Incidence and risk of hypertension with lenvatinib in treatment of solid tumors: An updated systematic review and meta‐analysis

Wu, Hongxiao; Ding, Xiaoyan; Zhang, Yongchao; Li, Wei; Chen, Jinglong

doi:10.1111/jch.14463

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…In addition to apatinib, hypertension was also reported in other small molecule tyrosine kinase inhibitors (TKI), such as sorafenib [24] , sunitinib [25] , lenvatinib [26] , and axitinib [27] . Among these TKI, the absolute risk of hypertension is significant.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of apatinib-related hypertension and identification of clinical risk factors

LE¹,

Liu²,

ma³

et al. 2023

Preprint

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Background: Antineoplastic therapy with the tyrosine kinase inhibitor(TKI) apatinib in patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma(GC) has been associated with hypertension (HTN), but little is known about predisposing clinical characteristics. This study describes the real-world association between baseline clinical characteristics and blood pressure (BP) response in patients prescribed apatinib with GC. Methods: 55 GC patients treated with apatinib were collected from the 1st December 2016 to the 1st December 2020 using medical records retrospectively. Outcomes were defined using the National Cancer Institute’s Common Terminology Criteria for Adverse Events v5.0. Univariate and multivariable logistic regression were used to investigate potential clinical risk factors. Results: 45.45% of patients were evaluated for apatinib-related HTN and Grade 3 HTN occurred 16.36% of patients. Median maximal systolic blood pressure (SBP) during apatinib treatment was 153 mmHg with median time to event of 25 days. New-onset HTN occurred in 10/33 (30.30%) patients. pre-existing HTN(odds ratio [OR]: 4.155; 95% confidence interval [CI]: 1.252-13.787; p =0.020 was key independent risk factors associated with apatinib-related HTN. Conclusions: More thorough BP monitor prior to starting apatinib especially in patients with pre-existing hypertension may reduce cardiovascular risk.

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Section: Discussionmentioning

confidence: 99%

Evaluation of apatinib-related hypertension and identification of clinical risk factors

LE¹,

Liu²,

ma³

et al. 2023

Preprint

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“…Bleeding complications occur in 25% of patients treated with this drug, among which fatal CNS events have been reported. Most commonly, lenvatinib causes high blood pressure in up to 72% of patients, which is severe in approximately half of these cases 8 9. Normal blood pressure values on admission rule out cerebral haemorrhage secondary to a hypertensive emergency.…”

Section: Discussionmentioning

confidence: 99%

Convexal subarachnoid haemorrhage in a patient under pembrolizumab-lenvatinib combination therapy

Simao,

Almeida,

Catela

et al. 2023

BMJ Case Rep

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A woman in her 60s was brought to the emergency department due to a new-onset seizure. She was drowsy on arrival and unable to provide a clinical history. She had a medical history of advanced endometrial cancer, for which she was under the therapeutic protocol pembrolizumab plus lenvatinib. Laboratorial investigations were unremarkable. The brain CT angiography provided further insight into the case by detecting a bilateral convexal subarachnoid haemorrhage with discrete bilateral opercular vasogenic oedema, without other noticeable structural changes. Cerebrospinal fluid analysis was macroscopically haemorrhagic, but otherwise unremarkable. The brain MRI did not provide additional information. Although considered a rare adverse reaction, cerebral haemorrhage has been described for both pembrolizumab and lenvatinib. We cautiously assumed a probable drug aetiology after a thorough review of potential causes. Following discontinuation of these drugs and under anti-convulsive therapy, the patient remained asymptomatic and was discharged home.

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“…26,27 A recent meta-analysis showed that lenvatinib-induced hypertension may be associated with better prognosis. 28 Lenvatinib-induced adverse events could be managed through regular monitoring, preventive measures and symptomatic management. 27 Lenvatinib shows promise for patients with HCC as numbers of studies have shown its benefits in prolonging the OS and PFS of the patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of combining Lenvatinib with Transarterial chemoembolization for unresectable hepatocellular carcinoma

Long,

Liu,

Yang

et al. 2023

Pak J Med Sci

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Objectives: To investigate the impact of combining lenvatinib with transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC). Methods: This was a retrospective observational study which reviewed the medical records of 103 unresectable HCC patients from January 2017 to June 2020 in The First Affiliated Hospital of Soochow University. It included 46 patients who received TACE plus lenvatinib and 57 patients who received TACE alone. The levels of serum indicators, clinical effect, adverse events, overall survival (OS), and progression-free survival (PFS) were compared between the two groups. Results: AFP and VEGF levels in the TACE+lenvatinib group post-treatment were significantly lower than the TACE group (P<0.05). The clinical efficacy in the TACE+lenvatinib group (69.57%) was higher than that in the TACE group (40.35%) post-treatment (P<0.05). There were significant differences in hypertension, diarrhea, and bleeding (gingiva) between the two groups (P<0.05). There were no significant differences in one or two year PFS rate or one year OS between groups (P>0.05), while the two years survival rate in the TACE+lenvatinib group was significantly higher than that in the TACE group (P<0.05). Conclusions: TACE combined with lenvatinib have a high clinical effective rate, with reduced AFP and VEGF levels, higher two year survival rate, and acceptable incidence of adverse events. doi: https://doi.org/10.12669/pjms.39.6.7944 How to cite this: Long J, Liu L, Yang X, Lu X, Qin L. Impact of combining Lenvatinib with Transarterial chemoembolization for unresectable hepatocellular carcinoma. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7944 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Incidence and risk of hypertension with lenvatinib in treatment of solid tumors: An updated systematic review and meta‐analysis

Cited by 10 publications

References 35 publications

Evaluation of apatinib-related hypertension and identification of clinical risk factors

Evaluation of apatinib-related hypertension and identification of clinical risk factors

Convexal subarachnoid haemorrhage in a patient under pembrolizumab-lenvatinib combination therapy

Impact of combining Lenvatinib with Transarterial chemoembolization for unresectable hepatocellular carcinoma

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