Lenvatinib
Lenvatinib is an orally administered multi-targeted tyrosine kinase inhibitor.
Lenvatinib is an orally administered multi-targeted tyrosine kinase inhibitor. It blocks the vascular endothelial growth factor receptors VEGFR1–3, which carries most of its antiangiogenic effect, together with the fibroblast growth factor receptors FGFR1–4, PDGFRα, Kit and RET. The FGFR component distinguishes it from earlier antiangiogenics such as sorafenib: FGF signaling is a common escape route when VEGF alone is blocked, and inhibiting both at once is the rationale for its broader activity. Structurally it binds the ATP site in a distinctive way that gives rapid, tight association, and its dosing is weight-based in hepatocellular carcinoma but fixed in most other approved indications.
Its approvals span radioiodine-refractory differentiated thyroid cancer, where it produces high response rates; unresectable hepatocellular carcinoma as first-line therapy after showing non-inferior survival against sorafenib; advanced renal cell carcinoma with everolimus or with pembrolizumab; and advanced endometrial carcinoma with pembrolizumab in mismatch repair–proficient disease. It is also studied as a comparator or backbone in liver cancer more broadly, thyroid cancer, lung adenocarcinoma and biliary tract malignancies.
Combination with immune checkpoint blockade is the dominant current direction, on the rationale that reducing VEGF-driven immunosuppression makes tumors more susceptible to T-cell attack: partners include anti-PD-1/PD-L1 antibodies such as pembrolizumab, sintilimab, durvalumab and nivolumab, the Programmed cell death 1 (PD-1)/CTLA-4 bispecific cadonilimab, and locoregional approaches — hepatic arterial infusion chemotherapy, stereotactic body radiotherapy and surgery — with conversion of unresectable disease to resectable an explicit goal. The toxicities are those of potent VEGFR blockade and limit delivery of the intended dose: hypertension in most patients, proteinuria, fatigue, diarrhea, hand-foot skin reaction, hypothyroidism and impaired wound healing, with dose reduction common.
Where the papers sit
32 papers from the last 6 months study lenvatinib directly · updated from PubMed 11 Oct 2026
Study type 9 clinical trials · 7 observational · 3 human data · 10 preclinical · 3 unclassified
Themes 3 themes · 1 new direction
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Immunotherapy in Liver Cancer
Lenvatinib is increasingly being combined with PD-1 or PD-L1 blockade and locoregional therapy for unresectable hepatocellular carcinoma. Trials test nivolumab, sintilimab, durvalumab–tremelimumab or atezolizumab-based sequencing, with progression-free survival, objective response and conversion to surgery as recurring endpoints. Hepatic arterial infusion chemotherapy and transarterial embolization are being added to intensify responses, but optimal timing of immune therapy remains unsettled. Real-world studies emphasize dose intensity, safety and treatment selection after prior checkpoint inhibition.
14 papers · 43.8%
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Advanced Renal Cell Carcinoma
Pembrolizumab–lenvatinib is being positioned as a major first-line option for advanced renal cell carcinoma, with CLEAR analyses extending benefit across subgroups. Real-world comparisons weigh this regimen against nivolumab–cabozantinib and cabozantinib-based therapy using survival, safety and prognostic factors. Belzutifan–lenvatinib is emerging after prior treatment, while Bayesian and cost-effectiveness analyses refine treatment selection. The evidence is moving toward individualized sequencing rather than a single preferred combination.
9 papers · 28.1%
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Resistance Mechanisms in HCC
Lenvatinib resistance in hepatocellular carcinoma is being traced to adaptive redox control, epithelial–mesenchymal transition and focal-adhesion signaling. EGR1–ZNF768–SLC7A11 responses limit ferroptosis, while RPRD1A–ITGA5–FAK signaling and NDST2-mediated EGFR N-glycosylation sustain resistance. Combination strategies, including ADI-PEG 20, immune therapy and biomimetic nanoplatforms, aim to restore sensitivity or improve delivery. The work is moving toward mechanism-guided sensitization rather than empiric escalation alone.
