Therapeutic efficacy of lenvatinib for stage IVC anaplastic thyroid cancer

  • Background: Anaplastic thyroid carcinoma (ATC) is an orphan disease with a very poor prognosis. The unresectable stage IVC of ATC in particular is extremely difficult to treat; its prognosis is only a few months even when treated with irradiation and/or chemotherapy. In 2015, lenvatinib was approved for clinical use against ATC in Japan. In the present study, we evaluated the efficacy of lenvatinib for stage IVC ATC. Methods: Twenty-eight patients with pathologically confirmed stage IVC ATC treated at Kanagawa Cancer Center from 2011 to 2018 were included in this study. Of these, seven patients were treated with weekly Paclitaxel (PTX group), 7 refused treatment (BSC group), and 14 were treated with lenvatinib (LT group). The respective survival curves were analyzed using the logrank test. Results: The median overall survival was 4.25 months for the LT group, 2.30 for the PTX group, and 2.00 for the BSC group. A statistically significant survival benefit was observed in the LT group (p = 0.014). There were no patients in the PTX group and five patients in the LT group (35.7%) whose tumor size reduced by 30% or more in the first month after treatment. Conclusions: The LT group demonstrated a median survival benefit of about 2 months over both the PTX group and the BSC group. Although tumor shrinkage of 30% or more was confirmed in five patients treated with lenvatinib, two treatment deaths occurred. These results suggest that an appropriate dose reduction is necessary.

 

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