Comprehensive Assessment of Multikinase Inhibitor Therapy Outcomes in RAIR-(P)DTC and Medullary Thyroid Cancer (MTC) at a Tertiary Referral Center
Authors' conclusion
Lenvatinib outperformed sorafenib, particularly in PDTC, suggesting the need for alternative treatments. In MTC, vandetanib was more effective than cabozantinib, supporting its use as first-line therapy. However, the choice of MKI was determined by the treating physician. Our data highlight MKI effectiveness under expert-center management compared to prior trials and real-world data.
Study context
- Population
- Patients with thyroid cancer (51 poorly differentiated thyroid cancer (PDTC), 49 DTC, 54 MTC) treated with multikinase inhibitors (MKIs) 2011–2024 at the Essen Endocrine Tumor Center51 PDTC, 49 DTC, 54 MTC
- Participants
- 154 patients
- Exposure
- Lenvatinib vs sorafenib inDTC; vandetanib vs cabozantinib in MTC
- Outcome
- ORR and median PFS in (P)DTC
Methodological detailssingle-centre, MKI choice determined by the treating physician
- Single-centre
- MKI choice determined by the treating physician
Main finding
As reported in the abstract
Objective response rate (ORR), lenvatinib vs sorafenib
64% vs 18%
Median progression-free survival (PFS), lenvatinib vs sorafenib
22.4 vs 6.7 months
Median PFS in PDTC, lenvatinib vs sorafenib
21.2 vs 3.5 months
Observational data: associations, not effects.
Further findings
ORR and PFS in MTC
- ORR, vandetanib vs cabozantinib
- 60% vs 18%
- PFS, vandetanib vs cabozantinib
- 26.1 vs 10.0 months
- ORR with first-line vandetanib (vs comparator)
- 67% vs 25%
- RET mutations and longer PFS, HR
- 0.14, P = .045
Lenvatinib-treated (P)DTC: prognostic factors
- ORR without vs with bone metastases
- 74% vs 53%
- Higher age and shorter PFS, HR
- 2.12, P = .039
- Liver metastases and shorter PFS, HR
- 2.34, P = .031
Original publication
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