PMID- 34804279
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220428
IS  - 1920-454X (Electronic)
IS  - 1920-4531 (Print)
IS  - 1920-4531 (Linking)
VI  - 12
IP  - 5
DP  - 2021 Oct
TI  - Maximum Plasma Concentration of Lenvatinib Is Useful for Predicting 
      Thrombocytopenia in Patients Treated for Hepatocellular Carcinoma.
PG  - 165-172
LID - 10.14740/wjon1399 [doi]
AB  - BACKGROUND: Although lenvatinib treatment has a favorable efficacy for 
      unresectable hepatocellular carcinoma (HCC), it is associated with adverse events 
      (AEs) that must be closely monitored and managed. Thrombocytopenia is one of the 
      major AEs. The aim of this study was to clarify whether thrombocytopenia can be 
      predicted by the plasma concentration of lenvatinib. METHODS: This was a 
      single-center retrospective observational study. Twenty-three patients with 
      unresectable HCC and pharmacokinetics data at the initial lenvatinib 
      administration between May 2018 and September 2020 at Oita University Hospital 
      were enrolled. The AEs during the 4 weeks after the initiation of treatment were 
      evaluated, and the correlations between the thrombocytopenia and the plasma 
      concentration of lenvatinib were examined. Spearman's correlation was used to 
      evaluate the correlation between two continuous variables. RESULTS: The rate of 
      platelet count decrease correlated with the maximum plasma concentration (C(max)) 
      (r = 0.65, P = 0.001), whereas it did not with the minimum plasma concentration 
      (C(min)) (r = 0.29, P = 0.206). After stepwise multiple linear regression 
      analysis, the starting dose of lenvatinib and the serum albumin concentration 
      were identified as independent explanatory variables. Next, a formula for 
      predicting the C(max) using these two variables was created. The predicted C(max) 
      was strongly correlated with the C(max) (r = 0.87, P < 0.0001) and the rate of 
      platelet count decrease (r = 0.67, P = 0.001). CONCLUSIONS: This study identified 
      the usefulness of the drug C(max) to predict the rate of platelet count decrease 
      within 4 weeks after the initiation of treatment. Although it is difficult to 
      measure the plasma concentration of lenvatinib in community hospitals, the 
      predicted C(max) is useful for predicting the rate of platelet count decrease 
      with this treatment.
CI  - Copyright 2021, Endo et al.
FAU - Endo, Mizuki
AU  - Endo M
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Honda, Koichi
AU  - Honda K
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Saito, Tomoko
AU  - Saito T
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Shiraiwa, Ken
AU  - Shiraiwa K
AD  - Department of Clinical Pharmacy, Oita University Hospital, 1-1 Idaigaoka, 
      Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Sueshige, Yoshio
AU  - Sueshige Y
AD  - Department of Clinical Pharmacy, Oita University Hospital, 1-1 Idaigaoka, 
      Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Tokumaru, Tomoko
AU  - Tokumaru T
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Iwao, Masao
AU  - Iwao M
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Tokoro, Masanori
AU  - Tokoro M
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Arakawa, Mie
AU  - Arakawa M
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Tanaka, Ryota
AU  - Tanaka R
AD  - Department of Clinical Pharmacy, Oita University Hospital, 1-1 Idaigaoka, 
      Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Tatsuta, Ryosuke
AU  - Tatsuta R
AD  - Department of Clinical Pharmacy, Oita University Hospital, 1-1 Idaigaoka, 
      Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Seike, Masataka
AU  - Seike M
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Itoh, Hiroki
AU  - Itoh H
AD  - Department of Clinical Pharmacy, Oita University Hospital, 1-1 Idaigaoka, 
      Hasama-machi, Yufu-City, Oita 879-5593, Japan.
FAU - Murakami, Kazunari
AU  - Murakami K
AD  - Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 
      Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan.
LA  - eng
PT  - Journal Article
DEP - 20211005
PL  - Canada
TA  - World J Oncol
JT  - World journal of oncology
JID - 101564097
PMC - PMC8577601
OTO - NOTNLM
OT  - Hepatocellular carcinoma
OT  - Lenvatinib
OT  - Plasma concentration
OT  - Thrombocytopenia
COIS- We have no financial relationships to disclose.
EDAT- 2021/11/23 06:00
MHDA- 2021/11/23 06:01
PMCR- 2021/10/05
CRDT- 2021/11/22 06:44
PHST- 2021/07/13 00:00 [received]
PHST- 2021/09/10 00:00 [accepted]
PHST- 2021/11/22 06:44 [entrez]
PHST- 2021/11/23 06:00 [pubmed]
PHST- 2021/11/23 06:01 [medline]
PHST- 2021/10/05 00:00 [pmc-release]
AID - 10.14740/wjon1399 [doi]
PST - ppublish
SO  - World J Oncol. 2021 Oct;12(5):165-172. doi: 10.14740/wjon1399. Epub 2021 Oct 5.