9 papers · 28.1%
Lenvatinib is repurposed as an antigen-releasing component of a personalized cancer vaccine
The autochthonous hepatocellular carcinoma mouse study used lenvatinib not merely as an antiangiogenic or direct antitumor drug, but to release tumor neoantigens that could be captured through a dendritic-cell-derived exosome vaccine 42492521Jul. The resulting DEXPNX/lenvatinib treatment promoted dendritic-cell recruitment, antigen cross-presentation, de novo T-cell responses, and immunological memory, while addition of anti-PD-1 eradicated established tumors. This assigns lenvatinib a vaccine-enabling role—generating the antigenic material for individualized immune activation—that lies outside the treatment and resistance categories used by the other papers.
Papers
The 32 papers from the last 6 months that study lenvatinib directly, newest first, by theme and by study type. Study types come from PubMed publication types and MeSH headings.
By theme
Immunotherapy in Liver Cancer (14)
- BAY-876 restores lenvatinib sensitivity in resistant hepatocellular carcinoma cells by disrupting the GLUT1-SLC7A11-NADPH redox axis. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 5 Oct 2026 PMID 42832095
- Synchronizing immunity and angiogenesis in lung adenocarcinoma: bridging biological synergy and clinical translation. Cancer biology & therapy · 8 Sept 2026 PMID 42708433
- Early lenvatinib dose intensity is associated with survival in super-older adults (≥80 years) with hepatocellular carcinoma: a real-world comparison with atezolizumab-bevacizumab. European journal of gastroenterology & hepatology · 28 Aug 2026 PMID 42664455
- Impact of PD-1 Inhibitor Timing Relative to Locoregional Therapy on Outcomes in uHCC Treated With Lenvatinib-Based Triple Therapy. Liver international : official journal of the International Association for the Study of the Liver · 28 Aug 2026 PMID 42661423
- Durvalumab and tremelimumab, with or without lenvatinib, combined with transarterial chemoembolisation in participants with embolisation-eligible hepatocellular carcinoma (EMERALD-3): a global, randomised, open-label, sponsor-blinded, phase 3 study. The Lancet. Oncology · 24 Aug 2026 PMID 42636832
- Efficacy of Lenvatinib as Subsequent Therapy After Combination Immune Checkpoint Inhibitors for Unresectable Hepatocellular Carcinoma. Anticancer research · 29 Jul 2026 PMID 42527085
- Combination of exosome vaccines, lenvatinib, and anti-PD-1 eradicates tumor in autochthonous hepatocellular carcinoma mice. Cell reports. Medicine · 23 Jul 2026 PMID 42492521
- Safety of Immune-Targeted Therapy in Patients with Hepatocellular Carcinoma in the Real-World. Journal of gastrointestinal cancer · 16 Jul 2026 PMID 42461453
- HSPA6 Confers Lenvatinib Resistance in Hepatocellular Carcinoma by Promoting Phase Separation-Mediated TXNRD1 Stabilization to Suppress Ferroptosis. Cancer research · 18 Jun 2026 PMID 42314062
- Nivolumab in combination with lenvatinib in unresectable hepatocellular carcinoma: The IKF-t006/IMMUNIB translational phase-2 study. European journal of cancer (Oxford, England : 1990) · 12 Jun 2026 PMID 42284972
- Targeted immunotherapy and tumor immunogenicity in liver transplant recipients: A study on lenvatinib and PD-L1 inhibition. Pakistan journal of pharmaceutical sciences · 9 Jun 2026 PMID 42262196
- HILL: the efficacy and safety of hepatic arterial infusion chemotherapy with the FOLFOX regimen combined with lenvatinib and the PD-L1 inhibitor durvalumab in unresectable hepatocellular carcinoma: a prospective, single-arm, phase 2 clinical trial. Signal transduction and targeted therapy · 14 May 2026 PMID 42135293
