Tyrosine kinase inhibitors for radioiodine refractory differentiated thyroid cancer: A systematic review and meta‐analysis
Pooled result · PFSResult — go to the resultHazard ratio 0.19 95% CrI 0.14–0.25Authors' conclusion
The results of this meta-analysis suggest that targeted therapy with TKIs may be beneficial for patients with radioiodine-refractory advanced or metastatic differentiated thyroid cancer. Among the TKIs analyzed, lenvatinib appeared to be the most effective at improving PFS, although it also had the highest incidence of AEs. Further research through direct randomized controlled trials is needed to determine the optimal choice of TKI for treating patients with RAIR-DTC. This study is beneficial for formulating patients' treatment plans and guides clinicians' decision-making.
Study context
- Population
- Patients with radioiodine refractory differentiated thyroid cancer (RAIR-DTC) in randomized clinical trials (RCTs) of TKI therapy
- Participants
- 1,310 patients7 studies
- Comparison
- TKI monotherapies vs placebo
- Outcome
- PFS
Methodological detailsCochrane risk-of-bias tool
- Cochrane risk-of-bias tool
Pooled result
As reported in the abstract
Hazard ratio
0.19
95% CrI 0.14–0.25
Further pooled results
| Outcome | HR (95% CrI) | |
|---|---|---|
| OSApatinibvs PlaceboCrI | 0.42 (0.18–0.97) | |
| OSAnlotinibvs PlaceboCrI | 0.36 (0.18–0.73) | |
| 0.20.5125Hazard ratio (log scale) |
Overall survival (OS)
- Only apatinib and anlotinib showed statistically significant OS benefit vs placebo
Subgroups (BRAF or RAS mutation; papillary or follicular subtype; prior TKI)
- TKI treatment may be similarly effective regardless of mutation, subtype or prior TKI treatment
Safety
- Higher incidence of grade ≥3 adverse events (AEs) with tyrosine kinase inhibitors (TKIs) vs placebo
- Lenvatinib had the highest incidence of AEs
Original publication
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