Optimal use of lenvatinib in the treatment of advanced thyroid cancer.

Cancers of the head & neck Pub Date : 2017-10-24 eCollection Date: 2017-01-01 DOI:10.1186/s41199-017-0026-0
Shunji Takahashi, Naomi Kiyota, Makoto Tahara
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引用次数: 24

Abstract

The development of orally active, multitargeted kinase inhibitors (MKIs) represents a significant advance in the treatment of progressive, metastatic thyroid cancer. Lenvatinib, an MKI targeting vascular endothelial growth factor receptor, fibroblast growth factor receptor, platelet-derived growth factor receptor, c-Kit, and RET, has shown efficacy in stabilizing previously progressive disease, with emerging evidence of a possible benefit in terms of overall survival. However, lenvatinib is associated with a side-effect profile similar to those of other MKIs that might affect the outcome of therapy. The aim of this review is to summarize the clinical efficacy and safety of MKIs in the treatment of advanced thyroid cancer in pivotal phase III trials. Common adverse events that may occur during lenvatinib therapy and their management are discussed, including conditions in which its administration should be temporarily withdrawn and resumed pending resolution of adverse events. We focus on data from a subanalysis of Japanese patients in the SELECT trial and in a post-marketing study in Japan. We suggest that lenvatinib is a valuable treatment option for advanced differentiated thyroid cancer. Monitoring and careful management of adverse events including supportive care are required to ensure continuation of therapy.

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乐伐替尼治疗晚期甲状腺癌症的最佳应用。
口服活性、多靶向激酶抑制剂(MKI)的开发代表了进展性、转移性甲状腺癌症治疗的重大进展。乐伐替尼是一种靶向血管内皮生长因子受体、成纤维细胞生长因子受体和血小板衍生生长因子受体,c-Kit和RET的MKI,已显示出在稳定先前进行性疾病方面的疗效,新出现的证据表明,它可能对总生存率有益。然而,乐伐替尼的副作用与其他MKI的副作用相似,可能会影响治疗结果。本综述的目的是总结MKI在关键的III期试验中治疗晚期甲状腺癌症的临床疗效和安全性。讨论了乐伐替尼治疗过程中可能发生的常见不良事件及其管理,包括在不良事件解决之前应暂时停止和恢复给药的情况。我们关注SELECT试验和日本上市后研究中对日本患者的亚分析数据。我们认为乐伐替尼是晚期分化型甲状腺癌症的一种有价值的治疗选择。需要监测和仔细管理不良事件,包括支持性护理,以确保治疗的持续性。
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