Real-World Data for Lenvatinib in Radioiodine-Refractory Differentiated Thyroid Cancer (RELEVANT): A Retrospective Multicentric Analysis of Clinical Practice in Austria

Author:

Rendl G.1ORCID,Sipos B.1ORCID,Becherer A.2ORCID,Sorko S.3,Trummer C.4ORCID,Raderer M.5ORCID,Hitzl W.678ORCID,Ardelt M.9ORCID,Gallowitsch H. J.3ORCID,Pirich C.1ORCID

Affiliation:

1. Department of Nuclear Medicine and Endocrinology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria

2. Department of Nuclear Medicine, Academic Teaching Hospital Feldkirch, Feldkirch, Austria

3. Department of Nuclear Medicine and Endocrinology, PET/CT Centre, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

4. Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria

5. Department of Internal Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria

6. Research Office (Biostatistics), Paracelsus Medical University Salzburg, Salzburg, Austria

7. Department of Ophthalmology and Optometry, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria

8. Research Program Experimental Ophthalmology and Glaucoma Research, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria

9. Institute of Pharmacy, Paracelsus Medical University Salzburg, Salzburg, Austria

Abstract

Background. Lenvatinib has proven efficacy in progressive, radioiodine- (RAI-) refractory thyroid cancer (TC). Dose reductions are commonly performed due to decreased tolerability and adverse effects. This retrospective multicenter study analyzed overall survival (OS) and progression-free survival (PFS) and tolerability in the Austrian patient population treated with lenvatinib. Methods. Clinical data of 43 patients (25 males and 18 females) with a median age of 70 years (range: 39–91 years) and RAI-refractory TC with metastases to the lymph nodes (74%), lungs (86%), bone (35%), liver (16%), and brain (12%) were analyzed. The mean duration of treatment with lenvatinib was 26.6 ± 15.4 months with dosage reductions required in 39 patients (91%). Results. PFS after 24 months was 71% (95% CI: 56–87), and overall survival (OS) was 74% (95% CI: 60–88), respectively. OS was significantly shorter ( p = 0.048 ) in patients with a daily maintenance dosage ≤ 10 mg (63%) (95% CI: 39–86) as compared to patients on ≥ 14 mg lenvatinib (82%) (95% CI: 66–98) daily. Dose reduction was noted in 39 patients (91%). Grade ≥3 toxicities (hypertension, diarrhea, weight loss, and palmar-plantar erythrodysesthesia syndrome) were most common leading to discontinuation of lenvatinib in 7 patients (16%). Conclusion. Lenvatinib showed sustained clinical efficacy in patients with metastatic RAI-refractory TC even with reduced maintenance dosages over years. The effects were comparable to the registration trial, although patients had a higher median age and, more commonly, dose reductions.

Publisher

Hindawi Limited

Subject

Endocrine and Autonomic Systems,Endocrinology,Endocrinology, Diabetes and Metabolism

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