索拉非尼和来伐替尼治疗晚期甲状腺癌的手足综合征。

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2024-07-29 Print Date: 2024-08-01 DOI:10.1530/ETJ-24-0009
Elisa Minaldi, Virginia Cappagli, Loredana Lorusso, Laura Valerio, Carlotta Giani, Matilde Viglione, Laura Agate, Eleonora Molinaro, Antonio Matrone, Rossella Elisei
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引用次数: 0

摘要

研究目的本研究的目的是在一大批晚期甲状腺癌患者中评估索拉非尼和仑伐替尼这两种多激酶抑制剂治疗期间手足综合征(HFS)的临床影响。此外,我们还研究了HFS的发生与临床和病理特征之间可能存在的关联:我们对239名晚期甲状腺癌患者进行了回顾性评估,其中165人接受了来伐替尼治疗,74人接受了索拉非尼治疗。我们进行了统计分析,以验证哪些特征可能与HFS的发生相关:接受索拉非尼或来伐替尼治疗的患者中,分别有35/74(47.4%)和43/165(26.7%)人出现HFS。索拉非尼从开始用药到出现HFS的中位潜伏期为27天,来伐替尼为2.9个月。接受索拉非尼治疗的患者中有16/35(45.7%)人出现了G3/G4毒性,而接受来伐替尼治疗的患者中只有3/43(7%)人出现了G3/G4毒性。索拉非尼和仑伐替尼治疗的患者中,分别有19/74(25.7%)和3/165(1.8%)人因HFS而需要减少药物剂量。在两组患者中,HFS的发生与治疗时间的延长有明显关系:结论:HFS是来伐替尼和索拉非尼治疗期间的常见不良反应,索拉非尼治疗期间发生的频率更高,毒性等级也更高。HFS是索拉非尼治疗患者最常见的减药或停药原因。HFS的早期诊断非常重要,可在多学科环境下进行早期干预,避免治疗中断,这与获得系统治疗的最大疗效密切相关。
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Hand-foot syndrome in sorafenib and lenvatinib treatment for advanced thyroid cancer.

Objective: The aim of this study was to assess the clinical impact of hand-foot syndrome (HFS) during treatment with two multikinase inhibitors, sorafenib and lenvatinib, in a large group of patients with advanced thyroid cancer. Moreover, we looked for possible associations between HFS occurrence and clinical and pathological features.

Methods: We retrospectively evaluated 239 patients with advanced thyroid cancer: 165 treated with lenvatinib and 74 with sorafenib. Statistical analyses were performed to verify which features could be correlated with HFS development.

Results: HFS was observed in 35/74 (47.4%) and in 43/165 (26.7%) patients treated with sorafenib or lenvatinib, respectively. The median latency from the drug beginning and HFS appearance was 27 days for sorafenib and 2.9 months for lenvatinib. G3/G4 toxicity was observed in 16/35 (45.7%) patients treated with sorafenib and only in 3/43 (7%) treated with lenvatinib. Drug dose reduction due to HFS was required in 19/74 (25.7%) and 3/165 (1.8%) patients treated with sorafenib and lenvatinib, respectively. HFS occurrence was significantly associated with a longer duration of therapy in both groups.

Conclusion: HFS was a frequent adverse event during both lenvatinib and sorafenib therapy, with a higher frequency and toxicity grade during sorafenib treatment. HFS was the most frequent reason for drug reduction or discontinuation in patient treated with sorafenib. Early diagnosis of HFS is important to allow early intervention, possibly in a multidisciplinary setting, and to avoid treatment discontinuation, which is highly relevant to obtain the maximum effectiveness of systemic therapy.

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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
期刊最新文献
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