Lenvatinib

(Lenvima®)

Lenvima®

Drug updated on 3/28/2024

Dosage FormCapsule (oral; 4 mg, 10 mg)
Drug ClassKinase inhibitors
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • For the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC).
  • Indicated in combination with pembrolizumab, for the first line treatment of adult patients with advanced renal cell carcinoma (RCC).
  • Indicated in combination with everolimus, for the treatment of patients with advanced renal cell carcinoma (RCC) following one prior antiangiogenic therapy.
  • For the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC).
  • Indicated in combination with pembrolizumab, for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy and are not candidates for curative surgery or radiation.

Summary
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  • Lenvatinib (Lenvima) is indicated for the treatment of locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer (DTC), advanced renal cell carcinoma (RCC), and unresectable hepatocellular carcinoma (HCC). It's also used in combination with pembrolizumab for first-line treatment of RCC and endometrial carcinoma.
  • A total of 45 systematic reviews/meta-analyses were reviewed to gather information about Lenvatinib's safety and effectiveness.
  • In treating metastatic Renal Cell Carcinoma, Lenvatinib combined with Pembrolizumab showed advantages in progression-free survival and objective response rate compared to other treatments such as Pembrolizumab plus Axitinib.
  • For patients suffering from unresectable Hepatocellular Carcinoma, studies found that Lenvatinib was comparable or superior in overall survival benefits when compared to Sorafenib. The best results regarding overall survival benefit were observed when it was combined with transcatheter arterial chemoembolization.
  • When treating Radioiodine-Refractory Differentiated Thyroid Cancer, a significant improvement in progression-free survival was noted when using lenvatinb compared to placebo.
  • However, there are concerns related to adverse events associated with the use of this drug. Studies show that its usage can lead higher incidence rates of grade ≥3 adverse events including hypertension proteinuria fatigue hand-foot syndrome necessitating careful management strategies.
  • The efficacy varies based on subgroup considerations like disease etiology patient’s prior exposure specific genetic molecular markers suggesting tailored approach might be beneficial particularly among Asian populations where varying effectiveness has been reported based on ethnicity etiology HCC.
  • Lenavtinb shows promise offering substantial PFS sometimes OS benefits however its use is associated noteworthy incidence AE necessitating attentive management strategies Efficacy safety profiles suggest decisions should consider disease characteristics previous treatments patient-specific factors including etiology possibly genetic markers optimize outcomes.

