Tumor-related symptom and performance status are indicators to predict prognosis of radioiodine-refractory differentiated thyroid carcinoma patients treated with lenvatinib
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Introduction: Lenvatinib has a potential to lead survival benefit to patients with radioiodine-refractory differentiated thyroid carcinoma (RR-DTC). The present study aimed to investigate indicators to predict treatment efficacy of lenvatinib in real-world patients at a single institution.
Methods: We retrospectively reviewed data from 42 RR-DTC patients (female, 30; median age, 66 [range, 33-83] years; median follow-up, 15.4 [range, 1-38.4] months; median treatment duration, 14.9 months) between May 2015 and February 2018.
Efficacy was evaluated by RECIST criteria. The total 10 indicators (age, sex, BMI, histopathology, Performance Status (PS), tumor-related symptom at baseline, metastasis other than lung, serum thyroglobulin doubling time, sum of tumor diameter, and ?12 months tumor progression) effect on overall survival (OS) and progression-free survival (PFS) were analyzed by using the Kaplan-Meier method.
Results: The median OS and PFS (95%CI, months) were NE (15.2-NR) and 13.8(4.4-NR). Partial response, stable disease, and progressive disease were seen in 26 (62%), 10 (24%), and 6 (14%) patients, respectively. PS and tumor-related symptom showed significantly difference in both OS and PFS. Age (?65y.o), follicular carcinoma and only lung metastasis were not revealed as prognostic factors though these were demonstrated in SELECT trial. Sum of tumor diameter was related to OS.
Conclusion: Absence of tumor-related symptom and PS<1 can be indicators to expect good prognosis in RR-DTC patients treated with lenvatinib. In order to obtain maximum efficacy of lenvatinib, treatment initiation under controlled symptom is important.
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