Key result
Concurrent lenvatinib and aspirin use is linked to acute aortic dissection in cancer patients.
Why the study?
Life-threatening drug-drug interactions involving VEGF-targeting anticancer drugs like lenvatinib are rarely reported, especially concerning concurrent aspirin use and aortic dissection risk.
Does concurrent use of lenvatinib and aspirin increase the risk of acute aortic dissection in patients with cancer?
Case Report (n=1)
Does concurrent use of lenvatinib and aspirin increase the risk of acute aortic dissection in patients with cancer?
The concurrent use of lenvatinib and aspirin may increase the risk of acute aortic dissection, highlighting the need for close monitoring of drug-drug interactions in cardio-oncology.
Answers are grounded in this paper and cite their sources.
May signal aortic dissection risk with lenvatinib-aspirin in cancer; hypothesis-generating and requires prospective validation.
Background: Although numerous anticancer drugs targeting vascular endothelial growth factor (VEGF) are commonly used in clinical practice, life-threatening drug-drug interactions (DDIs) involving these drugs are rarely reported. Case summary: A male patient had been taking aspirin for two years following a stroke. He was subsequently diagnosed with hepatocellular carcinoma (HCC) and initiated lenvatinib therapy. Shortly after, he developed lenvatinib-induced hypertension (191/102 mmHg) and was prescribed amlodipine for blood pressure control. At his first routine follow-up for HCC treatment, he was asymptomatic but was incidentally diagnosed with acute aortic dissection (AD). The patient declined endovascular treatment, and his AD lesions remained temporarily stable. Although lenvatinib is generally considered a safe and effective option for advanced HCC, this case raises concerns about a potential link between lenvatinib and aspirin in the development of AD due to their temporal association. This case highlights the need for increased clinical awareness regarding possible DDIs between these two drugs, particularly in patients with untreated acute AD. Conclusion: The concurrent use of lenvatinib and aspirin may increase the risk of AD in patients with cancer. To prevent life-threatening complications, patients receiving both therapies should be closely monitored and strictly adhere to treatment guidelines. For patients who decline invasive AD treatment, continued lenvatinib therapy might be a cost-effective option to improve prognosis, though the continuation of aspirin therapy requires careful consideration.
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Luo et al. (2025) conducted a case report in Hepatocellular carcinoma and acute aortic dissection (n=1). Concurrent use of lenvatinib and aspirin was evaluated on Development of acute aortic dissection. Concurrent use of lenvatinib and aspirin may increase the risk of acute aortic dissection in patients with cancer, highlighting a potential life-threatening drug-drug interaction.
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