KDR and neoplasm: ,25 Notably, unlike certain VEGF/VEGFR inhibitors (e.g., sorafenib, sunitinib, and bevacizumab) that primarily induce vessel pruning and potentially upregulate tumour PD-L1 expression, Lenvatinib demonstrates unique capabilities: it directly downregulates PD-L1 expression on tumour cells via fibroblast growth factor receptor (FGFR)-4 inhibition,26 causes immunomodulatory effects, including activation of effector T-cells and regulation of tumour-associated macrophages (TAMs), and establishes transient ‘vascular normalisation windows’.