Introduction: Tyrosine kinase inhibitors (sorafenib and sunitinib) have been used in treating refractory cases of thyroid cancer. The aim of our present study was to assess the efficacy of these agents in patients with refractory and progressive thyroid cancer, regarding patients quality of life, adverse events and response rates
Patients and methods: We retrospectively analyzed data of adult patients with differentiated and medullary thyroid cancer (DTC and MTC) treated with either Sorafenib or Sunitinib. Disease progression was assessed according to RECIST criteria. Adverse events were documented and graded with the use of the NCI Common Terminology Criteria for Adverse Events. Patients received treatment until disease progression, serious-grade 4-adverse events or until unwilling to continue treatment due to adverse events.
Results: From April 2009 to October 2011 a total of 16 patients (nine males and seven females) were included. Six patients with MTC and ten patients with DTC were placed on tyrosine kinase inhibitors. The median duration of treatment was four circles (range 0.516). Discontinuation of treatment was noted in 14 out of 16 (87.5%) patients, who were unwilling to continue treatment due to side effects, and reported worsening of quality of life. Though most adverse events were grade 1 and 2, two patients experienced grade 4 serious adverse events. Life threatening were: stage 4 heart failure in one patient, reversible with treatment withdrawal, and stage 4 nose bleeding noted in another. More than 50% of patients reported fatique, diarrhea, stomatitis and dermatologic disorders. Main laboratory abnormalities were anemia, neutropenia and hypertriglyceridemia. Dose reduction was required in five out of 16 patients. Concerning overall response, two patients showed partial response, nine stable and five progressive disease. Metastatic sites favouring response were lungs and liver.
Conclusions: Treatment with tyrosine kinase inhibitors should clearly balance benefits and risks of worsening patients good quality of life.
27 Apr - 01 May 2013
European Society of Endocrinology