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Predictors of maximum efficacy of lenvatinib for real-world patients with differentiated thyroid carcinoma

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Abstract

Background and objectives

Tyrosine kinase inhibitors (TKIs) have provided excellent clinical benefits to patients with advanced differentiated thyroid cancer (DTC): however, the tumor status for which maximum efficacy can be obtained remains controversial. We conducted this study to identify effective clinical predictors, focusing on disease progression.

Methods

Using the data of 42 DTC patients treated with lenvatinib, we investigated the clinical factors related to overall survival (OS) and progression-free survival (PFS), and conducted analyses by the scoring of the factors.

Results

The 3 year OS and median PFS were 51% and 13.8 months, respectively. Univariate analysis identified performance status (PS), tumor-related symptoms, and tumor diameter as the only factors affecting both these outcomes. Giving 1-point for each of these three factors, a higher score was significantly related to shorter OS and PFS. Patients with two or fewer points (n = 34) had better median OS (NR vs 3.9 months, p < 0.001) and PFS (15.7 vs 2.1 months, p < 0.001) than patients with three points (n = 8). Patients with all three factors had a significantly worse prognosis than patients with two or fewer factors.

Conclusion

DTC patients with all three indicators are unlikely to have longer survival. Therefore, it is important to commence TKIs before disease progression.

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Authors and Affiliations

  1. Department of Radiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Naoko Saito

  2. Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan

    Chie Masaki, Kiminori Sugino, Junko Akaishi, Kiyomi Y. Hames, Chisato Tomoda, Akifumi Suzuki, Kenichi Matsuzu, Keiko Ohkuwa, Wataru Kitagawa, Mitsuji Nagahama & Koichi Ito

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  1. Chie Masaki
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  2. Kiminori Sugino
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Correspondence to Chie Masaki.

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Masaki, C., Sugino, K., Saito, N. et al. Predictors of maximum efficacy of lenvatinib for real-world patients with differentiated thyroid carcinoma. Surg Today 52, 1660–1669 (2022). https://doi.org/10.1007/s00595-022-02498-4

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  • DOI: https://doi.org/10.1007/s00595-022-02498-4

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