Abstract
Among the differentiated forms of thyroid cancer, the least favorable clinical prognosis is observed in radioiodine-refractory differentiated thyroid cancer. The next step in the treatment of such patients is effective and potential toxicity multi-kinase inhibitors. Often, patients with refractory radioiodine thyroid cancer have a high tumor burden, various symptoms and comorbidity; therefore, clinicians may decide to initiate therapy at a reduced starting dose. In a randomized clinical multicenter study 211 higher objective response rate at 24th weeks were observed in the group of patients receiving lenvatinib at a dose of 24 mg per day compared with patients receiving Lenvatinib at a dose of 18 mg per day, while the difference in the incidence of serious adverse events grade 3–4 (SAE) at the 24th week of treatment were insignificant. Real clinical practice differs from randomized clinical trials regarding to the population of patients, their selection for treatment, adherence to drug dosage regimens, follow-ups, etc. In this paper, we analyzed the world and domestic clinical practice of the treatment of radioiod-refractory thyroid cancer and assessed the effect of the starting dose of lenvatinib and the duration of breaks in its administration on the effectiveness and safety of therapy.
Highlights
Among the differentiated forms of thyroid cancer, the least favorable clinical prognosis is observed in radioiodine-refractory differentiated thyroid cancer
In a randomized clinical multicenter study 211 higher objective response rate at 24th weeks were observed in the group of patients receiving lenvatinib at a dose of 24 mg per day compared with patients receiving Lenvatinib at a dose of 18 mg per day, while the difference in the incidence of serious adverse events grade 3–4 (SAE) at the 24th week of treatment were insignificant
Начальная доза данного препарата может быть снижена до 14 мг / сут у пациентов с дифференцированным РЩЖ, сопровождающимся тяжелой печеночной недостаточностью, и у больных с тяжелой почечной недостаточностью
Summary
Количество паци ентов, получавших ленватиниб в начальной дозе 24 мг / сут, % Number of patients receiving lenvatinib at the starting dose of 24 mg / day, %. Влияние длительности перерывов в приеме ленватиниба на эффективность лечения Нередко по тем или иным причинам приходится прерывать терапию ленватинибом. Оценка показателей выживаемости без прогрессирования и влияния прерывания терапии ленватинибом на общую эффективность лечения у пациентов с радиойодрефрактерным дифференцированным раком щитовидной железы в исследовании III фазы [10]. ДПТ – длительность перерывов в терапии; ДИ – доверительный интервал; ВБП – выживаемость без прогрессирования; НД – не достигнута; ОР – отношение рисков Assessment of progression-free survival rates and the effect of lenvatinib dose interruption on the overall treatment efficacy in patients with radioiodine refractory differentiated thyroid cancer in a phase III trial [10]. У умерших пациентов медиана длительности приема ленватиниба составила 4 мес (2–7 мес), причем все они Таблица 2.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