Product Monograph / Prescribing Information

Document TitleYearSource
Lenvima (lenvatinib) Prescribing Information. 2022Eisai Inc., Woodcliff Lake, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Comparing efficacy and safety of first-line treatment of metastatic renal cell carcinoma: A Bayesian network meta-regression analysis2023Frontiers in oncology
Systemic therapy with or without locoregional therapy for advanced hepatocellular carcinoma: A systematic review and network meta-analysis2023Critical reviews in oncology/hematology
Efficacy and safety of transarterial chemoembolization plus lenvatinib with or without programmed death-1 inhibitors in the treatment of unresectable hepatocellular carcinoma: a systematic review and meta-analysis2023Journal of cancer research
Lenvatinib in the treatment of unresectable hepatocellular carcinoma: a systematic review of economic evaluations2023European journal of clinical pharmacology
Efficacy and safety of atezolizumab plus bevacizumab versus lenvatinib for unresectable hepatocellular carcinoma: a systematic review and meta-analysis2023Journal of cancer
Comparison of the effects of lenvatinib and sorafenib on survival in patients with advanced hepatocellular carcinoma: A systematic review and meta-analysis2023Clinics and research in hepatology and gastroenterology
Clinical efficacy and safety of atezolizumab plus bevacizumab versus lenvatinib in the treatment of advanced hepatocellular carcinoma: A systematic review and meta-analysis 2023Medicine
Everolimus and temsirolimus are not the same second-line in metastatic renal cell carcinoma: a systematic review and meta-analysis2023Cost effectiveness and resource allocation
Comparative safety of tyrosine kinase inhibitors in the treatment of metastatic renal cell carcinoma: a systematic review and network meta-analysis2023Frontiers in pharmacology
Atezolizumab plus bevacizumab versus lenvatinib as first-line therapy for advanced hepatocellular carcinoma: A systematic review and meta-analysis2023Clinical and experimental hepatology
How immunotherapy modified the therapeutic scenario of endometrial cancer: a systematic review.2022Frontiers in Oncology
Clinical outcomes and adverse events after first-line treatment in metastatic renal cell carcinoma: a systematic review and network meta-analysis.2022The Journal of Urology
Efficacy and safety of first-line systemic therapy for metastatic renal cell carcinoma: a systematic review and network meta-analysis.2022European Urology Open Science
Evolving landscape of first-line combination therapy in advanced renal cancer: a systematic review.2022Therapeutic Advances in Medical Oncology
Clinical and pharmacoeconomic combined report.2022CADTH
Optimizing targeted drug selection in combination therapy for patients with advanced or metastatic renal cell carcinoma: A systematic review and network meta-analysis of safety.2022Cancer Medicine
Incidence and risk of hypertension with lenvatinib in treatment of solid tumors: An updated systematic review and meta-analysis.2022The Journal of Clinical Hypertension
Efficacy and safety of lenvatinib versus sorafenib in first-line treatment of advanced hepatocellular carcinoma: A meta-analysis.2022Frontiers in Oncology
Lenvatinib as first-line treatment for unresectable hepatocellular carcinoma: a systematic review and meta-analysis.2022Cancers
IO-IO vs IO-TKI efficacy in metastatic kidney cancer patients: A structured systematic review over time2022Seminars in oncology
Efficacy and safety of targeted therapeutics for patients with radioiodine-refractory differentiated thyroid cancer: Systematic review and network meta-analysis2022Frontiers in pharmacology
New first-line immunotherapy-based combinations for metastatic renal cell carcinoma: A systematic review and network meta-analysis2022Cancer treatment reviews
The effect of immune checkpoint inhibitor combination therapies in metastatic renal cell carcinoma patients with and without previous cytoreductive nephrectomy: A systematic review and meta-analysis2022International immunopharmacology
Systemic therapies for metastatic renal cell carcinoma in the second-line setting: A systematic review and network meta-analysis2022Medicine
Impact of Post-progression Survival on Outcomes of Lenvatinib Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Retrospective Cohort Study2022Anticancer research
Lenvatinib versus sorafenib as first-line therapy of advanced hepatocellular carcinoma: a systematic review and meta-analysis. 2021American Journal of Translational Research
Efficacy of first line systemic chemotherapy and multikinase inhibitors in advanced hepatocellular carcinoma: a systematic review and network meta-analysis.2021Frontiers in Oncology
Comparison of efficacy of systemic therapies in advanced hepatocellular carcinoma: updated systematic review and frequentist network meta-analysis of randomized controlled trials.2021Journal of Hepatocellular Cancer
Comparative efficacy of atezolizumab plus bevacizumab and other treatment options for patients with unresectable hepatocellular carcinoma: a network meta-analysis.2021Liver Cancer
Bleeding with vascular endothelial growth factor tyrosine kinase inhibitor: a network meta-analysis. 2021Critical Reviews in Oncology/ Hematology
Evidence-based management of hepatocellular carcinoma: systematic review and meta-analysis of randomized controlled trials (2002–2020). 2021Gastroenterology
Clinical efficacy of lenvatinib for the treatment of radioiodinerefractory thyroid carcinoma: a systematic review and meta-analysis of clinical trials.2021Clinical Endocrinology
Optimizing survival and the changing landscape of targeted therapy for intermediate and advanced hepatocellular carcinoma: a systematic review. 2021Journal of the National Cancer Institute
Selection of first-line systemic therapies for advanced hepatocellular carcinoma: a network meta-analysis of randomized controlled trials. 2021World Journal of Gastroenterology
A systematic literature review and network meta-analysis of first-line treatments for unresectable hepatocellular carcinoma based on data from randomized controlled trials. 2021Expert Review of Anticancer Therapy
A network meta-analysis of efficacy and safety of first-line and second-line therapies for the management of metastatic renal cell carcinoma.2021Journal of Clinical Pharmacy and Therapeutics
Adverse events of systemic immune-based combination therapies in the first-line treatment of patients with metastatic renal cell carcinoma: systematic review and network meta-analysis2021Current opinion in urology
First-line Immunotherapy-based Combinations for Metastatic Renal Cell Carcinoma: A Systematic Review and Network Meta-analysis2021European urology oncology
First-Line Systemic Treatment Strategies for Unresectable Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis of Randomized Clinical Trials2021Frontiers in oncology
Non-surgical management of advanced hepatocellular carcinoma: A systematic review by Cancer Care Ontario2021Canadian liver journal
Lenvatinib and sorafenib for differentiated thyroid cancer after radioactive iodine: a systematic review and economic evaluation.2020NIHR
Systemic therapy and sequencing options in advanced hepatocellular carcinoma: a systematic review and network meta-analysis.2020JAMA Oncology
Australian public assessment report: for lenvatinib.2020Australian Government: Department of Health
Anti-Tumor Activity and Safety of Multikinase Inhibitors in Advanced and/or Metastatic Thyroid Cancer: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials2020Hormone and metabolic research
A systematic review of lenvatinib and sorafenib for treating progressive, locally advanced or metastatic, differentiated thyroid cancer after treatment with radioactive iodine. 2019BMC Cancer
Targeted therapies for previously treated advanced or metastatic renal cell carcinoma: systematic review and network meta-analysis. 2019BMJ Open
Final clinical guidance report: Lenvima for renal cell carcinoma.2019CADTH
Final clinical guidance report: Lenvima for hepatocellular carcinoma.2019CADTH
Treatment-related adverse effects with TKIs in patients with advanced or radioiodine refractory differentiated thyroid carcinoma: a systematic review and meta-analysis2019Cancer management and research
Second-line Treatments of Advanced Hepatocellular Carcinoma: Systematic Review and Network Meta-Analysis of Randomized Controlled Trials2019Journal of clinical gastroenterology
Indirect treatment comparisons including network meta-analysis: Lenvatinib plus everolimus for the second-line treatment of advanced/metastatic renal cell carcinoma2019PloS one
Lenvatinib with everolimus for previously treated advanced renal cell carcinoma. 2018NICE

Clinical Practice Guidelines