Koyama, Satoshi1; Fukuhara, Takahiro1; Miyake, Naritomo1; Fujiwara, Kazunori1; Kitano, Hiroya1; Takeuchi, Hiromi1
1 Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
Background: Lenvatinib is the oral multitargeted tyrosine kinase inhibitor which has an anti-cancer effect for patients with differentiated thyroid cancer that was refractory to radioiodine. Efficacy and safety of lenvatinib for patients with anaplastic thyroid cancer has been unclear.
Methods: Five patients with unresectable anaplastic thyroid cancer diagnosed by aspiration cytology were enrolled this study. Lanvatinib 24mg once daily was administered until disease progression, unmanageable toxicity, withdrawal, or death. We retrospectively analysed objective response rate (ORR), median progression free survival, and safety.
Results: Three of 5 patients (60%) had the partial response, and 2 of 5 (40%) had the stable disease, therefore ORR was 60%. The median progression free survival was 88 days. Hypothyroidism was the most common treatment-related adverse effects, and 4 of 5 patients revealed hypothyroidism in any grades (80%). These 4 patients had not received total thyroidectomy prior to lenvatinib administration, however the other had received total thyroidectomy. Treatment-related adverse effects of any grades were hypertension (in 80%), diarrhea (in 40%), fatigue (in 80%), decreased appetite (in 80%). Discontinuations of lenvatinib because of adverse effects occurred in 2 patients.
Conclusions: Lenvetinib is an effective treatment for anaplastic thyroid cancer, and might have a benefit to improve the prognosis of unresectable anaplastic thyroid cancer. Four of 5 patients revealed hypothyroidism, which might be associated to the treatment-related injury of residual thyroid tissue. Patients had many treatment-related adverse effects, however the greater part of adverse effects were managed with dose modification and medical therapy.