Antiangiogenic drug is promising for radioiodine-refractory thyroid cancer
the ONA take:
Researchers at the University of Texas MD Anderson Cancer Center saw dramatic improvement in progression-free survival in patients with advanced radioiodine-refractory thyroid cancer who received the oral antiangiogenic lenvatinib in a phase III study.
The American Cancer Society estimates that thyroid cancer will be diagnosed in 62,450 in 2015, and 1,950 will die from the disease. Radioactive iodine has been the only treatment available to patients with metastatic thyroid disease.
Although the treatment is effective for some patients, more than half of patients do not respond to the therapy. In this international, randomized, phase III double-blind study, 392 patients with progressive, refractory thyroid cancer from 21 countries were randomized at a 2:1 ratio to receive either lenvatinib or a placebo.
The primary end point was progression-free survival; secondary end points tested response rate, overall survival, and safety. Study results included median progression-free survival of 18.3 months for those receiving lenvatinib vs 3.6 months for those receiving placebo; overall response rate was 64.8% (with four complete and 165 partial responses) vs 1.5%, respectively. Median overall survival was not reached in either group.
Side effects were reported for more than 40% of patients who received the study drug, with hypertension being the most common. Other side effects included diarrhea, fatigue, nausea, decreased appetite and weight.
Thirty-seven patients discontinued the drug because of the side effects, and 6 of 20 deaths that occurred during the study period were determined to be drug-related by the treating physicians.
Follow-up studies with lenvatinib and in combination with other novel therapies for radioiodine refractory disease, as well as in other types of thyroid cancers, are in development.
Dramatic improvement in progression-free survival in patients with advanced radioiodine-refractory thyroid cancer.
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