Effect of Hemodialysis on Total and Free Lenvatinib Concentrations in a Patient With Metastatic Renal Cell Carcinoma.

Introduction: Lenvatinib (LEN) concentrations in patients undergoing hemodialysis (HD) have not been examined. Herein, we report the effect of HD on total and free LEN concentrations in a patient with mRCC. Case Presentation: The hemodialyzed patient was a 55-year-old Japanese male who was treated with 20 mg LEN daily. The area under the plasma concentration-time curve for LEN from 0 to 24 h (AUC0-24) was calculated on Day 8 (off HD) and Day 9 (on HD) after starting administration of LEN. For total LEN on Days 8 and 9, the AUC0-24 was 2553 and 2783 ng × h/mL, respectively. The free LEN concentration just after HD on Day 9 was 40% lower than that at the same time on Day 8 (1.8 vs. 3.0 ng/mL). Conclusion: Although the free LEN concentration is reduced just after HD, LEN will have sufficient pharmacological activity on HD days for patients undergoing HD.