- Comparison of outcomes of second-line durvalumab plus tremelimumab versus lenvatinib following first-line atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. PloS one · 7 May 2026 PMID 42096473
- Sintilimab and lenvatinib plus hepatic arterial infusion chemotherapy and embolization as conversion therapy for uHCC: A phase 2 trial. Med (New York, N.Y.) · 7 May 2026 PMID 42092358
Advanced Renal Cell Carcinoma (9)
- Lenvatinib plus pembrolizumab for the treatment of patients with non-BRAF mutated anaplastic thyroid cancer: A single center, phase 2 clinical trial. European journal of cancer (Oxford, England : 1990) · 31 Aug 2026 PMID 42673705
- Cost‑effectiveness of first‑line immunotherapy-based combination regimens for advanced renal cell carcinoma in China and the United States. Human vaccines & immunotherapeutics · 22 Aug 2026 PMID 42630013
- Belzutifan plus lenvatinib versus cabozantinib in patients with previously treated advanced renal cell carcinoma (LITESPARK-011): an open-label, randomised, controlled, phase 3 trial. Lancet (London, England) · 12 Aug 2026 PMID 42586114
- Pembrolizumab Plus Lenvatinib in Metastatic Renal Cell Carcinoma: Real-world Prognostic Factors. Anticancer research · 29 Jul 2026 PMID 42527074
- Bayesian Analysis to Refine East Asian Subgroup Estimates in the CLEAR Trial (Lenvatinib Plus Pembrolizumab vs. Sunitinib) for Advanced Renal Cell Carcinoma. Anticancer research · 29 Jun 2026 PMID 42373289
- Lenvatinib plus pembrolizumab versus standard of care in recurrent/metastatic head and neck squamous cell carcinoma: Randomized, phase 2 LEAP-009 trial. European journal of cancer (Oxford, England : 1990) · 4 Jun 2026 PMID 42241967
- cR10-modified liposomes for efficient topical delivery of lenvatinib to the posterior segment: Enhanced suppression of choroidal neovascularization. International journal of pharmaceutics · 1 Jun 2026 PMID 42225176
- Comparison of effectiveness and safety of pembrolizumab plus lenvatinib versus nivolumab plus cabozantinib for metastatic renal cell carcinoma: a real-world study. International journal of clinical oncology · 27 May 2026 PMID 42204034
- Multi-Omics and Machine Learning-Uncovered FLT1-Mediated Epithelial-Endothelial Crosstalk in Cellular Senescence Driving Clear Cell Renal Cell Carcinoma Malignancy. FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 18 Apr 2026 PMID 41999263
Resistance Mechanisms in HCC (9)
- The Combined Therapeutic Effect of Lenvatinib and ADI-PEG 20 in Advanced Hepatocellular Carcinoma: A Case Report. In vivo (Athens, Greece) · 30 Jun 2026 PMID 42379775
- EGFR N-Glycosylation Catalyzed by NDST2 Promotes Lenvatinib Resistance in Hepatocellular Carcinoma. Cancer research · 22 Jun 2026 PMID 42329862
- Comprehensive multi-omics analysis identifies cancer subtypes and prognostic signatures of hepatitis B virus-associated hepatocellular carcinoma. NPJ precision oncology · 4 Jun 2026 PMID 42243437
- RPRD1A drives lenvatinib resistance in hepatocellular carcinoma via the ITGA5-FAK signaling axis. Molecular biomedicine · 22 May 2026 PMID 42171939
- Di-2-ethylhexyl Phthalate Reprograms Epithelial-Mesenchymal Transition and Lenvatinib Responsiveness in Hepatoma Cells via SPAG4-Dependent MAPK/ERK Signaling. Chemical research in toxicology · 13 May 2026 PMID 42126986
- Lenvatinib triggers an EGR1-ZNF768-SLC7A11 adaptive response to limit ferroptosis-mediated therapeutic efficacy in hepatocellular carcinoma. Cancer biology & medicine · 12 May 2026 PMID 42116728
- Sintilimab (PD-1 inhibitor) plus lenvatinib as conversion therapy followed by sequential surgery (SILENSES) for advanced unresectable hepatocellular carcinoma: a phase II, expansion trial. Signal transduction and targeted therapy · 6 May 2026 PMID 42091859
- A Biomimetic Mn-Doped Polydopamine Nanoplatform for MRI-Enabled Synergistic Therapy to Enhance Lenvatinib Efficacy in Liver Cancer. ACS applied materials & interfaces · 20 Apr 2026 PMID 42003816
