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Overall survival low with sorafenib treatment for anaplastic thyroid carcinoma
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Adults with medullary thyroid carcinoma can be treated safely and effectively with sorafenib, but the agent is less effective for treatment of anaplastic thyroid carcinoma, according to published findings from Japan.
Yasuhiro Ito, MD, PhD, of the Clinical Trial Management Center at Kuma Hospital in Japan, and colleagues evaluated 18 Japanese adults (mean age, 64 years; 11 women) with medullary thyroid carcinoma (n = 8) or anaplastic thyroid carcinoma (n = 10) to determine the safety and efficacy of sorafenib (Nexavar, Bayer; median daily dose, 530 mg; median treatment duration, 15.5 weeks). Treatment with sorafenib was continued in patients until the occurrence of disease progression, unacceptable toxicity or withdrawal of consent.
At least one dose reduction occurred in 14 patients; the primary reasons were palmar-planter erythrodysesthesia syndrome in eight patients, hypophosphatemia in two patients, proteinuria in two patients and maculopapular rash in two patients.
Twelve patients experienced drug interruptions, and palmar-planter erythrodysesthesia was the primary cause in seven patients (five patients with medullary thyroid carcinoma and two patients with anaplastic thyroid carcinoma).
Palmar-planter erythrodysesthesia was the most common treatment-emergent adverse event (13 patients), followed by alopecia (10 patients), hypertension (10 patients) and diarrhea (eight patients).
Median progression-free survival and overall survival times had not been reached by patients with medullary thyroid carcinoma at the time of the analysis. Median progression-free survival was 2.8 months and overall survival was 5 months in patients with anaplastic thyroid carcinoma. At 6 months, the progression-free survival rate was higher in those with medullary thyroid carcinoma (86%) compared with participants with anaplastic thyroid carcinoma (11%), and the same was true for overall survival (100% vs. 20%).
“The results of this study should be interpreted in consideration of the potential detection bias and/or risk of performance bias,” the researchers wrote. “To elucidate the effects of sorafenib on [medullary thyroid carcinoma] and [anaplastic thyroid carcinoma] more accurately, a large number of patients, based on a statistical sample calculation, would be required in the future.” – by Amber Cox
Disclosures: Ito reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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