Lenvatinib (Lenvima)

General information

Class/mechanism: Tyrosine kinase inhibitor of multiple receptor tyrosine kinases (RTKs), including: vascular endothelial growth factor (VEGF) receptors VEGFR1 (FLT1), VEGFR2 (KDR), and VEGFR3 (FLT4); fibroblast growth factor (FGF) receptors FGFR1, FGFR2, FGFR3, and FGFR4; platelet derived growth factor receptor alpha (PDGFRα), KIT, and RET. Inhibition of these receptor tyrosine kinases interferes with cancer cells' proliferation and pathogenic angiogenesis.
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the package insert.

Diseases for which it is used

• Endometrial cancer
• Hepatocellular carcinoma
• Renal cell carcinoma
• Thyroid cancer

Patient drug information

• Lenvatinib (Lenvima) package insert
• Lenvatinib (Lenvima) patient drug information (Chemocare)
• Lenvatinib (Lenvima) patient drug information (UpToDate)

History of changes in FDA indication

Endometrial cancer

• 9/17/2019: Accelerated approval in combination with Pembrolizumab (Keytruda) for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability high (MSI-H) or mismatch repair deficient (dMMR) and who have disease progression following prior systemic therapy but are not candidates for curative surgery or radiation. (New disease indication; based on KEYNOTE-146)

Hepatocellular carcinoma

• 8/16/2018: Approved for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). (Based on REFLECT)

Renal cell carcinoma

• 5/13/2016: Approved in combination with everolimus, for the treatment of advanced renal cell carcinoma following one prior anti-angiogenic therapy. (Based on E7080-G000-205)
• 8/10/2021: Approved in combination with Pembrolizumab (Keytruda) for first-line treatment of adult patients with advanced renal cell carcinoma (RCC). (Based on CLEAR)

Thyroid cancer

• 2/13/2015: Approved for the treatment of patients with locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer. (Initial approval; based on SELECT)

Also known as

• Code name: E7080
• Brand name: Lenvima