Improvement of lenvatinib-induced nephrotic syndrome after adaptation to sorafenib in thyroid cancer:A case report
作者机构:Division of UrologyDepartment of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan Division of General SurgeryDepartment of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan
出 版 物:《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期:2020年第8卷第20期
页 面:4883-4894页
核心收录:
学科分类:1002[医学-临床医学] 100210[医学-外科学(含:普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100214[医学-肿瘤学] 10[医学]
主 题:Molecular targeted therapy/methods Receptors Vascular endothelial growth factor/drug effects Vascular endothelial growth factor/therapeutic use Vascular endothelial growth factor A/drug effects Nephrotic syndrome/drug therapy Case report
摘 要:BACKGROUND Target therapy is licensed by United States Food and Drug Administration on certain *** sorafenib and lenvatinib are tyrosine kinase inhibitor and indicated on radioactive iodine(RAI)-refractory differentiated thyroid cancer(DTC).Lenvatinib is more effective in cancers control than sorafenib,but causes more nephrotoxicity than sorafenib *** case is the second published case about the serial adaptions from lenvatinib to sorafenib for improving the proteinuria and,meanwhile,achieving the therapeutic *** SUMMARY A 56-year-old man suffered from bilateral edematous lower extremities after 1-mo prescription of lenvatinib of 20 mg/d for RAI-refractory *** from this symptom,he also developed *** laboratory showed grade-3 proteinuria(estimated 24-h urine protein:9993 mg),hypoalbuminemia and ***-vascular endothelial growth factor(VEGF)therapyinduced nephrotic syndrome was *** reduced dosage of lenvatinib of 10 mg/d and related symptomatic drugs,limited improvement was observed in both adverse effects and caner *** this condition,we substituted sorafenib of 400 mg/d for lenvatinib of 10 mg/*** a 5-mo prescription,not only hypertension and peripheral edema were greatly improved,but also proteinuria was improved from grade three to grade one(estimated 24-h urine protein:962 mg).At the same time the cancer control was achieved,judged from computed tomography and laboratory evidence[thyroglobulin(Tg)before prescription of sorafenib:354.7 ng/m L;Tg after prescription of sorafenib:108.9 ng/m L].CONCLUSION Adaption from lenvatinib to sorafenib is a feasible method to improve the antiVEGF therapy-induced nephrotic syndrome and achieve the therapeutic goal at the same time.