Spotlight on lenvatinib in the treatment of thyroid cancer: patient selection and perspectives.

Details

Serval ID
serval:BIB_5ED363FD4BB1
Type
Article: article from journal or magazin.
Collection
Publications
Title
Spotlight on lenvatinib in the treatment of thyroid cancer: patient selection and perspectives.
Journal
Drug design, development and therapy
Author(s)
Costa R., Carneiro B.A., Chandra S., Pai S.G., Chae Y.K., Kaplan J.B., Garrett H.B., Agulnik M., Kopp P.A., Giles F.J.
ISSN
1177-8881 (Electronic)
ISSN-L
1177-8881
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
10
Pages
873-884
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Thyroid cancer is the most common endocrine malignancy, with over 60,000 cases reported per year in the US alone. The incidence of thyroid cancer has increased in the last several years. Patients with metastatic differentiated thyroid cancer (DTC) generally have a good prognosis. Metastatic DTC can often be treated in a targeted manner with radioactive iodine, but the ability to accumulate iodine is lost with decreasing differentiation. Until recently, chemotherapy was the only treatment in patients with advanced thyroid cancer, which is no longer amenable to therapy with radioactive iodine. The modest efficacy and significant toxicity of chemotherapy necessitated the need for urgent advances in the medical field. New insights in thyroid cancer biology propelled the development of targeted therapies for this disease, including the tyrosine kinase inhibitor sorafenib as salvage treatment for DTC. In 2015, the US Food and Drug Administration approved a second tyrosine kinase inhibitor, lenvatinib, for the treatment of radioiodine-refractory thyroid cancer. Although associated with a significant progression-free survival improvement as compared to placebo in a large Phase III study (median progression-free survival 18.2 vs 3.6 months; hazard ratio 0.21; 99% confidence interval 0.14-0.31; P<0.001), the benefit of lenvatinib needs to be proved in the context of associated moderate to severe toxicities that require frequent dose reduction and delays. This article reviews the evidence supporting the use of lenvatinib as salvage therapy for radioactive iodine-refractory thyroid cancer, with a focus on the toxicity profile of this new therapy.
Keywords
Antineoplastic Agents/adverse effects, Antineoplastic Agents/pharmacology, Antineoplastic Agents/therapeutic use, Clinical Trials, Phase III as Topic, Humans, Patient Selection, Phenylurea Compounds/adverse effects, Phenylurea Compounds/pharmacology, Phenylurea Compounds/therapeutic use, Protein Kinase Inhibitors/adverse effects, Protein Kinase Inhibitors/pharmacology, Protein Kinase Inhibitors/therapeutic use, Protein-Tyrosine Kinases/antagonists & inhibitors, Protein-Tyrosine Kinases/metabolism, Quinolines/adverse effects, Quinolines/pharmacology, Quinolines/therapeutic use, Thyroid Neoplasms/drug therapy, Thyroid Neoplasms/enzymology, Thyroid Neoplasms/genetics, Thyroid Neoplasms/pathology, differentiated thyroid cancer, lenvatinib, targeted therapy, thyroid cancer, tyrosine kinse inhibitor
Pubmed
Web of science
Open Access
Yes
Create date
27/12/2020 13:58
Last modification date
28/12/2020 6:26
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