Jen-Wei Liu1,2, Chiehfeng Chen3,4,5, El-Wui Loh6, Chun-Cheng Chu7, Mu-Yi Wang7, Hsin-Ju Ouyang7, Ya-Ting Chang7, Wei-Zhan Zhuang7, Ching-Wen Chou7, Der-Jr Huang7, Chia-Hwa Lee8,9,10, Yun Yen11, Ka-Wai Tam3,12. 1. a Department of Pharmacy , Shin Kong Wu Ho-Su Memorial Hospital , Taipei , Taiwan. 2. b School of Pharmacy , College of Pharmacy, Taipei Medical University , Taipei , Taiwan. 3. c Cochrane Taiwan , Taipei Medical University , Taipei , Taiwan. 4. d Department of Public Health , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan. 5. e Division of Plastic Surgery, Department of Surgery , Wan Fang Hospital, Taipei Medical University , Taipei , Taiwan. 6. f Center for Evidence-Based Health Care , Shuang Ho Hospital, Taipei Medical University , New Taipei City , Taiwan. 7. g School of Medicine , College of Medicine, Taipei Medical University , Taipei City , Taiwan. 8. h School of Medical Laboratory Science and Biotechnology , College of Medical Science and Technology, Taipei Medical University , Taipei , Taiwan. 9. i Comprehensive Cancer Center of Taipei Medical University , Taipei , Taiwan. 10. j Department of Laboratory Medicine , Shuang Ho Hospital, Taipei Medical University , Taipei , Taiwan. 11. k Graduate Institute of Cancer Biology and Drug Discovery , College of Medical Science and Technology, Taipei Medical University , Taipei , Taiwan. 12. l Department of Surgery , School of Medicine, College of Medicine, Taipei Medical University , Taipei , Taiwan.
Abstract
BACKGROUND AND AIMS: Radioiodine-refractory advanced or metastatic thyroid cancer has poor prognosis. We conducted a meta-analysis of randomized controlled trials to evaluate the effectiveness and safety of tyrosine kinase inhibitors (TKIs) for advanced or metastatic thyroid cancer treatment. METHODS: Studies published up to April 2017 were selected. The pooled effect size was calculated through meta-analysis by using random effects models. Outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (RR), and adverse events (AEs). RESULTS: Six studies examining 1615 patients were included. TKI treatment significantly improved PFS in patients with differentiated thyroid cancer (DTC; hazard ratio [HR] = 0.43; 95% confidence interval [CI], 0.23-0.82) and those with medullary thyroid cancer (MTC; HR = 0.36; 95% CI, 0.22-0.58). TKI treatment significantly prolonged OS in patients with DTC (HR = 0.74; 95% CI, 0.58-0.95). The TKI treatment group exhibited a significantly improved partial response rate (risk ratio = 15.8; 95% CI, 1.77-140.69) but a significantly higher number of AEs compared with the control group. CONCLUSION: TKIs significantly improved PFS and RR in patients with advanced or metastatic DTC or MTC. We recommend thoroughly evaluating patients' health status and cautiously using TKIs to maximize their benefits and minimize their toxicity.
BACKGROUND AND AIMS: Radioiodine-refractory advanced or metastatic thyroid cancer has poor prognosis. We conducted a meta-analysis of randomized controlled trials to evaluate the effectiveness and safety of tyrosine kinase inhibitors (TKIs) for advanced or metastatic thyroid cancer treatment. METHODS: Studies published up to April 2017 were selected. The pooled effect size was calculated through meta-analysis by using random effects models. Outcomes were overall survival (OS), progression-free survival (PFS), objective response rate (RR), and adverse events (AEs). RESULTS: Six studies examining 1615 patients were included. TKI treatment significantly improved PFS in patients with differentiated thyroid cancer (DTC; hazard ratio [HR] = 0.43; 95% confidence interval [CI], 0.23-0.82) and those with medullary thyroid cancer (MTC; HR = 0.36; 95% CI, 0.22-0.58). TKI treatment significantly prolonged OS in patients with DTC (HR = 0.74; 95% CI, 0.58-0.95). The TKI treatment group exhibited a significantly improved partial response rate (risk ratio = 15.8; 95% CI, 1.77-140.69) but a significantly higher number of AEs compared with the control group. CONCLUSION: TKIs significantly improved PFS and RR in patients with advanced or metastatic DTC or MTC. We recommend thoroughly evaluating patients' health status and cautiously using TKIs to maximize their benefits and minimize their toxicity.
Authors: Sabine Wächter; Alexander I Damanakis; Moritz Elxnat; Silvia Roth; Annette Wunderlich; Frederik A Verburg; Sebastian A Fellinger; Detlef K Bartsch; Pietro Di Fazio Journal: J Clin Med Date: 2018-03-21 Impact factor: 4.241
Authors: Nicole Pinto; Stephenie D Prokopec; Frederick Vizeacoumar; Karlee Searle; Matthew Lowerison; Kara M Ruicci; John Yoo; Kevin Fung; Danielle MacNeil; Jim C Lacefield; Hon S Leong; Joe S Mymryk; John W Barrett; Alessandro Datti; Paul C Boutros; Anthony C Nichols Journal: PLoS One Date: 2018-11-12 Impact factor: 3.240
Authors: María San Román Gil; Javier Pozas; Javier Molina-Cerrillo; Joaquín Gómez; Héctor Pian; Miguel Pozas; Alfredo Carrato; Enrique Grande; Teresa Alonso-Gordoa Journal: Int J Mol Sci Date: 2020-07-13 Impact factor: 5.923