- A plain language summary of the CheckMate 9DW study: nivolumab in combination with ipilimumab for unresectable hepatocellular carcinoma (advanced liver cancer). Future oncology (London, England) · 15 Apr 2026 PMID 41981891
By study type
Clinical trials (9)
- Lenvatinib plus pembrolizumab for the treatment of patients with non-BRAF mutated anaplastic thyroid cancer: A single center, phase 2 clinical trial. European journal of cancer (Oxford, England : 1990) · 31 Aug 2026 PMID 42673705
- Durvalumab and tremelimumab, with or without lenvatinib, combined with transarterial chemoembolisation in participants with embolisation-eligible hepatocellular carcinoma (EMERALD-3): a global, randomised, open-label, sponsor-blinded, phase 3 study. The Lancet. Oncology · 24 Aug 2026 PMID 42636832
- Belzutifan plus lenvatinib versus cabozantinib in patients with previously treated advanced renal cell carcinoma (LITESPARK-011): an open-label, randomised, controlled, phase 3 trial. Lancet (London, England) · 12 Aug 2026 PMID 42586114
- Bayesian Analysis to Refine East Asian Subgroup Estimates in the CLEAR Trial (Lenvatinib Plus Pembrolizumab vs. Sunitinib) for Advanced Renal Cell Carcinoma. Anticancer research · 29 Jun 2026 PMID 42373289
- Nivolumab in combination with lenvatinib in unresectable hepatocellular carcinoma: The IKF-t006/IMMUNIB translational phase-2 study. European journal of cancer (Oxford, England : 1990) · 12 Jun 2026 PMID 42284972
- Lenvatinib plus pembrolizumab versus standard of care in recurrent/metastatic head and neck squamous cell carcinoma: Randomized, phase 2 LEAP-009 trial. European journal of cancer (Oxford, England : 1990) · 4 Jun 2026 PMID 42241967
- HILL: the efficacy and safety of hepatic arterial infusion chemotherapy with the FOLFOX regimen combined with lenvatinib and the PD-L1 inhibitor durvalumab in unresectable hepatocellular carcinoma: a prospective, single-arm, phase 2 clinical trial. Signal transduction and targeted therapy · 14 May 2026 PMID 42135293
- Sintilimab and lenvatinib plus hepatic arterial infusion chemotherapy and embolization as conversion therapy for uHCC: A phase 2 trial. Med (New York, N.Y.) · 7 May 2026 PMID 42092358
- Sintilimab (PD-1 inhibitor) plus lenvatinib as conversion therapy followed by sequential surgery (SILENSES) for advanced unresectable hepatocellular carcinoma: a phase II, expansion trial. Signal transduction and targeted therapy · 6 May 2026 PMID 42091859
Observational studies and case reports (7)
- Early lenvatinib dose intensity is associated with survival in super-older adults (≥80 years) with hepatocellular carcinoma: a real-world comparison with atezolizumab-bevacizumab. European journal of gastroenterology & hepatology · 28 Aug 2026 PMID 42664455
- Impact of PD-1 Inhibitor Timing Relative to Locoregional Therapy on Outcomes in uHCC Treated With Lenvatinib-Based Triple Therapy. Liver international : official journal of the International Association for the Study of the Liver · 28 Aug 2026 PMID 42661423
- Pembrolizumab Plus Lenvatinib in Metastatic Renal Cell Carcinoma: Real-world Prognostic Factors. Anticancer research · 29 Jul 2026 PMID 42527074
- The Combined Therapeutic Effect of Lenvatinib and ADI-PEG 20 in Advanced Hepatocellular Carcinoma: A Case Report. In vivo (Athens, Greece) · 30 Jun 2026 PMID 42379775
- Targeted immunotherapy and tumor immunogenicity in liver transplant recipients: A study on lenvatinib and PD-L1 inhibition. Pakistan journal of pharmaceutical sciences · 9 Jun 2026 PMID 42262196
- Comparison of effectiveness and safety of pembrolizumab plus lenvatinib versus nivolumab plus cabozantinib for metastatic renal cell carcinoma: a real-world study. International journal of clinical oncology · 27 May 2026 PMID 42204034
