Multitargeted Kinase Inhibition in Metastatic Differentiated Radioiodine-Refractory Thyroid Cancer: A Look at New Therapeutic Options for a Rare Disease
Abstract
Background: Metastatic differentiated thyroid cancer (DTC) is a rare disease that is in the first line treated with iodine-131 radioisotope therapy. Until recently, options were very limited in the case of progressive radioactive-iodine (RAI)-refractory disease. Based on new study results, tyrosine kinase inhibitors (TKIs) have attracted attention. The TKI sorafenib demonstrated significantly improved progression-free survival (PFS) in a phase III trial. Recent data from another phase III trial showed that the TKI lenvatinib achieved high response rates and a large improvement in PFS in metastatic RAI-refractory DTC patients in the first-line setting and after 1 prior line of TKI. However, little is known about the response to lenvatinib in patients pretreated with multiple lines of TKIs. Case Report: We present the case of a 45-year-old man with metastatic RAI-refractory DTC progressing after multiple prior treatments with TKIs and chemotherapy. A very good and long-lasting response to lenvatinib was observed. Careful and prospective monitoring as well as management of side effects including dose adaptation were necessary to ensure success of treatment. Conclusion: Here, we review different novel treatment options for patients with metastatic RAI-refractory DTC.
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The two FDA approved multi-targeted TKIs sorafenib and lenvatinib have limited efficacy in DePTC patients.
“The two FDA approved multi-targeted TKIs sorafenib and lenvatinib have limited efficacy in DePTC patients [12, 13].”
From Restoration of p53 using the novel MDM2-p53 antagonist APG115 suppresses dedifferentiated papillary thyroid cancer cells (2017) · cites this paper as [12]
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(2016) · Reactions Weekly · doi:10.1007/s40278-016-22514-4
- Authors
- Mischler, K., Kneifel, S., & Cathomas, R.
- Affiliations
- Kantonsspital Graubünden (CH)
- Venue
- Oncology Research and Treatment
- Publisher
- S. Karger AG
- Published
- 2016
- Volume
- 39
- Issue
- 9
- Pages
- 548-552
- ISSN
- 2296-5262 (ISSN-L)
- 2296-5270
- OpenAlex
- W2512718980
- Cited by
- 4
- References
- 22
- Citations by year
- 2018: 2 · 2017: 1 · 2016: 1
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Oncology Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eisai
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- metastatic differentiated thyroid cancer, radioiodine-refractory thyroid cancer, lenvatinib, sorafenib, tyrosine kinase inhibitors, progression-free survival, second-line therapy, dose adjustment, adverse effects monitoring
- MeSH terms
- Antineoplastic Agents, Dose-Response Relationship, Radiation, Humans, Iodine Radioisotopes, Male, Middle Aged, Phenylurea Compounds, Quinolines, Thyroid Neoplasms, Treatment Outcome, Treatment Failure, Radiopharmaceuticals, Rare Diseases, Protein Kinase Inhibitors, Molecular Targeted Therapy
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