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Impact of baseline tumor burden on overall survival in patients with radioiodine‐refractory differentiated thyroid cancer treated with lenvatinib in the SELECT global phase 3 trial
Author(s) -
Kiyota Naomi,
Tahara Makoto,
Robinson Bruce,
Schlumberger Martin,
Sherman Steven I.,
Leboulleux Sophie,
Lee Eun Kyung,
Suzuki Takuya,
Ren Min,
Fushimi Kazuma,
Wirth Lori J.
Publication year - 2022
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.34181
Subject(s) - lenvatinib , medicine , refractory (planetary science) , hazard ratio , oncology , thyroid cancer , cancer , gastroenterology , confidence interval , physics , astrobiology
Background Radioiodine‐refractory differentiated thyroid cancer (RAI‐R DTC) is an aggressive form of thyroid cancer. Lenvatinib is a multikinase inhibitor approved for treatment of RAI‐R DTC. The impact of tumor response and tumor burden on overall survival (OS) after lenvatinib treatment in patients with RAI‐R DTC was assessed. Methods Data from patients treated with lenvatinib (N = 261) in SELECT were retrospectively analyzed. Patients were divided into lenvatinib responder or nonresponder subgroups and into low (≤40 mm) or high (>40 mm) tumor burden subgroups based on baseline sums of diameters of target lesions using Response Evaluation Criteria in Solid Tumors, version 1.1 (cutoff values were determined by receiver‐operating characteristic analyses). Associations of tumor response and tumor burden with OS were assessed. Results Median OS was prolonged in lenvatinib responders versus nonresponders (52.2 vs 19.0 months; hazard ratio [HR], 0.32; 95% CI, 0.23‐0.46). Patients with a lower tumor burden who received lenvatinib had prolonged OS versus those with a higher tumor burden (median OS, not reached vs 29.1 months, respectively; HR, 0.42; 95% CI, 0.28‐0.63). Baseline tumor burden was associated with OS by multivariate analysis (HR, 0.56; 95% CI, 0.35‐0.89; P = .0138). Conclusions Patients with a lower tumor burden receiving lenvatinib had prolonged OS compared with those with a higher tumor burden receiving lenvatinib. Baseline tumor burden may be a prognostic factor for OS in patients with RAI‐R DTC treated with lenvatinib.