everolimus, for the treatment of advanced renal cell carcinoma following one prior anti-angiogenic therapy.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Lenvatinib Is Given:

  • Lenvatinib is a pill, taken by mouth, once daily. It can be taken with or without food.
  • Take lenvatinib exactly as prescribed.
  • Swallow lenvatinib capsules whole. Do not crush, dissolve or open capsules.
  • Do not change your dose or stop lenvatinib unless your health care provider tells you to.
  • If you miss a dose, take it as soon as you remember. If your next dose is within 12 hours, skip the missed dose and take the next dose at your regular time.
  • Do not take more than 1 dose of lenvatinib at one time. Call your health care provider right away if you take too much.
  • The amount of lenvatinib that you will receive depends on many factors, your general health or other health problems, and the type of cancer or condition being treated.
  • Dose modifications are often made so it is important to let your healthcare provider know of any side effects.

Side Effects:

Important things to remember about the side effects of lenvatinib:

  • Most people do not experience all of the side effects listed.
  • Side effects are often predictable in terms of their onset and duration.
  • There are many options to help minimize or prevent side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects are common (occurring in greater than 30%) for patients taking lenvatinib:

These side effects are less common side effects (occurring in about 10-29%) of patients receiving lenvatinib:

Not all side effects are listed above. Some that are rare (occurring in less than 10% of patients) are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms.

When to contact your doctor or health care provider:

Contact your health care provider immediately, day or night, and go to the emergency room, if you should experience any of the following symptoms:

  • Fever of 100.4° F (38°C or higher, chills)
  • Symptoms of heart problems such as shortness of breath or swelling
  • Symptoms associated with a possible blood clot, such as: chest pain or pressure; pain in your arms, back, neck or jaw; numbness or weakness on one side of your body; trouble talking; sudden or severe headache; sudden vision changes
  • Severe stomach (abdominal) pain
  • Severe headache, seizures, weakness, confusion, blindness or change in vision. This could be a rare syndrome call Reversible Posterior Leukoencephalopathy.

The following symptoms require medical attention, but are not an emergency. Contact your health care provider within 24 hours of noticing any of the following:

  • High blood pressure
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
  • Skin or the whites of your eyes turn yellow
  • Urine turns dark or brown (tea color)
  • Light-colored bowel movements
  • Decreased appetite
  • Pain on the right side of your stomach
  • Bleed or bruise more easily than normal (nose bleeds, coughing up blood, heavy vaginal bleeding, bleeding from the rectum)
  • Skin changes (rash, acne, itching, blisters, peeling, redness or swelling).

Always inform your health care provider if you experience any unusual symptoms.

Precautions:

  • Before starting lenvatinib treatment, make sure you tell your doctor about any other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.).
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking lenvatinib.
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Pregnancy category D (lenvatinib may be hazardous to the fetus. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.)
  • For both men and women: Do not conceive a child (get pregnant) while taking lenvatinib. Barrier methods of contraception, such as condoms, are recommended during treatment and for at least 2 weeks following completion of therapy. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication.

Self-Care Tips:

  • High blood pressure may be a side effect of lenvatinib. You blood pressure should be well controlled before starting lenvatinib. Your healthcare provider will check your blood pressure regularly during treatment.
  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
  • Avoid sun exposure. Wear SPF 30 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Lenvatinib can cause tiredness, weakness or blurred vision. If you have any of these symptoms, use caution when driving a car, using machinery, or anything that requires you to be alert.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing:

You will be checked regularly by your health care professional while you are taking lenvatinib to monitor side effects and check your response to therapy. Testing may include but is not limited to:

  • Blood pressure
  • Liver and kidney functions
  • Electrolytes
  • Urine protein level
  • Electrocardiogram (EKG)
  • Thyroid hormone levels

How Lenvatinib Works:

Targeted therapy is the result of about 100 years of research dedicated to understanding the differences between cancer cells and normal cells. To date, cancer treatment has focused primarily on killing rapidly dividing cells because one feature of cancer cells is that they divide rapidly. Unfortunately, some of our normal cells divide rapidly too, causing multiple side effects.

Targeted therapy is about identifying other features of cancer cells. Scientists look for specific differences in the cancer cells and the normal cells. This information is used to create a targeted therapy to attack the cancer cells without damaging the normal cells, thus leading to fewer side effects. Each type of targeted therapy works a little bit differently but all interfere with the ability of the cancer cell to grow, divide, repair and/or communicate with other cells.

There are different types of targeted therapies, defined in three broad categories. Some targeted therapies focus on the internal components and function of the cancer cell. The targeted therapies use small molecules that can get into the cell and disrupt the function of the cells, causing them to die. There are several types of targeted therapy that focus on the inner parts of the cells. Other targeted therapies target receptors that are on the outside of the cell. Therapies that target receptors are also known as monoclonal antibodies. Antiangiogenesis inhibitors target the blood vessels that supply oxygen to the cells, ultimately causing the cells to starve.

Lenvatinib is a targeted therapy that targets and binds to the tyrosine kinase receptors and inhibits vascular epidermal growth factor receptor (VEGFR), vascular endothelial growth factor (VEGF), and inhibits other kinase receptors that have been implicated in pathogenic angiogenesis, tumor growth, and cancer progression in addition to their normal cellular functions, including fibroblast growth factor (FGF) receptors and platelet derived growth factor receptor alpha (PDGFRa), KIT and RET on the surface of the cell. By binding to these receptors lenvatinib blocks important pathways that promote cell division.

Research continues to identify which cancers may be best treated with targeted therapies and to identify additional targets for more types of cancer.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

References:

Lenvatinib.Lexicomp Online® [updated 2015 July 16; cited 2015 August 12]. Lexi-Drugs®. Hudson, Ohio: Lexi-Comp, Inc.; August 11, 2015

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