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Case Report: Posterior reversible encephalopathy syndrome after lenvatinib treatment for hepatocellular carcinoma

  • 0Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China.
Frontiers in Pharmacology +

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April 7, 2025

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April 7, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Lenvatinib, a cancer drug, can cause Posterior Reversible Encephalopathy Syndrome (PRES), a condition with neurological symptoms and brain swelling. Early detection and stopping lenvatinib can help patients recover.

Area Of Science

  • Oncology
  • Neurology
  • Radiology

Background

  • Posterior Reversible Encephalopathy Syndrome (PRES) presents with neurological deficits and reversible brain edema.
  • Lenvatinib is a multi-targeted kinase inhibitor used for hepatocellular carcinoma (HCC).
  • Lenvatinib-induced PRES is an emerging adverse effect requiring clinical attention.

Observation

  • A 72-year-old female HCC patient on lenvatinib developed confusion, altered mental status, headaches, and severe hypertension.
  • Neuroimaging confirmed vasogenic edema in the brain's white matter, consistent with PRES.
  • Symptoms and brain abnormalities resolved after lenvatinib discontinuation.

Findings

  • Lenvatinib therapy can precipitate PRES in HCC patients, even without prior hypertension.
  • Hypertension appears to be a key factor in the pathogenesis of lenvatinib-induced PRES.
  • Discontinuation of lenvatinib led to neurological and radiological improvement.

Implications

  • This case highlights the importance of monitoring for PRES in HCC patients receiving lenvatinib.
  • Vigilant management of hypertension and prompt recognition of PRES symptoms are crucial for patient safety.
  • Understanding lenvatinib's potential neurotoxicity is vital for optimizing cancer treatment strategies.

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