The action and resistance mechanisms of Lenvatinib in liver cancer

Anna Buttell1,2, Wei Qiu1,2

  • 1Departments of Surgery, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA.

Molecular Carcinogenesis
|September 6, 2023
PubMed

Insights

Lenvatinib, a tyrosine kinase inhibitor, combats cancer by blocking new blood vessel growth. Understanding Lenvatinib resistance mechanisms is crucial as resistance can negate its survival benefits.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Lenvatinib is a multi-targeted tyrosine kinase inhibitor used in cancer therapy.
  • It functions by inhibiting key receptors like VEGFRs and FGFRs, crucial for tumor growth and angiogenesis.
  • Despite its efficacy, acquired resistance limits Lenvatinib's long-term clinical benefit.

Purpose of the Study:

  • To review and synthesize the known mechanisms of Lenvatinib resistance.
  • To consolidate current research on how cancer cells evade Lenvatinib treatment.
  • To highlight the clinical importance of understanding resistance for improved patient outcomes.

Main Methods:

  • Literature review of preclinical and clinical studies on Lenvatinib resistance.
  • Analysis of molecular pathways and genetic alterations associated with resistance.
  • Synthesis of data from various research methodologies investigating resistance mechanisms.

Main Results:

  • Multiple mechanisms contribute to Lenvatinib resistance, including alterations in target receptor signaling and activation of bypass pathways.
  • Upregulation of alternative angiogenic pathways and changes in the tumor microenvironment are implicated.
  • Genetic mutations and epigenetic modifications play a significant role in developing resistance.

Conclusions:

  • Understanding Lenvatinib resistance is critical for developing strategies to overcome or prevent it.
  • Further research into resistance mechanisms may lead to novel therapeutic combinations or sequential treatments.
  • Addressing Lenvatinib resistance is essential for improving and prolonging patient survival in various cancers.

Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.3K
Combination Therapies and Personalized Medicine02:50

Combination Therapies and Personalized Medicine

Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
7.7K
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates...
198
Inhibition of Cdk Activity02:34

Inhibition of Cdk Activity

The orderly progression of the cell cycle depends on the activation of Cdk protein by binding to its cyclin partner. However, the cell cycle must be restricted when undergoing abnormal changes. Most cancers correlate to the deregulated cell cycle, and since Cdks are a central component of the cell cycle, Cdk inhibitors are extensively studied to develop anticancer agents. For instance, cyclin D associates with several Cdks, such as Cdk 4/6, to form an active complex. The cyclin D-Cdk4/6 complex...
4.8K
Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
152