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Does Dose Interruption of Lenvatinib Affect Outcomes in Patients With Thyroid Cancer?

By: Joseph Fanelli
Posted: Monday, January 21, 2019

Lenvatinib improved efficacy outcomes versus placebo in patients with radioiodine-refractory differentiated thyroid cancer, regardless of the duration of dose interruption. However, according to the post hoc analysis of the phase III SELECT study, published in the European Journal of Cancer, patients who experienced shorter dose interruptions had a greater magnitude of benefits than did those with longer dose interruptions.

“This analysis highlights the importance of timely management of lenvatinib toxicities to minimize dose interruptions and maximize lenvatinib efficacy in patients with [radioiodine-refractory differentiated thyroid cancer],” Makoto Tahara, MD, PhD, of the National Cancer Centre Hospital East in Japan, and U.S. colleagues stated.

In the randomized, double-blind, placebo-controlled SELECT trial, 261 patients with progressive thyroid cancer that was refractory to iodine-131 were randomly assigned to receive lenvatinib, and 131 patients received a placebo. In the post hoc analysis, dose modifications were required for grade 3 or intolerable grade 2 adverse events. Patients treated with lenvatinib were categorized by the duration of dose interruption relative to total treatment.

The median progression-free survival for those with a longer dose interruption was 12.8 months; it had not been determined for with the shorter dose interruption. Compared with placebo, the hazard ratios for progression-free survival in the cohorts of shorter and longer dose interruptions were 0.14 and 0.31, respectively. Dose interruption was significantly associated with lenvatinib efficacy, even after adjustment for patient characteristics.

Disclosure: The study authors’ disclosures may be found at ejcancer.com.


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