Extended Real-World Observation of Patients Treated with Sorafenib for Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma and Impact of Lenvatinib Salvage Treatment: A Korean Multicenter Study
- Authors
- Oh, HS[Oh, Hye-Seon]; Shin, DY[Shin, Dong Yeob]; Kim, M[Kim, Mijin]; Park, SY[Park, So Young]; Kim, TH[Kim, Tae Hyuk]; Kim, BH[Kim, Bo Hyun]; Kim, EY[Kim, Eui Young]; Kim, WB[Kim, Won Bae]; Chung, JH[Chung, Jae Hoon]; Shong, YK[Shong, Young Kee]; Lim, DJ[Lim, Dong Jun]; Kim, WG[Kim, Won Gu]
- Issue Date
- 1-Dec-2019
- Publisher
- MARY ANN LIEBERT, INC
- Keywords
- radioiodine-refractory differentiated thyroid carcinoma; sorafenib; overall survival; lenvatinib; salvage treatment
- Citation
- THYROID, v.29, no.12, pp.1804 - 1810
- Indexed
- SCIE
SCOPUS
- Journal Title
- THYROID
- Volume
- 29
- Number
- 12
- Start Page
- 1804
- End Page
- 1810
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/7815
- DOI
- 10.1089/thy.2019.0246
- ISSN
- 1050-7256
- Abstract
- Background: Treatment for patients with radioactive iodine (RAI)-refractory differentiated thyroid carcinoma (DTC) is challenging. Recently, two tyrosine kinase inhibitors (sorafenib and lenvatinib) have been approved and showed benefits for progression-free survival with tolerable adverse events. Methods: This is an extension study of a previous multicenter, retrospective cohort study of real-world experience in treating 98 patients with progressive RAI-refractory DTC with sorafenib. The primary endpoint was overall survival (OS). The efficacy of lenvatinib as salvage therapy after disease progression on first-line sorafenib was evaluated by comparing outcomes in 32 patients who were treated with lenvatinib with 41 patients who were not and therefore served as a no salvage treatment group. Results: The median OS of all 98 patients treated with sorafenib was 41.5 months, and the median progression-free survival was 13.5 months. Patients without disease-related symptoms before sorafenib treatment had better OS than those with symptoms (hazard ratio [HR] = 0.56 [95% confidence interval, CI 0.31-0.99], p = 0.048). Larger tumor size was associated with a minimally increased risk of death (HR = 1.02 [CI 1.00-1.03], p = 0.049). Best tumor response was not associated with OS (p = 0.490). Lenvatinib salvage treatment significantly improved OS in patients receiving it compared with those who did not (HR = 0.28 [CI 0.15-0.53], p < 0.001). The median OS from the time of disease progression after first-line sorafenib treatment was 4.9 months in no salvage treatment group, whereas it was not reached in the lenvatinib salvage group. Conclusions: The absence of disease-related symptoms and smaller tumor burden was associated with survival benefits of first-line sorafenib treatment in patients with progressive RAI-refractory DTC. Lenvatinib salvage therapy was effective in improving OS in patients with disease progression after first-line sorafenib.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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