Low‐Dose Versus High‐Dose Lenvatinib in Radioiodine Refractory Differentiated Thyroid Cancer—A Real‐World Safety and Efficacy Analysis
Authors' conclusion
The study suggests that starting with lower doses of lenvatinib, followed by dose escalation if tolerated, may offer a safer approach with significantly lower rates of drug interruptions and dose reductions, with comparable efficacy in RR-DTC patients. Further validation by larger prospective trials is warranted.
Study context
- Population
- Patients with radioiodine refractory differentiated thyroid cancer (RR-DTC) treated with lenvatinib
- Participants
- 105 patients
- Exposure
- Low-dose vs high-dose starting lenvatinib
- Group-An = 60
- Group-Bn = 45reference
- Outcome
- Drug interruptions
Methodological detailsreal-world
- Real-world
Main finding
As reported in the abstract
P = 0.035
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Objective response rate (RECIST 1.1)Similar | P = 0.936 |
| PFS (restricted mean survival time at 24 months)Comparable | P = 0.128 |
Objective response rate (RECIST 1.1)
- Both groups showed similar objective response rates
Progression-free survival (PFS) (restricted mean survival time at 24 months)
- Comparable PFS outcomes
Safety
Dose reductions · significantly higher with Group-B
P < 0.001
Hand-foot skin reaction · more frequent with Group-B
P < 0.05
Diarrhea · more frequent with Group-B
P < 0.05
Electrolyte imbalance · more frequent with Group-B
P < 0.05
| Outcome | Group-A | Group-B | P value |
|---|---|---|---|
| HepatotoxicityMore frequent with Group-B | 11.7-18.3% | 33.3-40% | P < 0.05 |
Original publication
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