Lenvatinib Therapy for Thyroid Cancer Via Nasogastric Tube: Case Study
Posted: Tuesday, May 19, 2020
Eleonora Molinaro, MD, PhD, of the University Hospital of Pisa, Italy, and colleagues presented a case study of a patient with poorly differentiated thyroid cancer who received the oral tyrosine kinase inhibitor lenvatinib via a nasogastric feeding tube. The significance of the case is that the drug was effective in reducing the tumor mass, although further studies are needed to validate this alternative route of administration. The full article was published in Case Reports in Endocrinology.
“Our result is of particular relevance in the management of thyroid cancer patients, especially in the presence of subjects unable to swallow,” the researchers noted.
A 62-year-old female patient with papillary thyroid carcinoma (follicular variant) experienced an onset of dysphonia and dysphagia 2 years after thyroidectomy. A CT scan of the neck found a lesion showing trachea deviation and cervical esophagus compression. A biopsy indicated the presence of poorly differentiated thyroid cancer, triggering tracheal lumen reduction and substenosis of the cervical esophagus for an ab-extrinsic compression. A nasogastric tube was inserted, and lenvatinib was started at a dose of 20 mg/day after capsules were diluted in 10 mL of saline solution.
One month later, a CT scan showed a significant reduction in the cervical lesion; bronchoscopy confirmed tracheal infiltration, and the residual caliber was improved from 50% to 75%. At the esophagogastroduodenoscopy, the substenosis of the cervical esophagus was no longer appreciated, and a double perforation of the esophagus was found, without fistula.
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