BACKGROUND: Historical anaplastic thyroid cancer (ATC) outcomes have been terrible, with a median survival of only five months and <20% one-year survival. Improved outcomes are now achieved with aggressive initial therapy in stages IVA and IVB disease, but patients with distant metastatic disease (stage IVC) still do poorly; improved therapies are sorely needed. Kinase inhibitors have emerged as promising agents in the therapy of advanced medullary and differentiated thyroid cancer, but there are limited data regarding the use of lenvatinib in ATC. The aim of this study was to delineate clinical outcomes in a series of patients with advanced ATC in response to lenvatinib therapy. METHODS: A retrospective analysis was conducted involving all lenvatinib-treated Mayo Clinic ATC patients in 2015. RESULTS: Of 28 distinct ATC patients seen in 2015, three (11%) with metastatic disease of ECOG performance status 2-3 were treated with lenvatinib. Two patients were male; age range at ATC diagnosis was 57-84 years. All three patients attained successful local control of their disease with surgery and/or combined chemoradiotherapy. Lenvatinib was offered as the second, third, or fourth line of therapy at the time of metastatic disease progression. Two patients incurred minor responses to therapy, with structural regression of distant metastatic tumor disease soon after starting lenvatinib treatment (at one to two months), while one patient achieved stable disease, but no Response Evaluation Criteria In Solid Tumors partial responses resulted. Overall survival after starting lenvatinib was two, six, and seven months. Fatigue and hypertension were prominent, and one patient developed pulmonary emboli while on lenvatinib. CONCLUSION: This initial single-institution experience suggests that lenvatinib may have some disease-modifying activity in metastatic ATC that is otherwise refractory to cytotoxic chemotherapy. Unfortunately, observed benefits were transient, and toxicities were prominent. Clinical trials are required to ascertain better the utility of lenvatinib in the management of advanced ATC.
BACKGROUND: Historical anaplastic thyroid cancer (ATC) outcomes have been terrible, with a median survival of only five months and <20% one-year survival. Improved outcomes are now achieved with aggressive initial therapy in stages IVA and IVB disease, but patients with distant metastatic disease (stage IVC) still do poorly; improved therapies are sorely needed. Kinase inhibitors have emerged as promising agents in the therapy of advanced medullary and differentiated thyroid cancer, but there are limited data regarding the use of lenvatinib in ATC. The aim of this study was to delineate clinical outcomes in a series of patients with advanced ATC in response to lenvatinib therapy. METHODS: A retrospective analysis was conducted involving all lenvatinib-treated Mayo Clinic ATC patients in 2015. RESULTS: Of 28 distinct ATC patients seen in 2015, three (11%) with metastatic disease of ECOG performance status 2-3 were treated with lenvatinib. Two patients were male; age range at ATC diagnosis was 57-84 years. All three patients attained successful local control of their disease with surgery and/or combined chemoradiotherapy. Lenvatinib was offered as the second, third, or fourth line of therapy at the time of metastatic disease progression. Two patients incurred minor responses to therapy, with structural regression of distant metastatic tumor disease soon after starting lenvatinib treatment (at one to two months), while one patient achieved stable disease, but no Response Evaluation Criteria In Solid Tumors partial responses resulted. Overall survival after starting lenvatinib was two, six, and seven months. Fatigue and hypertension were prominent, and one patient developed pulmonary emboli while on lenvatinib. CONCLUSION: This initial single-institution experience suggests that lenvatinib may have some disease-modifying activity in metastatic ATC that is otherwise refractory to cytotoxic chemotherapy. Unfortunately, observed benefits were transient, and toxicities were prominent. Clinical trials are required to ascertain better the utility of lenvatinib in the management of advanced ATC.
Authors: Katherine D Gray; Jaclyn E McCloskey; Yogindra Vedvyas; Olivia R Kalloo; Steve El Eshaky; Yanping Yang; Enda Shevlin; Marjan Zaman; Timothy M Ullmann; Heng Liang; Dessislava Stefanova; Paul J Christos; Theresa Scognamiglio; Andrew B Tassler; Rasa Zarnegar; Thomas J Fahey; Moonsoo M Jin; Irene M Min Journal: Clin Cancer Res Date: 2020-09-04 Impact factor: 12.531
Authors: Nancy Y Lee; Nadeem Riaz; Vanessa Wu; Thomas Brinkman; Chiaojung J Tsai; Wanquing Zhi; James Fetten; Alan Ho; Richard J Wong; Ronald Ghossein; Michael Tuttle; James Fagin; David G Pfister; Eric Sherman Journal: Thyroid Date: 2022-06-21 Impact factor: 6.506
Authors: Christian M Schürch; Matthias A Roelli; Stefan Forster; Marie-Hélène Wasmer; Frido Brühl; Renaud S Maire; Sergio Di Pancrazio; Marc-David Ruepp; Roland Giger; Aurel Perren; Anja M Schmitt; Philippe Krebs; Roch-Philippe Charles; Matthias S Dettmer Journal: Thyroid Date: 2019-05-10 Impact factor: 6.568
Authors: Keith C Bible; Electron Kebebew; James Brierley; Juan P Brito; Maria E Cabanillas; Thomas J Clark; Antonio Di Cristofano; Robert Foote; Thomas Giordano; Jan Kasperbauer; Kate Newbold; Yuri E Nikiforov; Gregory Randolph; M Sara Rosenthal; Anna M Sawka; Manisha Shah; Ashok Shaha; Robert Smallridge; Carol K Wong-Clark Journal: Thyroid Date: 2021-03 Impact factor: 6.568
Authors: Caitlin E Egan; Dessislava Stefanova; Adnan Ahmed; Vijay J Raja; Jessica W Thiesmeyer; Kevin J Chen; Jacques A Greenberg; Taotao Zhang; Bing He; Brendan M Finnerty; Rasa Zarnegar; Moonsoo M Jin; Theresa Scognamiglio; Noah Dephoure; Thomas Fahey; Irene M Min Journal: Thyroid Date: 2021-07-05 Impact factor: 6.506
Authors: Priyanka C Iyer; Ramona Dadu; Maria Gule-Monroe; Naifa L Busaidy; Renata Ferrarotto; Mouhammed Amir Habra; Mark Zafereo; Michelle D Williams; G Brandon Gunn; Horiana Grosu; Heath D Skinner; Erich M Sturgis; Neil Gross; Maria E Cabanillas Journal: J Immunother Cancer Date: 2018-07-11 Impact factor: 13.751