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Endocrine Abstracts (2018) 56 P1194 | DOI: 10.1530/endoabs.56.P1194

ECE2018 Poster Presentations: Thyroid Thyroid cancer (88 abstracts)

Efficacy and toxicity of lenvatinib treatment for radioiodine refractory thyroid cancer in daily clinical practice: a single centre experience

Lucía Prieto 1 , Rui Ferreira Carvalho 1 , Virginia Osés 1 , Concepción Blanco 2 , Nuria Palacios 1 & Javier Aller 1


1Endocrinology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Spain; 2Endocrinology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain.


Introduction: Lenvatinib is a multitarget tyrosine kinase inhibitor that has shown substantial efficacy in patients with progressive radioiodine refractory thyroid cancer (RAIRDTC) (progression free survival (PFS) 19.4 months and objective response rate 64.8%; SELECT trial) despite common adverse events (AEs).

Objective: To evaluate efficacy and toxicity of lenvatinib treatment for RAIRDTC in daily clinical practice.

Methods: Retrospective clinical record review of 12 RAIRDTC patients treated with lenvatinib from April 2015 to December 2017 in our hospital.

Results: Twelve patients were analyzed (4 females, median age 62 years (range, 47-82)). Every patient had distant metastasis (83% lung, 67% bone, 58% lymph nodes, 25% liver) and 11 out of 12 had evidence of progressive disease (PD) within 6 months prior to lenvatinib start. Only 4 patients received lenvatinib as first line treatment (range, 1st−6th line). Initial dose was 24 mg in 11 out of 12 patients and 10 mg in 1 patient (82 years, ECOG 3, several comorbidities). Median follow-up (duration of treatment) was 14.9 months [0.3-33.5]. Median PFS was 24.3 months (CI 14.7 - 33.8) although data are immature since only 4 patients had progressed at the time of analysis. In 2 patients lenvatinib was not stopped despite PD; both show stable disease at last follow up (6.1 and 3.1 months after first progression). 4 of the 8 patients (50%) in which evaluation of tumour response was available achieved a partial response; 4 (50%) stable disease. No complete responses were observed. All patients presented grade 3 (G3) or superior AEs. The most frequent AEs related to treatment were fatigue (100%; 16% G3), hypertension (83%; 83% G3), nausea (75%; 8% G3), weight loss (67%; 8% G3), diarrhea (50%; 0% G3), arthralgia (50%, 0% G3), mucositis (33%; 0% G3), hand-foot syndrome (25%; 0% G3) and proteinuria (17%, 0% G3). Seven (58%) and ten (83%) patients had dose reductions or interruption of lenvatinib due to AEs. Median time to dose reduction or interruption was 1.9 months. Most dose interruptions were very brief (median duration 2 days). Median dose at last follow-up was 14.9 mg/d (range 7.1 – 24 mg/d). Two deaths occurred, one considered to be drug related (bleeding during cervical abscess surgery).

Conclusion: Remarkable benefit of lenvatinib treatment for RAIRDTC is achieved in daily clinical practice. Our results, in heavily pretreated patients, are in agreement with those of the SELECT trial. AEs are frequent and require close management and dose titration.

Volume 56

20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

European Society of Endocrinology 

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