Real-World Efficacy and Safety of Lenvatinib and Sorafenib in Thyroid Cancer: A Retrospective, Propensity-Score-Matched Study
Authors' conclusion
Lenvatinib was associated with improved OS compared with sorafenib in patients with TC, with broadly comparable safety profiles. These findings, based on retrospective real-world data, support the use of lenvatinib as a preferred first-line mTKI in line with current treatment paradigms.
Study context
- Population
- Adults with thyroid cancer initiating lenvatinib or sorafenib; excluded other malignancies treated with these agents or exposure to the alternative mTKImatched cohorts
- Participants
- 214 vs 214
- Exposure
- Lenvatinib vs sorafenib
- Lenvatinibn = 214
- Sorafenibn = 214reference
- Outcome
- Overall survival
- Follow-up
- 1 and 3 years
Methodological detailspropensity-score matched, real-world TriNetX data
- Propensity-score matched
- Real-world TriNetX data
Main finding
As reported in the abstract
OS
Lenvatinib vs SorafenibHazard ratio (CI)
1 year; OS 78.5% vs 64.5%
0.538(0.373–0.775)
3 years; OS 62.1% vs 45.8%
0.590(0.444–0.784)
Observational data: associations, not effects.
Secondary outcomes
All-cause hospitalization and emergency care admission
- All-cause hospitalization and emergency care admission rates were comparable
Overall survival (OS) by subgroup
- Survival benefit with lenvatinib consistent across subgroups, especially pronounced with high tumor burden
- Exploratory
Safety
Treatment-emergent adverse events
- Hematological AEs more frequent with sorafenib; renal and cardiovascular events trended higher with lenvatinib
Original publication
Real-World Efficacy and Safety of Lenvatinib and Sorafenib in Thyroid Cancer: A Retrospective, Propensity-Score-Matched Study. Thyroid. Published 13 April 2026. doi:10.
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