- Comparison of outcomes of second-line durvalumab plus tremelimumab versus lenvatinib following first-line atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma. PloS one · 7 May 2026 PMID 42096473
Human data, design not indexed (3)
- Cost‑effectiveness of first‑line immunotherapy-based combination regimens for advanced renal cell carcinoma in China and the United States. Human vaccines & immunotherapeutics · 22 Aug 2026 PMID 42630013
- Efficacy of Lenvatinib as Subsequent Therapy After Combination Immune Checkpoint Inhibitors for Unresectable Hepatocellular Carcinoma. Anticancer research · 29 Jul 2026 PMID 42527085
- Safety of Immune-Targeted Therapy in Patients with Hepatocellular Carcinoma in the Real-World. Journal of gastrointestinal cancer · 16 Jul 2026 PMID 42461453
Preclinical: animal, cell and lab studies (10)
- BAY-876 restores lenvatinib sensitivity in resistant hepatocellular carcinoma cells by disrupting the GLUT1-SLC7A11-NADPH redox axis. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 5 Oct 2026 PMID 42832095
- Synchronizing immunity and angiogenesis in lung adenocarcinoma: bridging biological synergy and clinical translation. Cancer biology & therapy · 8 Sept 2026 PMID 42708433
- Combination of exosome vaccines, lenvatinib, and anti-PD-1 eradicates tumor in autochthonous hepatocellular carcinoma mice. Cell reports. Medicine · 23 Jul 2026 PMID 42492521
- EGFR N-Glycosylation Catalyzed by NDST2 Promotes Lenvatinib Resistance in Hepatocellular Carcinoma. Cancer research · 22 Jun 2026 PMID 42329862
- HSPA6 Confers Lenvatinib Resistance in Hepatocellular Carcinoma by Promoting Phase Separation-Mediated TXNRD1 Stabilization to Suppress Ferroptosis. Cancer research · 18 Jun 2026 PMID 42314062
- cR10-modified liposomes for efficient topical delivery of lenvatinib to the posterior segment: Enhanced suppression of choroidal neovascularization. International journal of pharmaceutics · 1 Jun 2026 PMID 42225176
- RPRD1A drives lenvatinib resistance in hepatocellular carcinoma via the ITGA5-FAK signaling axis. Molecular biomedicine · 22 May 2026 PMID 42171939
- Di-2-ethylhexyl Phthalate Reprograms Epithelial-Mesenchymal Transition and Lenvatinib Responsiveness in Hepatoma Cells via SPAG4-Dependent MAPK/ERK Signaling. Chemical research in toxicology · 13 May 2026 PMID 42126986
- A Biomimetic Mn-Doped Polydopamine Nanoplatform for MRI-Enabled Synergistic Therapy to Enhance Lenvatinib Efficacy in Liver Cancer. ACS applied materials & interfaces · 20 Apr 2026 PMID 42003816
- Multi-Omics and Machine Learning-Uncovered FLT1-Mediated Epithelial-Endothelial Crosstalk in Cellular Senescence Driving Clear Cell Renal Cell Carcinoma Malignancy. FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 18 Apr 2026 PMID 41999263
Unclassified: not yet indexed with MeSH (3)
- Comprehensive multi-omics analysis identifies cancer subtypes and prognostic signatures of hepatitis B virus-associated hepatocellular carcinoma. NPJ precision oncology · 4 Jun 2026 PMID 42243437
- Lenvatinib triggers an EGR1-ZNF768-SLC7A11 adaptive response to limit ferroptosis-mediated therapeutic efficacy in hepatocellular carcinoma. Cancer biology & medicine · 12 May 2026 PMID 42116728
- A plain language summary of the CheckMate 9DW study: nivolumab in combination with ipilimumab for unresectable hepatocellular carcinoma (advanced liver cancer). Future oncology (London, England) · 15 Apr 2026 PMID 41981891
Written from 32 PubMed abstracts, each one listed by PMID above. Published: 2026-06-16. Last written: 2026-09-10 by GPT. Corrections: 2026-09-26 by GPT. Drafted by language models from published abstracts; not medical advice.