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Efficacy of sorafenib and impact on cardiac function in patients with thyroid cancer: a retrospective analysis

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Abstract

Purpose

Sorafenib has recently been recognized as an important standard option for the management of patients with differentiated thyroid cancer. Although data concerning cardiac safety are available in pan-tumor studies, no data are available on its use in everyday clinical practice in patients with thyroid cancer.

Methods

In the off-label program of our institution, we enrolled 14 patients with different histological types of thyroid cancer suitable for treatment with sorafenib. Our aims were to evaluate cardiac safety factors—LVEF (left ventricular ejection fraction), heart rate and blood pressure—the cardiac markers NT-proBNP and troponin I, radiological response evaluated by CT and 18FDG-PET (according to RECIST 1.1 criteria) and biomarker reduction (Eastern Cooperative Oncology Group Performance Status: ECOG PS) 0–2.

Results

Patients with ECOG PS 2 accounted for 36 %. After starting sorafenib, many patients displayed reduced or stabilized metabolic activity in target lesions (clinical benefit = 44 %), radiologic reduction or stabilization (74 %) and decreased cancer markers (90 %). Lung metastases displayed the largest reductions in size. Median overall survival (OS) was 7 months and median progression-free survival (PFS) was 3 months. No sign of cardiotoxicity was observed in almost all patients. LVEF was altered in two patients and proved symptomatic in one.

Conclusions

Sorafenib seems to be effective in reducing disease progression in the early stages of treatment (3–6 months). Responses varied considerably according to the criteria investigated. Cardiac toxicities did not raise concerns and were in line with data reported in other malignancies. However, cardiac monitoring is recommended.

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Acknowledgments

M. Giusti received a research grant from the BAYER pharmaceutical company to perform this study.

Conflict of interest

The authors declare that they have no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Endocrine Unit, IRCSS IST-San Martino University Hospital, 16132, Genoa, Italy

    L. Mortara, G. Pera, E. Monti, F. Minuto & M. Giusti

  2. Nuclear Medicine Unit, IRCSS IST-San Martino University Hospital, Genoa, Italy

    S. Morbelli & G. Sambuceti

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  1. L. Mortara
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  2. G. Pera
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  3. E. Monti
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  4. S. Morbelli
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  7. M. Giusti
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Correspondence to L. Mortara.

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Mortara, L., Pera, G., Monti, E. et al. Efficacy of sorafenib and impact on cardiac function in patients with thyroid cancer: a retrospective analysis. J Endocrinol Invest 37, 1099–1108 (2014). https://doi.org/10.1007/s40618-014-0177-3

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  • DOI: https://doi.org/10.1007/s40618-014-0177-3

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