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Lenvatinib as a salvage therapy for advanced metastatic medullary thyroid cancer

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A Correction to this article was published on 05 June 2021

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Abstract

Purpose

Patients with advanced progressive metastatic medullary thyroid cancer (MTC), show poor prognosis and few available systemic therapeutic options. After the loss of clinical benefit with other tyrosine kinase inhibitors (TKI), we evaluated the use of lenvatinib as salvage therapy.

Methods

Ten patients who experienced the loss of clinical benefit after treatment with at least one previous TKI, were treated with lenvatinib. We assessed patient’s response immediately before, at the first (first-EV) and last (last-EV) evaluation, after the beginning of treatment.

Results

At first-EV, one patient died, while all the remaining 9 showed a stable disease (SD) in the target lesions. At last-EV, SD was still observed in seven patients, while partial response (PR) and progressive disease (PD), in one patient each. Conversely, analyzing all target and non-target lesions, at first-EV, we observed PR in one patient and SD in eight patients. At last-EV, PR was shown in two patients and SD was shown in seven. Bone metastases showed stable disease control at both first-EV and last-EV in only approximately 60% of cases. Tumor markers (CTN and CEA) decreased at first-EV, while they increased at last-EV. Seven patients experienced at least one dose reduction during treatment with lenvatinib.

Conclusions

In this real-life clinical experience, lenvatinib showed interesting results as salvage therapy in patients with advanced progressive metastatic MTC patients. Its usefulness could be effective in patients without any other available treatment, because previously used or unsuitable, especially with negative RET status with no access to the new highly selective targeted therapies.

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Funding

This study was supported by Grants to R.E. from Associazione Italiana per la Ricerca sul Cancro (AIRC, Investigator Grant 2018, project code 21790) and Agenzia Italiana del Farmaco (AIFA, project code AIFA-2016- 02365049).

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Author notes

  1. A. Matrone and A. Prete equally contributed to this study.

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Unit of Endocrinology, Pisa University Hospital, Via Paradisa 2, 56124, Pisa, Italy

    A. Matrone, A. Prete, L. Agate, E. Molinaro, C. Giani, L. Valerio, E. Minaldi & R. Elisei

  2. Department of Oncology, Oncological Endocrinology Unit, Azienda Ospedaliero Universitaria Città Della Salute E Della Scienza Di Torino, Corso Bramante, 88, 10126, Turin, Italy

    A. Nervo, A. Ragni & A. Piovesan

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  1. A. Matrone
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Contributions

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Corresponding author

Correspondence to R. Elisei.

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Conflict of interest

RE is a consultant for EISAI but this study was not influenced by this activity. The other authors have nothing to disclose.

Ethical approval

The study was approved by the local Ethical Committee (CEAVNO—Comitato Etico Area Vasta Nord-Ovest) and, for the policy of the University Hospital.

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All patients provided written informed consent to use their data for scientific purposes.

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Matrone, A., Prete, A., Nervo, A. et al. Lenvatinib as a salvage therapy for advanced metastatic medullary thyroid cancer. J Endocrinol Invest 44, 2139–2151 (2021). https://doi.org/10.1007/s40618-020-01491-3

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  • DOI: https://doi.org/10.1007/s40618-020-01491-3

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