A higher lenvatinib starting dose was preferred for maintaining health-related quality-of-life (HRQOL) outcomes, according to results of a study published in The Oncologist.

In renal cell carcinoma (RCC), preservation of HRQOL is an important treatment goal. To evaluate whether the starting dose of lenvatinib has a significant effect on HRQOL outcomes, patient-reported outcomes collected during a phase 2, multicenter, open-label trial were evaluated. A total of 343 patients with RCC were randomly assigned to receive 18 mg (171 patients) or 14 mg (172 patients) daily lenvatinib plus 5 mg daily everolimus following a single vascular endothelial growth factor-targeted treatment.

The higher- and lower-dose lenvatinib recipients were median age 62 and 61 years, 75.4% and 77.3% were men, 29.2% and 28.5% had favorable Memorial Sloan Kettering Cancer Center risk, and 81.9% and 75% had received 1 prior anticancer treatment, respectively.

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Compared with the lower starting dose, the higher starting dose was favored for the outcomes of Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease-Related Symptoms (FKSI-DRS) total score (least squares mean difference [LSMD], −1.35) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Patients with Cancer-Core 30 (EORTC QLQ-C30) role (LSMD, −5.92), physical (LSMD, −5.89), social (LSMD, −5.80), global health (LSMD, −4.54), emotional (LSMD, −3.72), nausea and vomiting (LSMD, 3.24), insomnia (LSMD, 4.44), pain (LSMD, 4.59), fatigue (LSMD, 5.52), and financial difficulties (LSMD, 6.68) scores (all P <.05).

Time to first deterioration in FKSI-DRS total score (hazard ratio [HR], 1.30) and EORTC QLQ-C30 financial difficulties (HR, 1.59), dyspnea (HR, 1.54), insomnia (HR, 1.45), emotional (HR, 1.35), social (HR, 1.32), and nausea and vomiting (HR, 1.30) scores were significantly prolonged for those who received the 18-mg dose compared with those who received 14 mg.

These data supported the use of 18 mg over 14 mg lenvatinib for maintaining HRQOL in RCC.

Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Bergerot C, Rha SY, Pal S, et al. Health-related quality of life outcomes with two different starting doses of lenvatinib in combination with everolimus for previously treated renal cell carcinoma. Oncologist. 2023;28(1):59-71. doi:10.1093/oncolo/oyac142