Comparative Pharmacology
Head-to-head clinical analysis: LENVIMA versus MIDOSTAURIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LENVIMA versus MIDOSTAURIN.
LENVIMA vs MIDOSTAURIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lenvatinib is a multikinase inhibitor that targets vascular endothelial growth factor receptors (VEGFR1, VEGFR2, VEGFR3), fibroblast growth factor receptors (FGFR1, FGFR2, FGFR3, FGFR4), platelet-derived growth factor receptor alpha (PDGFRα), KIT, and RET. It inhibits angiogenesis, tumor growth, and progression by blocking these receptor tyrosine kinases.
Midostaurin is a multikinase inhibitor that targets FLT3 (FMS-like tyrosine kinase 3), KIT, PDGFRα/β, VEGFR2, and PKC. It inhibits FLT3 receptor signaling and downstream MAPK/ERK and PI3K/AKT pathways, inducing apoptosis in FLT3-mutated cells.
24 mg orally once daily for differentiated thyroid carcinoma; 18 mg orally once daily plus everolimus 5 mg orally once daily for renal cell carcinoma; 12 mg orally once daily plus pembrolizumab 200 mg intravenously every 3 weeks for endometrial carcinoma; 8 mg orally once daily (or 10 mg for patients with body weight ≥60 kg) plus pembrolizumab 200 mg intravenously every 3 weeks for hepatocellular carcinoma.
50 mg orally twice daily with food for acute myeloid leukemia (AML) with FLT3 mutation; for advanced systemic mastocytosis, 100 mg orally twice daily.
None Documented
Clinical Note
moderateMidostaurin + Digoxin
"Midostaurin may decrease the cardiotoxic activities of Digoxin."
Clinical Note
moderateMidostaurin + Digitoxin
"Midostaurin may decrease the cardiotoxic activities of Digitoxin."
Clinical Note
moderateMidostaurin + Deslanoside
"Midostaurin may decrease the cardiotoxic activities of Deslanoside."
Clinical Note
moderateMidostaurin + Acetyldigitoxin
"Midostaurin may decrease the cardiotoxic activities of Acetyldigitoxin."
None Documented
Terminal elimination half-life is approximately 28 hours, supporting once-daily dosing.
The terminal elimination half-life (t½) of midostaurin is approximately 20 hours (range 17–22 h) for the parent drug and slightly longer for its active metabolite CGP52421 (~30 h). This supports twice-daily dosing while maintaining steady-state concentrations.
Approximately 71% of the dose is excreted in feces (34% as unchanged drug) and 25% in urine (0.4% as unchanged).
Midostaurin is primarily eliminated via feces (approximately 95% of total radioactivity after a single 50 mg oral dose), with <5% excreted in urine. Biliary excretion is the major route for fecal elimination; unchanged midostaurin accounts for <10% of the dose, with the remainder as metabolites.
Category C
Category C
Tyrosine Kinase Inhibitor
Tyrosine Kinase Inhibitor