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Real-world experience of lenvatinib in patients with advanced anaplastic thyroid cancer

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Abstract

Purpose

We aimed to evaluate the clinical efficacy and safety of lenvatinib in patients with advanced anaplastic thyroid cancer (ATC) in real-world practice.

Methods

This multicenter, retrospective cohort study included 14 patients with advanced ATC who received lenvatinib. We evaluated the response rate according to RECIST.

Results

Ten patients had de novo ATC, and lenvatinib was used as a neoadjuvant treatment in eight patients. During a median follow-up of 6.7 months, patients received lenvatinib at a median dose of 13 mg daily. Overall, four patients (29%) showed partial response, nine (64%) had stable disease, and one (7%) had progressive disease. Tumor burden was reduced in 13 patients (93%), and the median best percent change from the baseline was −15.8%. The median progression-free survival and overall survival were 5.7 months (95% confidence interval [CI], 2.2–8.3) and 6.7 months (95% CI, 3.0–8.4), respectively. All patients experienced adverse events (AEs). Most AEs were manageable but two AEs—tracheal perforation, and pneumothorax and pneumomediastinum—were life-threatening. One patient underwent flap surgery for reconstruction of their tracheal perforation, and another died of pneumothorax and pneumomediastinum, which seemed to be related to lenvatinib.

Conclusions

In this multicenter real-world study, lenvatinib demonstrated limited clinical activity in advanced ATC. It effectively reduced the tumor burden but showed doubtful survival benefit. Although most AEs were manageable, one fatal AE was related to rapid tumor shrinkage. Further studies are needed to clarify the efficacy and optimal dose of lenvatinib in patients with advanced ATC.

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Funding

This research did not receive any specific grant from any funding agency in public, commercial, or not-for-profit sectors.

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Author notes

  1. These authors contributed equally as co-first authors: Mijin Kim, Jonghwa Ahn

Authors and Affiliations

  1. Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Mijin Kim & Bo Hyun Kim

  2. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Jonghwa Ahn, Won Gu Kim, Tae Yong Kim, Won Bae Kim, Young Kee Shong & Min Ji Jeon

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Dong Eun Song

  4. Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam, Republic of Korea

    Jee Hee Yoon & Ho-Cheol Kang

  5. Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Dong Jun Lim

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  1. Mijin Kim
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Correspondence to Min Ji Jeon or Bo Hyun Kim.

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This study protocol was reviewed and approved by the Institutional Review Board of each participating institution.

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Kim, M., Ahn, J., Song, D.E. et al. Real-world experience of lenvatinib in patients with advanced anaplastic thyroid cancer. Endocrine 71, 427–433 (2021). https://doi.org/10.1007/s12020-020-02425-y

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