Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer?
Objective: To analyse at our institution the criteria for selecting a first-line therapy for patients with advanced radioiodine-refractory thyroid cancer and their clinical responses, safety and survival outcomes. Patients and methods: We extracted data from 69 consecutive patients referred to Feder...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2025-02-01
|
| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/14/1/ETJ-24-0332.xml |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823860049385095168 |
|---|---|
| author | Tommaso Porcelli Cristina Luongo Anna Cerbone Carmine Di Luccio Mariantonia Nacchio Maria Angela De Stefano Martin Schlumberger Domenico Salvatore |
| author_facet | Tommaso Porcelli Cristina Luongo Anna Cerbone Carmine Di Luccio Mariantonia Nacchio Maria Angela De Stefano Martin Schlumberger Domenico Salvatore |
| author_sort | Tommaso Porcelli |
| collection | DOAJ |
| description | Objective: To analyse at our institution the criteria for selecting a first-line therapy for patients with advanced radioiodine-refractory thyroid cancer and their clinical responses, safety and survival outcomes. Patients and methods: We extracted data from 69 consecutive patients referred to Federico II University Hospital from September 2016 to September 2024, among whom 44 patients were treated with TKIs as first-line treatment and outside any clinical trial, and form the basis of this report. Results: Thirty-one (71%) patients were treated with the antiangiogenesis inhibitor lenvatinib and 13 (29%) were treated with selective tyrosine kinase inhibitors (s-TKIs). Among the latter, eight patients were treated with dabrafenib + trametinib (DT), two patients were treated with selpercatinib because of contraindications to lenvatinib, and three patients received DT as redifferentiation therapy. A RECIST partial response was observed in 28% of patients treated with lenvatinib, in 63% of those treated with DT and in one of the two patients treated with selpercatinib. Grade ≥3 adverse events occurred in 13 (42%) patients treated with lenvatinib and only in 1 (9%) patient treated with DT. Progression-free survival (PFS) and overall survival rates at 1 year were 72% and 83% in lenvatinib-treated patients and 69% and 83% in DT-treated patients, respectively. In both selpercatinib-treated patients, the PFS at data cut-off was 10 months. No treatment-related deaths were observed. Conclusion: S-TKIs permitted tailoring systemic treatment based on disease location, tumour volume and patient comorbidities, achieving satisfactory tolerance and outcomes in selected patients with an actionable driver mutation and with contraindications to angiogenesis inhibitors or candidates for redifferentiation therapy. |
| format | Article |
| id | doaj-art-6ca4162ffd8144aa8c59b32653513d9f |
| institution | Kabale University |
| issn | 2235-0802 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj-art-6ca4162ffd8144aa8c59b32653513d9f2025-02-10T16:58:04ZengBioscientificaEuropean Thyroid Journal2235-08022025-02-0114110.1530/ETJ-24-03321Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer?Tommaso Porcelli0Cristina Luongo1Anna Cerbone2Carmine Di Luccio3Mariantonia Nacchio4Maria Angela De Stefano5Martin Schlumberger6Domenico Salvatore7Department of Public Health, University of Naples “Federico II”, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, ItalyDepartment of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, ItalyDepartment of Public Health, University of Naples “Federico II”, Naples, ItalyDepartment of Public Health, University of Naples “Federico II”, Naples, ItalyDepartment of Endocrine Oncology, Gustave Roussy Cancer Centre and University Paris-Saclay, Villejuif, FranceDepartment of Public Health, University of Naples “Federico II”, Naples, ItalyObjective: To analyse at our institution the criteria for selecting a first-line therapy for patients with advanced radioiodine-refractory thyroid cancer and their clinical responses, safety and survival outcomes. Patients and methods: We extracted data from 69 consecutive patients referred to Federico II University Hospital from September 2016 to September 2024, among whom 44 patients were treated with TKIs as first-line treatment and outside any clinical trial, and form the basis of this report. Results: Thirty-one (71%) patients were treated with the antiangiogenesis inhibitor lenvatinib and 13 (29%) were treated with selective tyrosine kinase inhibitors (s-TKIs). Among the latter, eight patients were treated with dabrafenib + trametinib (DT), two patients were treated with selpercatinib because of contraindications to lenvatinib, and three patients received DT as redifferentiation therapy. A RECIST partial response was observed in 28% of patients treated with lenvatinib, in 63% of those treated with DT and in one of the two patients treated with selpercatinib. Grade ≥3 adverse events occurred in 13 (42%) patients treated with lenvatinib and only in 1 (9%) patient treated with DT. Progression-free survival (PFS) and overall survival rates at 1 year were 72% and 83% in lenvatinib-treated patients and 69% and 83% in DT-treated patients, respectively. In both selpercatinib-treated patients, the PFS at data cut-off was 10 months. No treatment-related deaths were observed. Conclusion: S-TKIs permitted tailoring systemic treatment based on disease location, tumour volume and patient comorbidities, achieving satisfactory tolerance and outcomes in selected patients with an actionable driver mutation and with contraindications to angiogenesis inhibitors or candidates for redifferentiation therapy.https://etj.bioscientifica.com/view/journals/etj/14/1/ETJ-24-0332.xmladvanced thyroid cancerdifferentiated thyroid cancertyrosine kinase inhibitorsselective kinase inhibitorsfirst-line treatment |
| spellingShingle | Tommaso Porcelli Cristina Luongo Anna Cerbone Carmine Di Luccio Mariantonia Nacchio Maria Angela De Stefano Martin Schlumberger Domenico Salvatore Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? European Thyroid Journal advanced thyroid cancer differentiated thyroid cancer tyrosine kinase inhibitors selective kinase inhibitors first-line treatment |
| title | Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? |
| title_full | Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? |
| title_fullStr | Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? |
| title_full_unstemmed | Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? |
| title_short | Did selective kinase inhibitors change the management of patients with radioiodine-refractory thyroid cancer? |
| title_sort | did selective kinase inhibitors change the management of patients with radioiodine refractory thyroid cancer |
| topic | advanced thyroid cancer differentiated thyroid cancer tyrosine kinase inhibitors selective kinase inhibitors first-line treatment |
| url | https://etj.bioscientifica.com/view/journals/etj/14/1/ETJ-24-0332.xml |
| work_keys_str_mv | AT tommasoporcelli didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT cristinaluongo didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT annacerbone didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT carminediluccio didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT mariantonianacchio didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT mariaangeladestefano didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT martinschlumberger didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer AT domenicosalvatore didselectivekinaseinhibitorschangethemanagementofpatientswithradioiodinerefractorythyroidcancer |