Hypocalcemia During Lenvatinib Treatment for Advanced Thyroid Cancer: Clinical Features and Management in a Real-Life Setting
Authors' conclusion
In this relatively small cohort, we observed an incidence of hypocalcemia of 24%, which is higher than that reported in the registration trial (6.9%). Both PTH-dependent and PTH-independent mechanisms explained hypocalcemia in the present cohort.
Study context
- Population
- Consecutive patients with advanced thyroid cancer treated with lenvatinib for ≥6 months, single tertiary center in Italy
- Participants
- 25 patients
- Outcome
- Incidence of hypocalcemia during LEN treatment
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Incidence of hypocalcemia
Hypocalcemia occurred in 6 of the 25 patients
24%
95% CI 9.36–45.13%
Observational data: associations, not effects.
Further findings
Grade ≥3 hypocalcemia
- Grade ≥3 hypocalcemia in 2 of the 25 patients
- 8%
Recurrent hypocalcemia
- Recurrent in 4 of 6 patients
- 67%
Time to hypocalcemia onset from starting lenvatinib (LEN)
- Median time to onset (range 0.5-13 months)
- 3 months
Predictors of hypocalcemia
- No differences between patients who developed or not hypocalcemia in starting/mean LEN dose or clinicopathological characteristics
Mechanisms during hypocalcemic crisis
- Both patients with grade ≥3 hypocalcemia had low magnesium and low or inappropriately normal parathormone (PTH)
- 2
- Patients with grade 2 hypocalcemia who had secondary hyperparathyroidism
- 2 of 3
Management of hypocalcemia
- Oral calcium supplementation in most cases; required IV calcium and transient LEN withdrawal
- up to 10% of patients
Original publication
Hypocalcemia During Lenvatinib Treatment for Advanced Thyroid Cancer: Clinical Features and Management in a Real-Life Setting. Thyroid. Published 28 November 2022. doi:10.
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