Tivozanib (Fotivda) is a kinase inhibitor. By targeting multiple tyrosine kinase targets such as vascular endothelial growth factor receptor (VEGFR), it inhibits tumor angiogenesis and is used for the treatment of recurrent or refractory advanced renal cell carcinoma (RCC) in patients who have received two or more lines of systemic therapy.
Precautions for Administration of Tivozanib (Fotivda)
Cardiovascular System Screening
A comprehensive assessment of blood pressure levels and cardiac function status is required. For patients with uncontrolled hypertension (systolic blood pressure > 150 mmHg or diastolic blood pressure > 100 mmHg), or those who have experienced severe cardiovascular events such as symptomatic heart failure, myocardial infarction, or unstable angina within the past 6 months, the use of this medication may be considered only after evaluation by a cardiovascular specialist.
For patients with abnormal baseline blood pressure, antihypertensive treatment should be initiated and blood pressure should be stably controlled before administering tivozanib.
Major Organ Function Testing
Liver function: The baseline liver function classification must be confirmed. For patients with moderate liver impairment, a dose-adjustment regimen should be initiated directly.
Thyroid function: Indicators such as thyroid-stimulating hormone (TSH) should be tested to establish baseline data.
Urinalysis: Quantitative measurement of 24-hour urine protein or routine urinalysis should be performed to rule out proteinuria.
Screening for Special Populations
Reproductive-aged females: A pregnancy test must be conducted, and the result must be negative.
Surgical plans: For patients scheduled to undergo elective surgery (including dental surgery), the timing of medication administration needs to be adjusted.
Medication Monitoring for Tivozanib (Fotivda)
Dynamic Blood Pressure Monitoring
The first blood pressure monitoring should be performed within 2 weeks after the start of treatment, followed by regular monitoring at least once a month thereafter.
When persistent hypertension occurs, the antihypertensive medication treatment regimen should be initiated or adjusted immediately.
Bleeding Risk Assessment
For patients with bleeding tendencies or a history of bleeding, enhanced monitoring of coagulation function is required.
When any signs of bleeding appear, the severity should be evaluated promptly to determine whether adjustments to the treatment regimen are necessary.
Cardiovascular Event Monitoring
Regular assessment of heart failure symptoms (including clinical manifestations such as dyspnea and ankle edema) is required.
For patients at risk of cardiac ischemia, close monitoring of indicators such as chest pain and electrocardiogram (ECG) changes is necessary.
Regular Laboratory Reassessment
Hematological tests: Pay attention to the changing trend of lymphocyte count.
Biochemical indicators: Focus on monitoring laboratory parameters such as blood sodium, phosphate, and lipase.
Urinalysis: Proteinuria screening should be conducted before each treatment cycle.
