A randomized trial of doxorubicin versus doxorubicin plus cisplatin in patients with advanced thyroid carcinoma

Abstract

A randomized evaluation of the effectiveness and toxicity of the combination of doxorubicin and cisplatin and of doxorubicin alone in patients with advanced thyroid carcinoma was carried out. Ninety-two patients were entered and 84 were evaluable. They were stratified according to histological classification, Eastern Cooperative Oncology Group (ECOG) performance status, and metastatic sites. Forty-one patients received doxorubicin as a single agent and seven had partial response (17%). Forty-three patients received the combination, and there were five complete and six partial responses (combined response rate of 26%). This difference for overall response rate is not significant (P greater than 0.1). However, five complete responses were seen in the combination-treatment group, whereas none were observed in the single-agent treatment group; a significant difference was obtained (P = 0.03). Four of these five complete responders survived for more than 2 years, and two patients remained in a complete response after the discontinuation of therapy and are still alive. None of the partial responses exceeded 2 years in duration. The life-threatening toxicities from chemotherapy occurred in five patients treated with the combination of drugs and two treated with doxorubicin alone. However, none of the toxicities were fatal. The study has shown clearly that the quality of response achieved by the combination of drugs is far superior to that achieved by single-agent chemotherapy.

Phase II Efficacy and Pharmacogenomic Study of Selumetinib (AZD6244; ARRY-142886) in Iodine-131 Refractory Papillary Thyroid Carcinoma with or without Follicular Elements

“…The 10-year survival rate is less than 15% (6, 7). Doxorubicin is the only U.S. Food and Drug Administration–approved therapy but is generally considered of low efficacy and high toxicity (8, 9). …”

Surgery and survival outcomes of 22 patients with epidural spinal cord compression caused by thyroid tumor spinal metastases

“…However, some studies have reported that single-agent doxorubicin has a response rate of 25-40 % and is the most effective chemotherapeutic agent. Also, there is little evidence to suggest that combination chemotherapy is more effective [19][20][21]. Therefore, the development of novel therapies, such as biological modifiers or new chemotherapy agents, is urgently needed for this disease.…”

Follow-up of patients treated with retinoic acid for the control of radioiodine non-responsive advanced thyroid carcinoma

“…In the Eastern Cooperative Oncology Group trial of doxorubicin-containing regimens, PFS time for patients with metastatic iodine non-avid differentiated thyroid cancer was estimated at 2 months for both doxorubicin alone and doxorubicin plus cisplatin, and median overall survival time was 8 months (29). In the present study, we observed a median PFS of 26.5 months, which might represent a considerably significant improvement in the outcome of these patients.…”