Therapeutic drug monitoring · 2025
Serum Lenvatinib and Interleukin-6 Profiles and Their Relationship With Acute Heart Failure Development in a Patient With Thymic Carcinoma and Cancer Inflammation.
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Asakura Mitsutoshi, Seki Natsumi, Mino Yasuaki, Kobayashi Takashi, Koizumi Tomonobu, Naito Takafumi
Аннотация
BACKGROUND: A 63-year-old woman diagnosed with unresectable thymic carcinoma received modified ADOC therapy, followed by thoracic radiotherapy. Because she had a poor response to both chemotherapy and radiotherapy, lenvatinib was initiated at a dose of 24 mg once daily on day 1. The dose was reduced to 20 mg once daily on day 16.
METHODS: The serum levels of lenvatinib and interleukin-6 (IL-6) alongside serum markers of heart failure and other lenvatinib-related adverse effects were monitored.
RESULTS: The serum trough levels of lenvatinib on days 4 and 9 were both 108 ng/mL. On day 25, the serum brain natriuretic peptide level and left ventricular ejection fraction were 2567 pg/mL and 26%, respectively. Lenvatinib was discontinued on day 26, after which her serum brain natriuretic peptide levels decreased to 767 pg/mL on day 30 and 27 pg/mL on day 51. The toxicity threshold for the serum trough level of lenvatinib has been reported to be 88 ng/mL. The patient had severe cancer inflammation due to carcinomatous pleurisy and tumor fever. The serum IL-6 levels during treatment ranged from 13.7 to 25.5 pg/mL.
CONCLUSIONS: These findings suggest that elevated serum IL-6 levels lead to delayed elimination of lenvatinib. The increased serum levels of both lenvatinib and IL-6 may be associated with the development of acute heart failure in patients with thymic carcinoma.
METHODS: The serum levels of lenvatinib and interleukin-6 (IL-6) alongside serum markers of heart failure and other lenvatinib-related adverse effects were monitored.
RESULTS: The serum trough levels of lenvatinib on days 4 and 9 were both 108 ng/mL. On day 25, the serum brain natriuretic peptide level and left ventricular ejection fraction were 2567 pg/mL and 26%, respectively. Lenvatinib was discontinued on day 26, after which her serum brain natriuretic peptide levels decreased to 767 pg/mL on day 30 and 27 pg/mL on day 51. The toxicity threshold for the serum trough level of lenvatinib has been reported to be 88 ng/mL. The patient had severe cancer inflammation due to carcinomatous pleurisy and tumor fever. The serum IL-6 levels during treatment ranged from 13.7 to 25.5 pg/mL.
CONCLUSIONS: These findings suggest that elevated serum IL-6 levels lead to delayed elimination of lenvatinib. The increased serum levels of both lenvatinib and IL-6 may be associated with the development of acute heart failure in patients with thymic carcinoma.