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Improvement of lenvatinib-induced nephrotic syndrome after adaptation to sorafenib in thyroid cancer:A case report

World Journal of Clinical Cases 2020年第20期8卷 4883-4894页

作者： Che Hseuh Yang Kuo Tung Chen Yi Sheng Lin Chao Yu Hsu Yen Chuan Ou Min Che Tung Division of Urology Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan Division of General Surgery Department of SurgeryTungs'Taichung MetroHarbor HospitalTaichung City 435403Taiwan

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.

关键词： 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

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