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Updated: Jul 25, 2025

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Effects of Lenvatinib on Skeletal Muscle Volume and Cardiac Function in Patients with Hepatocellular Carcinoma

Hidenari Nagai1, Makoto Amanuma1, Takanori Mukozu1

  • 1Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.

Oncology
|June 26, 2023
PubMed
Abstract

Insights

Lenvatinib (LEN) treatment in hepatocellular carcinoma (HCC) patients significantly reduces skeletal muscle volume and carnitine levels, potentially worsening cardiac function. Further research is needed to mitigate these adverse effects.

Area of Science:

  • Oncology
  • Cardiology
  • Metabolism

Background:

  • Tyrosine kinase inhibitors (TKIs) like sorafenib are known to decrease carnitine and skeletal muscle volume.
  • TKIs may also contribute to cardiomyopathy and heart failure.

Purpose of the Study:

  • To evaluate the effects of lenvatinib (LEN) on skeletal muscle volume and cardiac function in patients with hepatocellular carcinoma (HCC).

Main Methods:

  • Retrospective study of 58 HCC patients treated with LEN.
  • Serum carnitine and myostatin levels measured pre- and post-treatment.
  • Skeletal Muscle Index (SMI) and cardiac function (global longitudinal strain, ejection fraction) assessed via CT and echocardiography.

Main Results:

  • LEN treatment significantly decreased SMI and serum total carnitine levels.
  • Global longitudinal strain was significantly reduced, indicating worsened cardiac function.
  • Serum myostatin levels increased, while left ventricular ejection fraction remained unchanged.

Conclusions:

  • Lenvatinib (LEN) negatively impacts skeletal muscle mass and carnitine levels in HCC patients.
  • LEN treatment is associated with impaired cardiac function, specifically global longitudinal strain.
  • These findings highlight potential adverse effects of LEN that warrant clinical attention.
Keywords:
Cardiac functionCarnitineHepatocellular carcinomaLenvatinibLiver cirrhosisMuscle volumeMyostatinSarcopenia

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