伦瓦提尼
耐火材料(行星科学)
甲状腺癌
医学
肿瘤科
内科学
甲状腺
生物
天体生物学
作者
Vincenzo Marotta,Domenico Rocco,Anna Crocco,Maria Grazia Deiana,Reinaldo Martinelli,Francesca Di Gennaro,M. Valeriani,Luca Valvano,Alessia Caleo,Luciano Pezzullo,Antongiulio Faggiano,Mario Vitale,Salvatore Monti
标识
DOI:10.1210/clinem/dgae181
摘要
Abstract Context Lenvatinib is approved for the treatment of radioiodine-refractory differentiated thyroid cancer (RR-DTC). The definition of predictive factors of survival is incomplete. Objective To identify pre- and post- treatment survival predictors in a real-life cohort of RR-DTC treated with lenvatinib. Design Multicenter, retrospective, cohort study. Setting Three Italian thyroid cancer referral centers. Partecipants 55 RR-DTC treated with lenvatinib. Main outcome measures Progression-free survival (PFS) and overall survival (OS). Results Lenvatinib was the first-line kinase-inhibitor in 96.4% of subjects. Median follow-up was 48 months. Median PFS and OS were 26 (95% CI 19.06-32.93) and 70 months (95% CI 36-111.99), respectively. Pre-treatment setting: Eastern Cooperative Oncology Group (ECOG) performance status was independently related to PFS (p < 0.001; HR 18.82; 95% CI 3.65-97.08: score 0-1 as reference) and OS (p = 0.001; HR 6.20; 95% CI 2.11-18.20; score 0-1 as reference); radioactive iodine (RAI)-avidity was independently related to PFS (p = 0.047; HR 3.74; 95% CI 1.01-13.76; avid disease as reference). Patients with good ECOG status (0-1) and RAI-avid disease obtained objective response in 100% of cases and achieved a median PFS of 45 months without any death upon a median follow-up of 81 months. Post-treatment setting: best radiological response independently predicted PFS (p = 0.001; HR 4.6; 95% CI 1.89-11.18; partial/complete response as reference) and OS (p = 0.013; HR 2.94; 95% CI 1.25-6.89; partial/complete response as reference). Conclusions RR-DTC with good performance status and RAI-avid disease obtain the highest clinical benefit from lenvatinib. After treatment initiation, objective response was the only independent survival predictor.
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