Thyroid Cancer Coverage from Every Angle
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ASCO20: Outcomes in Subgroups of Patients With Medullary Thyroid Carcinoma Treated With Anlotinib

By: Sarah Campen, PharmD
Posted: Wednesday, June 17, 2020

In patients with medullary thyroid carcinoma who are treated with the novel tyrosine kinase inhibitor anlotinib, some characteristics—including a better Eastern Cooperative Oncology Group (ECOG) performance status, younger age, and a lower tumor burden—appear to be associated with an improvement in progression-free survival compared with other patients treated with anlotinib. Presented during the ASCO20 Virtual Scientific Program (Abstract 6527), these findings were the result of a subanalysis of the ALTER01031 trial.

“These results indicate it is reasonable to start anlotinib treatment at a relative earlier disease stage before the worsening of ECOG performance status, increase of tumor size, or aging,” stated Ming Gao, MD, of Tianjin Medical University Cancer Institute and Hospital, China, and colleagues.

In the placebo-controlled phase IIb trial, 91 patients with medullary thyroid carcinoma were randomly assigned to receive anlotinib (n = 62) or placebo (n = 29). In the original study, progression-free survival was nearly doubled in patients treated with anlotinib, meeting the primary endpoint. For this analysis, patients were separated into subgroups based on ECOG functional status (0 vs. 1), median tumor lesion diameter (< 67 vs. ≥ 67 mm), and age (< 55 vs. ≥ 55 years).

In the placebo arm, the median progression-free survival was significantly longer in patients younger than age 55 compared with those 55 years of age or older. However, survival did not differ in the other placebo-arm subgroups. Anlotinib treatment improved progression-free survival in both age groups, more so in patients younger than age 55. Patients in the anlotinib arm with an ECOG performance status of 0 had longer progression-free survival than those with an ECOG performance status of 1 (34.6 vs. 14.0 months, P = .002). Those treated with anlotinib and with a tumor lesion diameter less than 67 mm achieved a significantly longer progression-free survival compared with patients with larger tumors as well.

Disclosure: The study authors reported no conflicts of interest.

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