Real-world efficacy and safety of lenvatinib: data from a compassionate use in the treatment of radioactive iodine-refractory differentiated thyroid cancer patients in Italy

Locati, Laura D.; Piovesan, Alessandro; Durante, Cosimo; Bregni, Marco; Castagna, Maria Grazia; Zovato, Stefania; Giusti, Massimo; Ibrahim, Toni; Puxeddu, Efisio; Fedele, Guido; Pellegriti, Gabriella; Rinaldi, Gaetana; Giuffrida, Dario; Verderame, Francesco; Bertolini, Federica; Bergamini, Cristiana; Nervo, Alice; Grani, Giorgio; Rizzati, Silvia; Morelli, Silvia; Puliafito, Ivana; Elisei, Rossella

doi:10.1016/j.ejca.2019.05.031

Cited by 78 publications

(58 citation statements)

References 16 publications

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“…The highest PFS in lenvatinib-treated patients was 33.1 months (95% CI, 27.8-44.6) in Gianoukakis et al [36], which is up to 3 times as high as published in some of the other included studies [32,35]. It is worth noting that Gianoukakis et al [36] was a post hoc analysis focusing only on patients with a response in the SELECT trial [24], thus sorting out the patients with early progression of disease and therefore heightening the PFS compared to other studies.…”

Section: Discussionmentioning

confidence: 72%

“…Table 2 shows that AEs are almost ubiquitous. Locati et al [32] found the lowest prevalence of AEs, with a value of 87.2%, whereas the other studies found a prevalence close to or of 100%. A pattern of the most frequently appearing AEs can be observed in Table 2.…”

Section: Resultsmentioning

confidence: 88%

“…Locati et al [32] reported that their patients had a worse performance status compared to the SELECT trial [24]. The condition of the patients is crucial when evaluating the efficacy of the treatment but certainly, also the tolerability.…”

Section: Discussionmentioning

confidence: 99%

“…Only data where MKIs were used as first-line monotherapy were included in the results if possible. Locati et al [32] did not mention the method of evaluating the efficacy of lenvatinib, but since the study was made by example of the SELECT trial [24], it is assumed that the evaluation was based on RECIST. In Iwasaki et al [33], there was an incongruence regarding the sex of the participants: the text talked about a trial population of 15 women (65.2%) and 8 men, but the table in the article registered 16 women (69.6%) and 7 men.…”

Section: Data Itemsmentioning

confidence: 99%

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Multikinase Inhibitor Treatment in Thyroid Cancer

Ancker

Krüger

Wehland

et al. 2019

IJMS

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Thyroid cancer is the most common endocrine malignancy. Most thyroid cancer types respond well to conventional treatment consisting of surgery and radioactive iodine (RAI) therapy. Unfortunately, some thyroid cancer types are resistant to surgical and RAI therapy. Multikinase inhibitors (MKIs) can be used in the treatment of advanced refractory thyroid cancers. The objective of this review is to give an update on MKI treatment (lenvatinib, sorafenib, sunitinib, cabozantinib, pazopanib, vandetanib) of thyroid cancer, regarding its efficacy and safety profile. We evaluated 212 articles through a PubMed search. A total of 20 articles met the inclusion and none the exclusion criteria. The studies showed promising progression-free survival rates compared to placebo treatment from earlier studies and similar or better results compared to the SELECT and DECISION trials. Adverse effects (AEs) are substantial in the treatment with MKIs. Almost all patients treated with these novel drugs experienced AEs. It is therefore crucial to focus on the management of AEs for a decent long-term outcome. The AEs are often more severe in patients with high efficacy of MKIs, which could indicate a correlation. Taken together, the novel therapeutic regimen with MKIs has shown favorable results in otherwise treatment-resistant thyroid cancer.

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Section: Discussionmentioning

confidence: 72%

Section: Resultsmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Data Itemsmentioning

confidence: 99%

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Multikinase Inhibitor Treatment in Thyroid Cancer

Ancker

Krüger

Wehland

et al. 2019

IJMS

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“…The worldwide growing use of lenvatinib for the treatment of RAI refractory thyroid cancer and other tumors will lead the clinicians to deal with adverse events not reported in the SELECT study (5) or in the reports of real-life experience (22). Combining knowledge of the risk factors-signs of FG and our findings reported in this case, should push clinicians, during periodic evaluation of patients on lenvatinib, to ask questions about symptoms of discomfort of perineal area and consider anorectal abscess/FG in differential diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Fournier's gangrene during lenvatinib treatment: A case report

et al. 2020

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Fournier's gangrene is a rare and severe complication reported in patients with cancer treated with antiangiogenic drugs, most frequently with bevacizumab. The present report describes the case of an 80-year-old man with radioactive iodine-refractory metastatic thyroid cancer treated with lenvatinib (an oral multikinase inhibitor with antiangiogenic properties) who developed Fournier's gangrene in the absence of other known risk factors. To the best of our knowledge, this is the first case described during treatment with lenvatinib. The condition was likely due to a perturbation of vascular endothelial cells of the skin due to the inhibition of VEGF/VEGFR signaling. Fournier's gangrene may be a class effect of antiangiogenic treatment that clinicians should be aware of, as early diagnosis and treatment are associated with an improved outcome.

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A Patient with Papillary Thyroid Carcinoma and Biochemical Evidence of Disease at Follow-Up Visits and Increasing Serum Tg Values at Follow-Up Assessments

Ito¹,

Miyauchi²

2020

Thyroid Cancer

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Real-world efficacy and safety of lenvatinib: data from a compassionate use in the treatment of radioactive iodine-refractory differentiated thyroid cancer patients in Italy

Cited by 78 publications

References 16 publications

Multikinase Inhibitor Treatment in Thyroid Cancer

Multikinase Inhibitor Treatment in Thyroid Cancer

Fournier's gangrene during lenvatinib treatment: A case report

A Patient with Papillary Thyroid Carcinoma and Biochemical Evidence of Disease at Follow-Up Visits and Increasing Serum Tg Values at Follow-Up Assessments

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