Please use this identifier to cite or link to this item:
Title: Axitinib treatment in advanced RAI-resistant differentiated thyroid cancer (DTC) and refractory medullary thyroid cancer (MTC).
Authors: Capdevila, Jaume
Trigo, José Manuel
Aller, Javier
Manzano, José Luís
Adrián, Silvia García
Llopis, Carles Zafón
Reig, Òscar
Bohn, Uriel
Cajal, Teresa Ramón Y
Duran-Poveda, Manuel
Astorga, Beatriz González
López-Alfonso, Ana
Martínez, Javier Medina
Porras, Ignacio
Reina, Juan Jose
Palacios, Nuria
Grande, Enrique
Cillán, Elena
Matos, Ignacio
Grau, Juan Jose
metadata.dc.subject.mesh: Adult
Aged, 80 and over
Carcinoma, Neuroendocrine
Iodine Radioisotopes
Longitudinal Studies
Magnetic Resonance Imaging
Middle Aged
Positron Emission Tomography Computed Tomography
Protein Kinase Inhibitors
Retrospective Studies
Thyroid Neoplasms
Treatment Outcome
Issue Date: 7-Jul-2017
Abstract: Axitinib, an antiangiogenic multikinase inhibitor (MKI), was evaluated in the compassionate use programme (CUP) in Spain (October 2012-November 2014). 47 patients with advanced radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC, n = 34) or medullary thyroid cancer (MTC, n = 13) with documented disease progression were treated with axitinib 5 mg b.i.d. The primary efficacy endpoint was objective response rate (ORR) by Response Evaluation Criteria In Solid Tumors (RECIST) v1.1. Progression-free survival (PFS) and adverse events (AEs) were secondary objectives. Regulatory authorities validated the CUP, and all patients signed informed consent form. Axitinib was administered as first-line therapy in 17 patients (36.2%), as second-line in 18 patients (38.3%) and as third/fourth-line in 12 patients (25.5%). With a median follow-up of 11.5 months (0-24.3), ORR was 27.7% (DTC: 29.4% and MTC: 23.1%) and median PFS was 8.1 months (95% CI: 4.1-12.2) (DTC: 7.4 months (95% CI: 3.1-11.8) and MTC: 9.4 months (95% CI: 4.8-13.9)). Better outcomes were reported with first-line axitinib, with an ORR of 53% and a median PFS of 13.6 months compared with 16.7% and 10.6 months as second-line treatment. Twelve (25.5%) patients required dose reduction to 3 mg b.i.d. All-grade AEs included asthenia (53.2%), diarrhoea (36.2%), hypertension (31.9%) and mucositis (29.8%); grade 3/4 AEs included anorexia (6.4%), diarrhoea (4.3%) and cardiac toxicity (4.3%). Axitinib had a tolerable safety profile and clinically meaningful activity in refractory and progressive thyroid cancer regardless of histology as first-line therapy. To our knowledge, this is the first time that cross-resistance between MKIs is suggested in thyroid cancer, highlighting the importance of prospective sequential clinical studies.
metadata.dc.identifier.doi: 10.1530/EJE-17-0243
Appears in Collections:Producción 2020

Files in This Item:
There are no files associated with this item.

This item is protected by original copyright

Except where otherwise noted, Items on the Andalusian Health Repository site are licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives License.