Abstract

Background: Survival rates for anaplastic thyroid cancer (ATC) have not improved in the past four decades; however, preliminary clinical data indicate that lenvatinib may provide efficacy benefits for patients with ATC. This real-world study aimed to define the potential role of lenvatinib in ATC by examining the impact of treatment administered alongside existing therapies.Methods: This was a retrospective, single-center analysis of Korean patients with confirmed ATC who received lenvatinib between October 2015 and February 2018. Eighteen patients were included (mean ± standard deviation age, 64.9 ± 11.1 years; 61.1% female). Six [33.3%] had resectable disease that progressed after a combination of surgery, radiotherapy, and chemotherapy, and 12 [66.7%] had unresectable disease that progressed after radiation treatment and chemotherapy. Study endpoints were overall survival (OS) and change in volume of the largest tumor assessed via imaging.Results: Median OS for the 18 lenvatinib-treated patients was 230 days (range 64–839 days). Survival rates at 6 months and 1 year were 61.1 and 22.2%, respectively. Three patients (16.7%) survived beyond 1 year; 15 patients died, of whom four (26.7%) had local disease and 11 (73.3%) had distant metastasis. Two patients (11.1%) had tumor volume increases of 9–10%. The other 16 patients (88.9%) had tumor volume reductions of 2–69%. Six patients (33.3%) had tumor volume reductions ≥50%.Conclusions: In patients with ATC who had progressed on prior therapy, addition of lenvatinib could improve survival duration and reduce tumor volume. Further studies of lenvatinib in ATC are warranted.

Highlights

  • Anaplastic thyroid cancer (ATC) is a rare, highly aggressive malignancy composed of undifferentiated thyroid follicular cells [1]

  • A recent analysis of the Surveillance, Epidemiology, and End Results (SEER) database suggested that the incidence of ATC may be increasing [5], which is likely caused by increased detection of tumors due to improved diagnosis guidelines

  • The multitargeted tyrosine kinase inhibitor (TKI) lenvatinib is currently recommended for use in patients without curative options who have no response to other agents [7]

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Summary

Introduction

Anaplastic thyroid cancer (ATC) is a rare, highly aggressive malignancy composed of undifferentiated thyroid follicular cells [1]. There were 1,527 patients diagnosed with ATC between 1973 and 2014; in 1973 the age-adjusted incidence rate was 0.2 per 1,000,000 people, compared with a rate of 1.2 per 1,000,000 in 2014. Survival rates for anaplastic thyroid cancer (ATC) have not improved in the past four decades; preliminary clinical data indicate that lenvatinib may provide efficacy benefits for patients with ATC. This real-world study aimed to define the potential role of lenvatinib in ATC by examining the impact of treatment administered alongside existing therapies

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