Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press45310.17650/2222-1468-2019-9-4-49-61REVIEWОБЗОРНАЯ СТАТЬЯManaging the adverse events associated with lenvatinib therapy in radioiodine-refractory differentiated thyroid cancerЛечение нежелательных явлений, ассоциированных с приемом ленватиниба, у пациентов с радиойодрефрактерным дифференцированным раком щитовидной железыhttps://orcid.org/0000-0002-5124-1811CabanillasM. E.
United States

Maria E. Cabanillas

Department of Endocrine Neoplasia & Hormonal Disorders

Houston, Texas

mcabani@mdanderson.orghttps://orcid.org/0000-0002-5031-1953TakahashiS.
Japan

Department of Medical Oncology, Cancer Institute Hospital

Tokyo

The University of Texas M.D. Anderson Cancer CenterJapanese Foundation for Cancer Research071220199449610702202007022020Copyright ©; 2019, Cabanillas M.E., Takahashi S.Copyright ©; 2019, Cabanillas M.E., Takahashi S.2019Cabanillas M.E., Takahashi S.Cabanillas M.E., Takahashi S.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/453

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Ленватиниб – мультикиназный ингибитор рецепторов к фактору роста эндотелия сосудов (vascular endothelial growth factor, VEGF) 1–3, фактору роста фибробластов 1–4, тромбоцитарному фактору роста α, а также протоонкогенов RET и KIT. Ленватиниб был одобрен в качестве препарата для монотерапии радиойодрефрактерного дифференцированного рака щитовидной железы, а также (в комбинации с эверолимусом) как препарат 2-й линии для терапии прогрессирующего почечно-клеточного рака. Кроме того, сейчас проводятся исследования эффективности ленватиниба в отношении нескольких типов злокачественных новообразований, включая неоперабельный гепатоцеллюлярный рак. Несмотря на то что ленватиниб имеет высокую эффективность, при его применении могут развиваться неблагоприятные явления (НЯ), которые необходимо тщательно контролировать и активно лечить. Большинство из этих НЯ свойственны всем анти-VEGF-препаратам. Это артериальная гипертензия, диарея, повышенная утомляемость или астения, снижение аппетита и массы тела. В данном обзоре обобщены сведения о безопасности ленватиниба и представлены рекомендации по лечению как частых, так и редких НЯ. Обсуждаются потенциальные механизмы, лежащие в основе этих НЯ, и предлагаются рекомендации по уменьшению выраженности токсических эффектов. Разработка плана лечения, включающего стратегии профилактики и терапии НЯ, ассоциированных с приемом ленватиниба, позволит улучшить качество жизни пациентов, повысить их приверженность к лечению, уменьшить необходимость в снижении дозы, временной или полной отмене препарата, а также обеспечить наилучшие исходы лечения.

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