Lenvatinib use appears to disrupt wound healing

Lenvatinib, a vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor for thyroid and renal malignancies, seems to play a role in wound healing complications based on temporality and biologic plausibility, suggests evidence from the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).

This case series showed a wide range in the reported time to identification of delayed wound healing from tissue injury or surgery (4–58 days). The time on initial lenvatinib exposure relative to the tissue injury was also wide-ranging, and this could have impacted the development and detection of impaired healing, according to the investigators.

“Healthcare professionals should be aware of this safety risk to facilitate prompt recognition and risk mitigation,” they said.

To assess wound healing complications as a potential safety risk for patients treated with lenvatinib, the FAERS database for postmarketing reports of wound healing complications with lenvatinib was searched between 13 February 2015 (FDA approval date) and 15 February 2017.

Nine FAERS cases of lenvatinib-related wound healing complications that were previously not reported in the medical literature were identified. Of these, seven involved postoperative wound healing complications, such as impaired healing or wound dehiscence.

“The US FDA has approved several VEGFR tyrosine kinase inhibitors, including lenvatinib, for thyroid and renal malignancies,” the investigators said. “Inhibition of the VEGFR signaling pathway impairs angiogenesis and can disrupt wound healing.”