PMID- 34725855 OWN - NLM STAT- MEDLINE DCOM- 20220328 LR - 20230501 IS - 1440-1746 (Electronic) IS - 0815-9319 (Print) IS - 0815-9319 (Linking) VI - 37 IP - 3 DP - 2022 Mar TI - Expert consensus on the management of adverse events in patients receiving lenvatinib for hepatocellular carcinoma. PG - 428-439 LID - 10.1111/jgh.15727 [doi] AB - Lenvatinib is an oral multikinase inhibitor approved for use as first-line treatment for patients with advanced hepatocellular carcinoma (HCC). However, like other agents in this drug class, lenvatinib is associated with clinically important adverse events (AEs) that could adversely affect patient outcomes. Hypertension, diarrhea, decreased appetite/weight, hand-foot skin reaction, and proteinuria are among the most common AEs associated with lenvatinib therapy. This article provides strategies for the effective management of lenvatinib-associated AEs based on the expert opinion of authors and currently available literature. Due to the high risk of AEs in patients receiving lenvatinib, prophylactic measures and regular monitoring for AEs are recommended. Lenvatinib dose interruption, adjustment, or discontinuation of treatment may be required for patients who develop AEs. For grade 1 or 2 AEs, dose interruption is generally not required. For persistent or intolerable grade 2 or 3 AEs, lenvatinib treatment should be interrupted until symptoms improve/resolve to grade 0-1 or baseline levels. Thereafter, treatment should be resumed at the same or a lower dose. Disease progression may occur in patients who do not initially respond to treatment or receive a suboptimal lenvatinib dose following dose reduction, resulting in lack of efficacy. Therefore, to derive maximum treatment benefit and ensure long-term disease control, lenvatinib should be maintained at the highest possible dose when managing AEs. To conclude, lenvatinib-associated AEs can be managed with prophylactic measures, regular monitoring and symptomatic management, which can ensure continued treatment and maximum survival benefit in patients with advanced HCC receiving first-line lenvatinib therapy. CI - (c) 2021 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. FAU - Kim, Bo Hyun AU - Kim BH AD - Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Republic of Korea. FAU - Yu, Su Jong AU - Yu SJ AD - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. FAU - Kang, Wonseok AU - Kang W AD - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. FAU - Cho, Sung Bum AU - Cho SB AD - Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea. FAU - Park, Soo Young AU - Park SY AD - Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. FAU - Kim, Seung Up AU - Kim SU AUID- ORCID: 0000-0002-9658-8050 AD - Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea. FAU - Kim, Do Young AU - Kim DY AUID- ORCID: 0000-0002-8327-3439 AD - Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. AD - Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea. LA - eng GR - Eisai Korea/ PT - Journal Article PT - Review DEP - 20211117 PL - Australia TA - J Gastroenterol Hepatol JT - Journal of gastroenterology and hepatology JID - 8607909 RN - 0 (Phenylurea Compounds) RN - 0 (Protein Kinase Inhibitors) RN - 0 (Quinolines) RN - EE083865G2 (lenvatinib) SB - IM CIN - Hepatobiliary Surg Nutr. 2023 Apr 10;12(2):248-251. PMID: 37124689 MH - *Carcinoma, Hepatocellular/drug therapy MH - Consensus MH - *Drug-Related Side Effects and Adverse Reactions/therapy MH - Humans MH - *Liver Neoplasms/drug therapy MH - *Phenylurea Compounds/adverse effects MH - Protein Kinase Inhibitors/adverse effects MH - *Quinolines/adverse effects PMC - PMC9299126 OTO - NOTNLM OT - adverse events OT - hepatocellular carcinoma OT - lenvatinib OT - management EDAT- 2021/11/03 06:00 MHDA- 2022/03/29 06:00 PMCR- 2022/07/20 CRDT- 2021/11/02 06:30 PHST- 2021/10/12 00:00 [revised] PHST- 2021/08/18 00:00 [received] PHST- 2021/10/20 00:00 [accepted] PHST- 2021/11/03 06:00 [pubmed] PHST- 2022/03/29 06:00 [medline] PHST- 2021/11/02 06:30 [entrez] PHST- 2022/07/20 00:00 [pmc-release] AID - JGH15727 [pii] AID - 10.1111/jgh.15727 [doi] PST - ppublish SO - J Gastroenterol Hepatol. 2022 Mar;37(3):428-439. doi: 10.1111/jgh.15727. Epub 2021 Nov 17.