Predictors of maximum efficacy of lenvatinib for real-world patients with differentiated thyroid carcinoma.

Abstract

BACKGROUND AND OBJECTIVES:

Tyrosine kinase inhibitors (TKIs) have provided excellent clinical benefits to patients with advanced differentiated thyroid cancer (DTC): however, the tumor status for which maximum efficacy can be obtained remains controversial. We conducted this study to identify effective clinical predictors, focusing on disease progression.

METHODS:

Using the data of 42 DTC patients treated with lenvatinib, we investigated the clinical factors related to overall survival (OS) and progression-free survival (PFS), and conducted analyses by the scoring of the factors.

RESULTS:

The 3 year OS and median PFS were 51% and 13.8 months, respectively. Univariate analysis identified performance status (PS), tumor-related symptoms, and tumor diameter as the only factors affecting both these outcomes. Giving 1-point for each of these three factors, a higher score was significantly related to shorter OS and PFS. Patients with two or fewer points (n = 34) had better median OS (NR vs 3.9 months, p < 0.001) and PFS (15.7 vs 2.1 months, p < 0.001) than patients with three points (n = 8). Patients with all three factors had a significantly worse prognosis than patients with two or fewer factors.

CONCLUSION:

DTC patients with all three indicators are unlikely to have longer survival. Therefore, it is important to commence TKIs before disease progression.

• Authors: Chie Masaki, Kiminori Sugino, Naoko Saito, Junko Akaishi, Kiyomi Y Hames, Chisato Tomoda, Akifumi Suzuki, Kenichi Matsuzu, Keiko Ohkuwa, Wataru Kitagawa, Mitsuji Nagahama, Koichi Ito
• Journal: Surgery today (Surg Today) Vol. 52 Issue 11 Pg. 1660-1669 (Nov 2022) ISSN: 1436-2813 [Electronic] Japan
• PMID: 35411497 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

Chemical References

• lenvatinib
• Iodine Radioisotopes
• Antineoplastic Agents
• Protein Kinase Inhibitors

Topics

• Humans
• Iodine Radioisotopes (adverse effects)
• Antineoplastic Agents (therapeutic use)
• Thyroid Neoplasms (drug therapy, pathology)
• Adenocarcinoma (drug therapy)
• Disease Progression
• Protein Kinase Inhibitors (therapeutic use)