Neoadjuvant lenvatinib for inoperable thyroid cancer: A case report and literature review

Abstract

Background: Poorly differentiated thyroid cancer (PDTC) is now classified as a separate thyroid tumor entity. It has male predominance and poor prognosis compared to differentiated TC.Case: We report a case of a patient with PDTC who was previously deemed inoperable. A trial of neoadjuvant lenvatinib therapy was given to the patient after that the tumor become operable and the surgery went successfully.Conclusions: Lenvatinib is a feasible option in patients with inoperable TC and can stabilize the lesion size or even reduce it, leading to a more favorable surgical outcome.

The Long Journey towards Personalized Targeted Therapy in Poorly Differentiated Thyroid Carcinoma (PDTC): A Case Report and Systematic Review

“…Unlike in DTC [ 123 , 124 ], RAI appears to be relatively ineffective in the control of distant metastases in PDTC; thus, it is reasonable to consider the use of RAI for metastatic/advanced disease that demonstrates definite iodine uptake [ 125 , 126 ]. Likewise, most cases in our review received at least one cycle of RAI treatment, even without detectable metastatic foci [ 38 , 39 , 40 , 41 , 42 , 43 , 46 , 48 , 49 , 50 , 51 , 53 , 54 , 55 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 73 , 74 , 75 , 80 , 81 , 82 , 85 , 86 , 87 , 88 , 90 , 91 , 97 , 99 , 101 , 102 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 ...…”

“…Since cytological diagnosis of PDTC based on FNAC is challenging, our review has shown that some patients underwent a hemithyroidectomy or subtotal thyroidectomy with a completion thyroidectomy after histological diagnosis [ 38 , 44 , 52 , 54 , 59 , 65 , 69 , 85 , 103 , 104 , 107 , 108 , 115 , 117 ], but the majority of them were submitted to a total thyroidectomy as the initial operation [ 40 , 41 , 42 , 43 , 46 , 48 , 49 , 50 , 51 , 53 , 54 , 55 , 56 , 58 , 60 , 61 , 62 , 64 , 67 , 68 , 69 , 72 , 73 , 75 , 79 , 80 , 81 , 82 , 85 , 86 , 88 , 89 , 90 , 91 , 92 , 93 , 95 , 96 , 100 , 101 ,…”

“…In our case report, RAIR disease was evident after two RAI treatments. External beam radiation therapy (EBRT) is a viable option for controlling local disease in patients with PDTC and was utilized in the subset of patients with unresected, locally advanced disease or with metastatic foci such as bone lesions [ 42 , 49 , 50 , 58 , 60 , 61 , 62 , 63 , 64 , 67 , 68 , 69 , 70 , 74 , 75 , 80 , 81 , 85 , 90 , 91 , 97 , 98 , 102 , 106 , 107 , 108 , 109 , 112 , 113 , 116 ].…”

Use of multikinase inhibitors/lenvatinib concomitant with locoregional therapies for the treatment of radioiodine‐refractory differentiated thyroid cancer

“…A promising and possible strategy reported by several clinical cases 13 and that is being tested in several clinical trials (Table 1 ) is the use of MKIs for neoadjuvant treatment of thyroid cancer. However, more robust data are needed for standardization in clinical practice.…”

Donafenib as neoadjuvant therapy in locally advanced thyroid cancer: protocol for the DONATHYCA phase II prospective single-arm trial in China

“… 5–7 However, neoadjuvant therapy remains in the exploratory stages for thyroid cancer. 8 9 At present, multitarget tyrosine kinase inhibitors are the main drugs for the treatment of advanced iodine-resistant differentiated thyroid cancer, and of these drugs, lenvatinib and sorafenib have been recommended in China. Neoadjuvant therapy with these two drugs in LATC has also been reported.…”